HIV Is an LGBTQ Issue. Why Aren’t More Funders Responding?

By Alli Jernow, FCAA Board Treasurer and Social Justice Program Vice President at the Arcus Foundation 

In the leadup to the ILGA World Conference this November in Cape Town, South Africa, Alli Jernow shares her perspective on the deep connection between HIV work and LGBTQ rights – and why it’s time for more LGBTQ funders to join the HIV fight. 

As funders, we’re familiar with the siloization of philanthropy. We categorize our work by issue area: health, reproductive justice, LGBTQ rights, women and girls, and so on. But as funders, we also know that this practice doesn’t reflect reality. It doesn’t reflect people’s lived experiences.  And it makes it too easy to overlook or ignore complex and interconnected root causes.

I’m the Vice President for Social Justice at the Arcus Foundation. We firmly believe that advancing LGBTQ human rights requires addressing the conditions that drive the HIV crisis. In 2023, Arcus joined Funders Concerned About AIDS – a global group of 50+ funders who represent more than US$331 million in HIV-related grantmaking annually – because we know that a cross-sector approach is critical to promote health and human rights in the communities we serve. I’m here to tell you three reasons why all LGBTQ funders should be HIV funders, too. 

1. LGBTQ people are disproportionately impacted by HIV. 

The LGBTQ community has experienced disproportionately high rates of HIV from the epidemic’s earliest days. Today, 55% of new HIV diagnoses worldwide are from key populations and their sexual partners—including transgender people; gay, bisexual, and other men who have sex with men; people who use drugs; and sex workers. That number skyrockets to close to 80% when looking outside of sub-Saharan Africa. Meanwhile, rising anti-rights rhetoric further threatens the health and safety of LGBTQ people. 

Consider that: 

• The risk of acquiring HIV is 23 times higher for gay men and other men who have sex with men than the general population.
• The HIV prevalence among trans people is 14 times higher than adults aged 15 to 49. 
• The HIV prevalence among men who have sex with men in countries that criminalize identities is 5 times higher than in countries that do not.  

Better access to HIV prevention and care is a fundamental step in promoting the well-being of LGBTQ people. At the same time, we cannot end the HIV crisis without tackling the pervasive discrimination faced by the LGBTQ community. The two are inextricably linked. 

2. When we support health services, we support human rights.

As a U.S.-based organization, Arcus has witnessed the longstanding bifurcation between HIV work and LGBTQ advocacy across America—despite the history of HIV activism in queer movements. We often hear things across the LGBTQ philanthropic community like, “We work in advocacy, not services,” or “Our focus is on human rights, not health.” Yet that split between health and human rights funding creates a false dichotomy that doesn’t reflect the needs of our communities. 

The harmful effects of this dichotomy are clear in places like the U.S. South. The region has historically and intentionally underinvested in the public health needed to fight HIV, creating a hotbed for HIV infections. The South makes up more than half of new diagnoses in the U.S., yet receives just 26 cents of every dollar in U.S.-based philanthropic funding for HIV. These impacts weigh heavily on gay and bisexual men, trans women, and people of color. Despite representing the highest burden of the epidemic, Black people also account for just 22% of PrEP—or pre-exposure prophylaxis—users in the South, an effective medication to prevent the transmission of HIV. 

These numbers tell us that social injustices like racism, homophobia, transphobia, and sexism continue to fuel the epidemic. You can’t be concerned about inequality without being concerned about HIV, and Arcus’ grantees know this. They work with and are led by people impacted by HIV, and they are pushing for better access to services. They understand that health for people living with and vulnerable to HIV is not just about service delivery; it’s a demand for justice. 

3. The HIV response opens new avenues for LGBTQ advocacy.

In many of the countries we fund, LGBTQ organizations and HIV organizations are one and the same. Our grantee partners in Eastern and Southern Africa are advocating, litigating, and organizing around the HIV response, and offering prevention services, testing, and counseling to their communities. 

Given this range of support, a brilliant trans activist in Kenya explained to me that she is always asking, “What is my entry point for advocacy?” For her and so many others, HIV work is a valuable opportunity to engage with government stakeholders. 

For example, during the development of the National AIDS Country Operation Plan, this activist and her organization developed relationships with public health commissioners in all 47 counties in Kenya. They attended meetings as HIV advocates—creating a web of allies inside and outside of government that have laid the foundation for future progress. The partnerships they forged as queer and trans Kenyans matter not just in fighting HIV, but in all their efforts to combat stigma and discrimination against LGBTQ people. 

Progress Requires Our Collective Efforts

The intersecting factors that make up our identities cannot be untangled, and our funding priorities must follow suit. If your organization wants to advance equality, joining the HIV response is a critical way to make a difference. We invite all LGBTQ funders to join the Arcus Foundation in funding HIV work that supports health and human rights for millions around the globe.