HIV/AIDS and the Military After 28 Years
Published Thursday, 23-Sep-2010 in issue 1187
Randy Shilts very accurately described the early stages of the treatment of HIV/AIDS in the military in his ground breaking book And The Band Played On. In short he described a military that when faced with an epidemic that at the time was largely viewed as being a gay disease, against the odds, they chose the higher road. The military’s initial response while far from perfect, was among the most progressive at the time.
Among other things the military made the wise choice of letting medical fact rather than social stigma and fear guide their policy. They recognized early on that HIV was not transmitted through casual contact and therefor those who had contracted HIV were not a threat to their coworkers. That realization led to a sensible policy that those who were diagnosed with HIV would not be discharged, and apart from certain restrictions, could continue in their careers so long as their health permitted. There seemed to be a sober recognition that the military had made large investments in training that should not be abandoned in the face of a health condition unless and until it began to limit ones duty status.
The military also made a solemn commitment not to abandon those in our ranks who were diagnosed with HIV when it came to medical care thus ensuring access to treatment and medication. Similarly progressive were the rules protecting a diagnosed service member’s confidentiality. Commanders or other personnel who disclosed someone’s status without their permission would be brought up on charges and likely end their career. The military has also served a pivotal role in furthering research and advancing treatment techniques for HIV/AIDs. Collectively, these policies were among the most progressive in the nation.
That was then.
Since then the military has preferred to regard the issues surrounding HIV/AIDS in the military as being resolved. In the intervening time however, not only has treatment advanced dramatically, but infection rates have begun to rise and the face of HIV in the military has quietly begun to morph. As infection rates have risen, so to has the reactionary drum beat to purge those who become infected from the military altogether.
The military stands at a cross roads. From here, they can chose to either retreat into their own fear and allow stigma and prejudice to form policy, or they can once again chose the higher road.
What is the higher road?
1. Acknowledge, confront and challenge within our ranks the notion that HIV is a gay disease. We will not do our service members any favors if we fail to dispel these notions as we deploy to Africa and South East Asia more frequently. The face of HIV/AIDS is not that of a gay disease in these regions, nor should it be viewed this way at home.
2. If the military wants to reduce the financial burden of treating HIV in our ranks then fight it through more active prevention and education, not by targeting those who have become infected. Break the ‘cone of silence’ around HIV and encourage those living with HIV in our ranks who are willing to play a role in our prevention efforts. No one can speak to us better than one of our own.
3. Remove restrictions on the deployment of HIV positive service members. While some of these restrictions made sense earlier in the epidemic, they have become vestigial and in most cases no longer serve a valid purpose. Many countries have dropped their treaty restrictions on HIV positive persons, and advances in medical treatment no longer require positive personnel to be within 24 hours of a major medical facility. Similarly, treatment needs have been reduced to the point that almost any clinic at any military base is adequately equipped to handle HIV treatment. Most service members who are positive are taking one pill a day and a blood test every six months. whatever restrictions there are should recognize this state of treatment. Most positive service members are eager to deploy and ‘pull their weight’, so let them.
4. Change the Equal Opportunity mission to include HIV status. Discrimination exists in our military and certainly HIV status is a basis for discrimination among some commanders. Those who face discrimination have little if any recourse. The standard grievance procedure known as Request Mast requires too much disclosure on the part of service members who wish to protect their confidentiality, and is ill equipped to handle issues of discrimination.
5. Resume annual screening for HIV for all service members and combine it with syphilis screening (current standard for HIV is once every two years). Research is showing that not only is a syphilis infection a significant cofactor in increased HIV infection rates, but syphilis rates are rapidly on the rise in population centers where we have large military bases. The recent incident at SDSU in which 80% of a group of college students tested positive for syphilis should be a wake up call for the military. The military population is not that much different in terms of social demographics.
6. Remove restrictions on moving between active duty and reserve duty for HIV positive service members. This restriction made little sense to begin with and in light of treatment advances and potential changes in deployability, it makes no sense at all. If there is a space for you and you have the skills and desire, we should not stand in the way. Similarly, enlisted HIV positive personnel should be accepted into commissioning programs and allowed ascension into the officer corps if they are qualified.
7. Standardize HIV policy between all our military branches. There is no valid reason why an HIV positive service member in one branch should be greeted with opportunity and equal treatment while boxed up and hidden in another branch.
Our military has always been its strongest when it has brought to bare all its resources to accomplish our missions. This was true with the Tuskegee Airmen, it was true of the ‘Wind Talkers’, it is true of muslims and our arabic speaking translators today and will no doubt be true of our gay and lesbian service members if they are allowed to serve openly in the near future.
So to is it true of those among us who are HIV positive in the military, and it can be more true if we make the right choices now. Anyone who is reading this share it with a friend or family member, but just as important sign and mail this article to your legislator or to:
Rep. Susan Davis.
Attn.: Katherine Fortner
4305 University Ave. Suite 515
San Diego, CA 92105
Secretary of Defense Robert M. Gates
1400 Defense Pentagon
Washington, DC 20301-1400
Or Call: 619-280-5353
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