Love saves lives: Why marriage equality is an HIV issue

“Marriage equality is legal recognition that you exist. That you can assert your rights, your personhood. It’s a message not only that others respect you but that you are allowed to respect yourself.”

That’s how Quinton, our community organizer, explained what Friday’s court decision meant to him. That decision was a main topic of conversation at our staff meeting last week.

HIV has always been a civil rights issue. The communities most affected by HIV and AIDS in North Carolina face legal and medical systems rooted in classism, racism, homophobia, and sexism, from Jim Crow and the Tuskegee experiments to Amendment One and the failure to expand Medicaid.

Marriage equality is a civil rights victory. It asserts the human dignity of LGBTQ North Carolinians and the right to visibility and love.

In 2003, when Massachusetts became the first state in the nation to recognize marriage equality, that state’s Supreme Court acknowledged that dignity, love, and celebration were important aspects of legal marriage. They also said this:

For those who choose to marry, and for their children, marriage provides an abundance of legal, financial, and social benefits. It is undoubtedly for these concrete reasons, as well as for its intimately personal significance, that marriage has long been termed a civil right.

For many North Carolinians living with HIV and AIDS, their loved ones, and those at high risk, marriage equality brings many of those concrete benefits. Just a few:

• Access to health insurance through a spouse’s employer, which helps reduce the disparity in insurance coverage between same-sex and opposite-sex couples

• The ability to make health decisions for an incapacitated partner without needing to make special legal arrangements

• The right to take 12 weeks of leave to care for a family member, including a spouse if needed, through the Family Medical Leave Act

Marriage equality in other states has also been shown to have non-legal medical benefits:

• Couples with legally recognized marriages experience lower rates of depression, a mental illness that is at least two times more prevalent among people living with HIV.

• Individuals - even unmarried LGBTQ people - living in states with marriage equality experience fewer mood disorders and less anxiety. 

And then there’s this: Marriage equality has been shown to lower the rate of new HIV infections. Emory University researchers have found that when states instituted a constitutional ban on same-sex marriage, there were four additional HIV infections for every 100,000 people. To put that in perspective, the rate of new HIV diagnoses in North Carolina is 16.4 per 100,0000 people.

HIV stigma is one of the strongest factors influencing whether people get tested, get treatment, and stay in care. Because of the history of the AIDS epidemic and the continuing high rates of HIV among the LGBTQ community, homophobia and HIV stigma are closely linked. They can form a feedback loop of fear, ignorance, and hatred. That loop has a very real cost.

Friday’s marriage equality victory is a huge step forward for the right to visibility, dignity, love, and partnership for all LGBTQ North Carolinas - and it’s a step forward in the fight for the right to visibility, dignity, love, and health for the tens of thousands of North Carolinians living with HIV, their families, and their communities.