By Rich Arenschieldt
Activist Sean Strub has spent three decades at the center of the HIV epidemic. In that time, he has run for congressional office (the first openly HIV-positive man to do so), founded POZ magazine, and is now executive director of the “Sero Project,” a nonprofit organization that addresses HIV criminalization and stigma reduction. Strub, who was last in Houston two decades ago, is looking forward to being the featured speaker at the annual AIDS Foundation Houston World AIDS Day Luncheon on Thursday, December 1.
“I’m happy to be invited,” Strub says. “I had a very nice call with the organizers who gave me great information about the event and its audience; my message will relate to stigma and its implications for controlling the epidemic.”
In 2014, Strub wrote Body Count, a comprehensive, highly personal retrospective of his life during the earliest days of the AIDS crisis. “I’ve been involved since 1981,” Strub says. “Upon hearing the first reports of gay men with immune suppression, I knew those events were in some way connected to me.”
Strub, who began his advocacy work with several New York-based organizations, founded POZ magazine in 1994. Known for its cutting-edge treatment information, advocacy, and social commentary, POZ was a publication that many found liberating, especially during the darkest days of the epidemic.
“In the early years, concern revolved around transmission,” Strub recalls. “The public had an irrational fear of ‘casual contagion,’ which triggered intense stigmatization. However, for those of us who’ve had HIV for a long time, the stigma now feels worse than ever—albeit more subtle, but at the same time much more discriminatory.
“Responding to the epidemic was a collective responsibility,” Strub continues. “In the 1980s, a diagnosis, though devastating, provided an entrée into a specific (and welcoming) sect of the LGBT community that offered love and support. You were often advised not to disclose until you’d developed a strong network of caring [HIV-positive] people, just in case you were confronted with negative ‘consequences of disclosure’ from friends and family.”
“With new therapeutics, the world thought that we were going to ‘treat our way out of the epidemic,’ a mindset that impacted resource allocation,” Strub says. “Funding [has disappeared] for LGBT-centered support groups that coalesced around the issue, [as well as for many] related services. As a result, in many ways, today it’s a much ‘lonelier’ diagnosis.
“Previously, the disease was seen through a ‘lens of human compassion,’” he adds. “With the advent of effective therapy and normal mortality, the public ‘consciousness’ of HIV changed. People with HIV are now viewed as a ‘dangerous population,’ especially because they are living longer [and more sexually active] lives. Some public-health and law-enforcement officials believe that HIV-positive individuals need to be sought out, tracked down, identified, tested, reported, and, in many cases, criminalized.
“The current paradigm,” Stub says, is that “we have extraordinarily effective treatment, but no cure for ‘stigma’—now worse than ever.” Much of that surrounds the issue of transmission, since every new infection results from an existing one. The public-health and justice systems have begun to define people with HIV differently—as vectors for disease.
Strub’s view on the criminalization of HIV transmission is nuanced. “I think this issue speaks to the intent of the individual,” Strub says. “If someone has malicious intent to harm another person with any sort of weapon—a gun, their fists, or a virus—then they should be subject to some sort of criminal sanction. Absent that intent, it should not be criminalized.
The degree of responsibility and ability to make healthy sexual decisions varies dramatically from one person to another. Some individuals are so damaged or uncaring that they become a ‘one-man epidemic.’ The principal illness in those cases isn’t a viral one, it’s a mental one, often from someone dealing with addiction or other mental-health issues who is not getting appropriate treatment and care.”
Strub’s justification for his view is predicated more on public health policy than on jurisprudence. “Many states passed punitive statutes, believing that HIV transmission would be reduced; however, there are no studies that support this premise,” he says. “In actuality, a rapidly growing body of research evidences the exact opposite—that because of these statutes, the epidemic is worsening.”
An unintended consequence: “If you don’t know your status, you don’t get prosecuted,” Strub says. These laws discourage people from being tested, essentially punishing responsible behavior (i.e. knowing your status) and providing those unaware of their status with legal cover. This is particularly applicable to gay men of color—many of whom have already had unpleasant interactions with a criminal justice system that they inherently distrust. Why should they get tested and, in so doing, assume additional legal risk?
“There are other sexually transmitted diseases that don’t carry criminal statutes, in spite of the fact that, if left untreated, they can kill someone,” Strub says. “I suspect that more women have died as the result of cervical cancer from various strains of the human papilloma virus than have died of AIDS. Yet, there are no criminal statutes for HPV; it isn’t stigmatized the way HIV is. This points to an inherent hypocrisy in the law.
“The state, and our society, need to take some responsibility for implementing policies that discourage HIV testing and disclosure,” Stub says. “The Sero Project encourages policymakers to use science, rather than stigma, to accomplish that.”
What: AIDS Foundation Houston’s annual World AIDS Day Luncheon
When: December 1, 11 a.m.
Where: Hilton Houston Post Oak, 2001 Post Oak Blvd.
Rich Arenschieldt was a certified HIV counselor during his 20 years working in the HIV/AIDS field.