In 1984, Roger Gail Lyon spoke in front of Congress asking that more efforts be made to combat the new disease that was killing him. In Congress, he made an iconic statement:
I came here today with the hope that this administration would do everything possible, make every resource available—there is no reason this disease cannot be conquered. We do not need in fighting, this is not a political issue. This is a health issue. This is not a gay issue. This is a human issue. And I do not intend to be defeated by it. I came here today in the hope that my epitaph would not read that I died of red tape.
Roger Gail Lyon died later that year. In the early years of the epidemic in America, HIV prevention methods were poorly understood. Today, through the incredible efforts of researchers and activists, HIV is a completely preventable disease. The most vulnerable and oppressed people in America, though, continue to “die of red tape.”
One of the most effective ways of preventing the transmission of HIV and other blood-borne infections is syringe exchange programs, in which intravenous drug users turn in used needles and receive clean ones in exchange. This prevents addicts from sharing needles with others who already have the disease. One-third of HIV positive people in the United States contract it directly from IV drug use, and many more from sexual contact with infected drug users.
Syringe exchange programs are also one of the most cost-effective HIV prevention methods. Syringes cost less than ten cents, while lifetime anti-retroviral HIV treatment on average costs $385,200. According to The Harm Reduction Coalition, this is enough to prevent 30 HIV transmissions through syringe exchange programs. Additionally, six government studies and much outside scholarship have found that syringe exchanges do not promote increases in drug use rates. In fact, as they provide safe, non-judgmental space for users, they are often a path to rehabilitation and recovery.
In light of this, it was shocking when the FY2012 Budget reinstated a ban on federal funding for syringe exchange programs that President Obama had lifted in 2009. With a single sentence, the budget slashed one of the most important tools in HIV prevention. According to The Drug Policy Alliance, 32,000 people in the US are infected with HIV and Hepatitis C from sharing dirty needles each year. Without federal funding for syringes, each and every one of these people’s lives will be in danger.
This, though, is not merely a health issue: this is a feminist issue. The people who will suffer most from the reinstatement of the ban are women—particularly poor women, queer women, and women of color. Feminists must make syringe exchange a key political issue in the upcoming year. Vocally and actively opposing the ban is a necessary facet in the ongoing fight for social justice.
The Centers for Disease Control and Prevention (CDC) report that in the United Sates, 61% of HIV cases in women are caused by drug use or sexual contact with someone who contracted HIV from sharing needles. In 2009, women comprised 23% of Americans newly infected with HIV. The incidence of HIV in women of color is staggering: 1 in 32 African-American women will contract the virus in her lifetime. The CDC goes on to state, “from 2000–2007, HIV infection was among the top 10 leading causes of death for black females aged 10–54 and Hispanic/Latina females aged 15–54.” The funding ban, then, will only serve to exacerbate the challenges women of color face.
Sex workers are also disproportionately affected by HIV and drug use. A study of sex work among women at US syringe exchange programs found that the percentage of women who were sex workers ranged from 15% to 40%. Sex workers are also very likely to have sex with drug users, and may not be able to negotiate condom use, thereby potentially leaving themselves open to HIV infection from clients, especially in light of the ban.
Poor women are more likely to be drug users, and their addictions exacerbate their poverty. The same study indicated that 53.8% of women at syringe exchange programs who frequently sold sex had lived on the streets in the last six months. Only 42.5% had graduated high school. The ban, then, will heavily impact these vulnerable populations, who are rarely able to afford HIV treatment.
Queer people of all genders will also disproportionately suffer as a result of the federal funding ban. The National Network for Youth estimates that up to 40% of street youth identify as gay or lesbian. When transgender and queer people are included, the figures are even more staggering. A National Gay and Lesbian Task Force study indicates that 26% of surveyed gay males became homeless the day they came out. Unsafe schools, unwelcoming families and discriminatory workplaces leave LGBT young people with few options, making them turn to drugs and sex work in disproportionate numbers; 46% of transgender youth reported sex work. Much like in the case of women sex workers, syringe exchange programs are one of the only barriers between these young people and blood-borne diseases.
Transgender people are also at particular risk as those who buy black-market hormones rarely have access to safe, clean needles. For many transgender people, hormone treatments are essential for good mental health and to help prevent violence against them in the work place and elsewhere based on gender presentation. A San Francisco Transgender Health Project study found that over 50% of clients had injected hormones outside of traditional medical settings. As 29% of transgender people have experienced harassment in medical settings, and as transgender people are four times as likely to have an annual income of under $10,000 than the general population, it is unsurprising that the hormone black market is flourishing. Without needle exchanges, these many transgender people will have to struggle even more to find safe access to the hormones that they need. They, like so many other impoverished and excluded populations, will have a vital health measure removed.
The federal government made a cowardly decision at the end of last year. The language of the ban does not cut any money—it simply makes it impossible for groups to apply the funding in the best way that they see fit. HIV prevention groups will no longer be able to use federal funds to buy needles—thus limiting one of the most effective ways of stopping the disease. By cutting funding for needle exchange programs specifically, they condemn women, people of color, poor people, queer people, and sex workers to disease and death.
Albert Camus once stated, “It is the job of thinking people not to be on the side of the executioners.” As feminists, as progressives, as activists, we must not stand by as the federal government sentences people to death for their poverty, their work, their gender, their color. We must speak for the politically voiceless. Feminists have changed the world a thousand times over before—and we can do it again.
If we believe that discrimination is wrong, we will stand in opposition of the ban. If we want to claim the “AIDS-Free Generation” our president so optimistically speaks about, we will push him to not include the ban in his FY2013 budget and to push Congress to remove the ban.
Roger Gail Lyon died of red tape. He died because to the federal government, he was unimportant—after all, he was a homosexual sufferer of a disease of difference. The ban on federal funding for syringe exchange programs will only perpetuate the myth that some people are disposable, and that it is not our obligation to prevent disease whenever possible. Feminists, as leaders and “thinking people,” must apply our skills, our energy, and our passion to this issue. No one should have to die of red tape.
This post was originally published in Broad Recogniton, an online feminist magazine at Yale.