By Jonathan Cohen
It has often been said that COVID-19 reveals all manner of injustices, from hazardous work to overcrowded nursing homes to domestic violence. But with the increasing availability of the vaccine in wealthy countries, COVID-19 reveals something else; the intimate details of our pre-existing health conditions.
Last month, when I received my COVID-19 vaccine, it was due to a health condition I had kept hidden from many friends and colleagues; for the past eleven years, I have been living with HIV.
I have never lied about my HIV status, but I have never been public about it either. So why, upon receiving my first dose of the vaccine, did I suddenly feel moved to come out?
Maybe it was because I felt self-conscious about receiving the vaccine before others, and I wanted to publicly assure people that I ‘deserved’ it.
Or maybe I wanted to send a message. HIV and AIDS killed 690,000 people in 2019, most of them in the world’s poorest countries. By revealing my HIV status, I could make a personal statement about fighting the silence and stigma surrounding this continuing pandemic.
For many people, COVID-19 has stirred painful memories of the HIV pandemic’s earliest days— the hysteria over what is making people sick, the need to blame someone, the rumours and myths about how to protect ourselves.
Whether it is COVID-19 or HIV, many of us with a positive diagnosis feel shame. We blame ourselves for being irresponsible, keep our symptoms to ourselves, and wallow in self-recrimination. In too many cases, shame prevents us from seeking medical care or support from others, which only makes us sicker.
Our political leaders often make matters worse. Instead of calling for compassion, many of them lie, obfuscate, and point fingers. Worse, they crack down—censoring critical health information, punishing scientists who speak out, monitoring our private lives.
When the US Department of Justice declared in March 2020 that individuals who intentionally transmit coronavirus could be charged with ‘terrorism’, it recalled the worst impulses of authorities to criminalize transmission of HIV.
Vaccines and medicines have the power to change that. They not only provide a clinical benefit by preventing illness and death—they also help break the cycle of fear that stymies public health. They give people hope, a reason to come forward and learn their status, and a way to protect themselves and their communities.
When antiretroviral treatment for HIV became available in 1996, it brought millions of people from the brink of death. In so doing, it blunted the stigma of HIV, by transforming the virus from a perceived death sentence to a chronic and manageable disease. This stigma would lessen further, when, in 2011, scientists discovered that HIV treatment also prevents people living with the virus from infecting others.
That was a year after I learned I was infected. Realizing that if I followed my treatment regimen I would no longer be infectious to others, helped my fear dissolve. I gained pride in knowing and dealing with my HIV status. My own health became bound up in the health of my community.
This experience gives me a unique perspective on the COVID-19 vaccine. My own eligibility for the vaccine [not only protects me] from the potential added risk of contracting the coronavirus while being HIV-positive, it also, if early research proves true, prevents me from infecting others with COVID-19. Far from a disability, my HIV status has become a privileged opportunity to help others.
This is true at a community level as well. The closer we progress towards herd immunity, the further we get from the fear, finger pointing, and blame that marked the beginning of the pandemic. We return not only to our livelihoods and physical intimacy, but also to our collective humanity.
Of course, the ability to receive the vaccine is currently limited to those living in a handful of wealthy countries, who have hoarded the global vaccine supply. My US address is as much of a prerequisite for the vaccine as my HIV status. By acknowledging my privilege in receiving the vaccine, I also join the global call for vaccine justice for all.
The largest lesbian, gay, bisexual, and transgender synagogue in the United States, of which my husband and I are proud members, takes its motto from Psalm 118:
“The stone that the builders rejected has become the cornerstone.”
We take this to mean that LGBT people, having been rejected and ostracized, are pillars of our community. The same is true for people living with HIV.
This, I now realize, is why I disclosed my HIV status upon receiving the COVID vaccine. With the jab came a shot in the arm.
I have nothing to hide. I have something to give.
Jonathan Cohen, is director of the Open Society Public Health Program.
In his role at the Open Society Foundations, Jonathan oversees grant making and advocacy to improve social inclusion in public health policy and practice. He is a former member and co-chair of UNAIDS Reference Group on HIV/AIDS and Human Rights.
[All opinions are the writer’s own]