American civil rights history has marked noted change in acceptance, and the protection of, minority groups. Of these minority groups, homosexual men and women are better protected now than they were a few decades ago. Although Americans are becoming more supportive of civil rights for the lesbian, gay, bisexual, and transgender (LGBT) population, there are still widespread attitudes that reflect moral disapproval and repulsion towards homosexuals. In 2006, a Gallop Poll was performed and suggested that 41% of the Americans surveyed believe homosexuality is not an acceptable lifestyle, and 38% believe there should be less societal acceptance of the LGBT community (Brown & Henriquez, 2008). Research indicates that attitudes towards homosexuals are not necessarily predicted by region or city, but are associated with various socio-demographic factors, such as religion, political affiliation, and gender role beliefs (Brown & Henriquez, 2008).

One issue that has had a near parallel journey with LGBT civil rights is the AIDS epidemic. As the LGBT community and straight allies started to gain momentum while championing for LGBT civil rights, the prevalence of HIV and AIDS gained unprecedented awareness. Attitudes towards HIV and AIDS have also shifted in the last two decades, as HIV / AIDS is now understood as a disease that does not discriminate between sexual orientation, and also affects those who share needles, or anyone who is in a situation to exchange bodily fluids. HIV and AIDS, however, are still significant issues within the LGBT population as 61% of new HIV infections in 2009 were attributed to men who have sex with men (MSM) (CDC Fact sheet, 2011). The city with the highest rate of HIV / AIDS in the United States is the nation’s capital, Washington D.C. (Greenberg, Hader, Masur, Young, Skillicorn & Dieffenbach, 2009). There are 117.7 newly reported cases of AIDS per 100,000 people in Washington, D.C. (Greenberg et al., 2009). Addressing the HIV / AIDS issue in Washington, D.C., has included collaboration among public health agencies and community organizations. Continued education, medical, and social research are necessary to ultimately reduce negative attitudes towards homosexuals and empower individuals to make healthy choices to prevent HIV / AIDS.

American attitudes towards homosexuals have become more supportive in regards to civil rights and social acceptance within the last few decades. Some states have legalized gay marriage, civil unions, and the repeal of Don’t Ask Don’t Tell are examples of recent efforts to extend legal rights and protections within the U.S. Despite apparent policy changes, negative attitudes towards homosexuals are still prevalent in American society. Many Americans still regard homosexuality as morally wrong, and do not condone homosexuality as an acceptable lifestyle. In 2006, the results of a Gallop Poll showed that 41% of the individuals who were surveyed believed homosexuality should not be considered an acceptable lifestyle, and 38% felt there should be fewer acceptances for gays and lesbians in society (Brown & Henriquez, 2008).

American civil rights for the LGBT population continue to gain attention and make positive progress for the legal protection of homosexuals. Overall, the American attitude towards homosexuals has made improvements towards acceptance. The greater acceptance of homosexuals in society, however, has not been enough to eradicate negative attitudes. Negative attitudes and repulsive feelings towards homosexuals can lead to discrimination and hate crimes. In 2005, the Federal Bureau of Investigation (FBI) reported that hate crimes based on sexual orientation were the third-highest category reported, and represented 13.8% of all hate crimes (Brown & Henriquez, 2008). In addition to hate crimes, homosexuals report discriminatory experiences in the workforce, housing, and with other institutions. The Kaiser Family Foundation conducted a national survey in 2001 and reported 34% of the gays and lesbians who participated in the survey were unable to rent or buy a home because of their sexual orientation (Brown & Henriquez, 2008). On a national level, it appears Americans are divided on their attitude towards homosexuality. The same could be said for the capital, Washington D.C., whose population is largely divided between social conservatives and those who are socially liberal, and its residents are culturally and economically diverse, similar to other major U.S. cities.

To say the nation, or a particular city, holds one specific attitude towards homosexuality, however, would be too great of a generality; instead, studies have been performed to identify certain socio-demographic factors that are predictors of attitudes towards gays and lesbians. One study surveyed 320 undergraduate students using Herek’s Attitudes Towards Lesbians and Gays Scale (ATLGS), Kerr and Holden’s Gender Role Beliefs Scale (GRBS), and a socio-demographic questionnaire (Brown & Henriquez, 2008). Ages of the participants ranged from 17-52, represented white, African-American, Asian, Hispanic, Caribbean, Middle Eastern, and other ethnicities, and also represented Protestant, Catholic, Islamic, Buddhist, and other religions. The study supported that individuals who reported being more religious and more politically conservative were associated with negative attitudes towards homosexuals (Brown & Henriquez, 2008). There was an indirect correlation between gender and negative attitudes towards homosexuals. Females tended to me more religious, which signifies higher levels of negative attitudes, however, females tended to have less traditional gender role beliefs, which is related to less anti-gay attitudes (Brown & Henriquez, 2008).

The greatest socio-demographic predictor for negative attitudes towards homosexuals, as resulting from this study, was the individual’s adherence to traditional gender role beliefs (Brown & Henriquez, 2008). According to the study, gender role beliefs, rather than gender alone, is a more significant predictor of attitudes towards the LGBT population. The second greatest predictor of attitude was the individual’s interpersonal experiences with gays and lesbians. Interpersonal experiences with homosexuals was a greater predictor of attitude that political conservativeness and religious affiliation (Brown & Henriquez, 2008). The mentioned socio-demographic factors are only considered predictors of attitude towards homosexuals, and are not to be confused with causes of anti-gay sentiments. American attitudes towards homosexuality vary from person to person, which culminates in a nation with citizens who represent an extensive range of attitudes towards the LGBT population.

One issue that is often related with LGBT community is the HIV / AIDS epidemic. Although HIV, AIDS, and sexually transmitted diseases (STDs) do not discriminate between sexual orientation, race, or gender, the prevalence of HIV / AIDS in the U.S. has contributed to its stigma towards IV drug use, prostitution, and homosexuality (Mahajan et al., 2008). The Center for Disease Control and Prevention (CDC) reported that in 2009, men who have sex with men (MSM) account for only 2% of the U.S. population, but represent 61% of all new HIV infections (CDC HIV Fact sheet, 2011). The CDC advised White MSM represented the most new HIV infections, followed by Black MSM, then Latino MSM. Black heterosexual women represented the next largest gender/race group reporting new HIV infections, followed by Black heterosexual males, Latina heterosexual women, White heterosexual women, Black male injection drug users, and Black female injection drug users, respectively (CDC HIV Fact sheet, 2011). The CDC reports that MSM account for 49% of the 1.2 million people estimated to be living with HIV in the U.S. (CDC HIV Fact sheet, 2011).

The city with the highest prevalence of HIV / AIDS in the U.S. is the nation’s capital, Washington D.C. In 2005, the rate of newly reported AIDS cases per 100,000 in Washington, D.C. was 117.7, which is greater than Philadelphia (96.6), Baltimore (68.3), and New York City (50.7) (Greenberg et al., 2009). By the end of 2007, almost 3% of the adult population in D.C., more than 15,000 people, was living with HIV and AIDS (Greenberg et al., 2009). The incidence of HIV and AIDS in Washington D.C. is comparable with such countries as Nigeria and the Congo (Greenberg et al., 2009). Various factors have been associated with the enormity of the local epidemic in D.C.; one of which is the greater number of residents who are at increased risk of HIV infection, such as MSM, high-risk heterosexuals, and injection drug users (Greenberg et al., 2009). Researchers also speculate that extreme differences in economic status and poverty contribute to the local epidemic, as poorer populations would have lesser access to prevention education and medical care services (Greenberg et al., 2009).

While a larger at-risk and resource-poor population would contribute to the HIV / AIDS local epidemic in Washington D.C. (Wolitski, Stall & Valdiserri, 2008), observers also note failed public policy to be partially responsible for the severity of the situation (Greenberg et al., 2009). The independent organization, DC Appleseed, investigated the local public health and policy response to the capital’s HIV epidemic in 2005. The group reported on a number of failed systems and policies: an unproductive HIV / AIDS surveillance system that had not supplied data in a timely manner; a pattern of frequent adjustments in HIV / AIDS leadership within the D.C. Department of Health; inadequate and indistinct HIV testing and condom distribution programs; insufficient HIV prevention education for the general public and school systems; and poor substance abuse treatment programs (Greenberg et al., 2009).

Following the release of the DC Appleseed report, D.C. Mayor Adrian Fenty made HIV / AIDS the most important public health priority (Greenberg et al., 2009). Funding from the CDC allowed for a partnership between the D.C. Department of Health’s HIV / AIDS Administration and the George Washington University School of Public Health and Healthy Services, which was responsible for the Epidemiology Annual Report for 2007 — the first to be published for D.C. since 2002 (Greenberg et al., 2009). The Department of Health also initiated a routine HIV screening campaign to help provide testing resources and lower stigma, titled “Come Together DC — Get Screened for HIV” (Greenberg et al., 2009).

Efforts to address the epidemic in D.C. included a combination of increased resource availability and educational services as offered by public health departments. The “Come Together DC — Get Screened for HIV” campaign provided approximately 73,000 tests in 2008, which was a 70% testing increase from 2007 (Greenberg et al., 2009). The success of the campaign is attributed to the promotion of routine HIV testing in medical tests that did not require separate written informed consent or an “opt out” option. Another preventative measure arose from the information attained by the National HIV Behavioral Surveillance system, whose research indicated people have difficulty understanding HIV risk within their relationships (Greenberg et al., 2009). The research showed that less than one-third of heterosexuals in the D.C. at-risk communities used a condom the last time they had sex, and only half were aware of their partner’s HIV status (Greenberg et al., 2009). Due to the research findings, social marketing efforts were geared towards making better decisions in relationships and condom use. Washington D.C. also became the second U.S. city (after New York) to initiate a public-sector condom distribution program; 115,000 condoms were distributed in 2006, 1.3 million in 2007, and 1.5 million in 2008 (Greenberg et al., 2009). In addition to prevention, D.C. primary HIV care has been provided to numerous clinical settings, such as academic medical centers and community-based clinics, to promote and administer HIV treatment (Greenberg et al., 2009). Addressing the HIV / AIDS epidemic in Washington D.C. has been an extensive, complex, and thorough exercise in preventative measures and proper treatment.

In the last twenty years, Americans have grown significantly in their support of civil rights for the LGBT population. Although attitudes are increasingly becoming more accepting of the LGBT population in the U.S., there is still a considerable amount of Americans who regard homosexuality as morally wrong and as an unacceptable lifestyle. Recent studies support that certain socio-demographic factors can be predictors of attitudes towards homosexuals. According to one study, an individual’s adherence to gender roles and personal experiences with gays and lesbians were the two greatest predictors of attitude towards homosexuals (Brown & Henriquez, 2008). The prevalence of HIV / AIDS in the U.S. is often related to the LGBT community; according to the CDC, men who have sex with men account for only 2% of the population, but represent 61% of new HIV infections (CDC HIV Fact sheet, 2011). The CDC reports that MSM account for 49% of the 1.2 million people estimated to be living with HIV in the U.S. (CDC HIV Fact sheet, 2011).

The nation’s capital, Washington D.C., has the highest prevalence of HIV, and the city’s prevalence rate of HIV / AIDS, 3%, is comparable to Nigeria and the Congo (Greenberg et al., 2009). The independent organization, DC Appleseed, investigated the local public health and policy response to the capital’s HIV epidemic in 2005, and discovered several insufficient and inadequate policies and their failed execution to be main contributors to the local epidemic (Greenberg et al., 2009). To address the HIV / AIDS local epidemic, HIV testing was made a part of routine medical procedure, educational materials have been released to educate about at-risk relationships, more than 3 millions condoms were distributed, and HIV treatment capability has been expanded to academic and community health centers. Combating the local epidemic in Washington D.C. has required a combined effort in education material and medical service expansion.

References

Brown, M., & Henriquez, E. (2008). Socio-demographic predictors of attitudes towards gays and lesbians. Individual Differences Research, 6(3), 193-202.

CDC HIV Fact sheet. (2011, November 07). HIV in the United States. Retrieved from http://www.cdc.gov/hiv/resources/factsheets/us.htm

CDC Fact sheet. (2011, September). HIV and AIDS among gay and bisexual men. Retrieved from http://www.cdc.gov/nchhstp/newsroom/docs/fastfacts-msm-final508comp.pdf

Greenberg, A., Hader, S., Masur, H., Young, A., Skillicorn, J., & Dieffenbach, C. (2009). Fighting HIV / AIDS in washington, d.c. Health Affairs, 28(6), 1677-1687.

Mahajan, A., Sayles, J., Patel, V., Remien, R., Ortiz, D., Szekeres, G., & Coates, T. (2008). Stigma in the HIV / AIDS epidemic: A review of the literature and recommendations for the way forward. AIDS, 22(2), 67-79.

Wolitski, R., Stall, R., & Valdiserri, R. (2008). Unequal opportunities: Health disparities affecting gay and bisexual males in the United States. Oxford, UK: Oxford University Press.

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