Gov. Nathan Deal, comfortably delivered to a second term last month, is no friend to LGBT equality. It's not so much that he's an outspoken opponent – OK, maybe he is – but it's his inaction that proves deadly.
When it comes to HIV and AIDS, Georgia often leads the nation in diagnoses, people living with the disease and deaths. And Deal, presented with chance after chance to take action to improve those numbers, won't. He doesn't take action, doesn't provide leadership and can't even be bothered to talk about it.
Creative Loafing's cover story this week, We need to talk about HIV, takes a deep dive into HIV's impact on black gay Atlanta, efforts to help, and the dire impact it has on young black gay men. When the Loaf asked Deal – who has considerable control over budget issues, funding and the priorities of state health agencies – he couldn't be bothered.
Yet there's practically no urgency among elected officials to tackle the complex problem. Repeated requests for comment from Gov. Nathan Deal about the issue were met with silence.
Then the Loaf explains how Deal's silence and inaction helps HIV flourish in gay Atlanta. It's equal parts disturbing and shameful.
Deal won't expand Medicaid
Thousands of people living on low incomes still don't have coverage. Expanding Medicaid would help connect an estimated 600,000 people to health care, but Deal has refused to join the program. During the past legislative session, he ceded his authority to expand Medicaid to the Republican-controlled General Assembly, making it even more difficult for his successor to make health insurance available to more Georgians.
“The southeast cities like New Orleans, Atlanta, Jacksonville, Charlotte, Memphis, and other jurisdictions have seen rapid increases in the rates of HIV and STDs,” says Devin Barrington-Ward, a health equity fellow at the Washington, D.C.-based National Coalition of STD Directors. “Georgia is now No. 1 for primary and secondary syphilis. It's no coincidence that many of these places are in jurisdictions where Medicaid expansion has not happened. You have a whole swath of people who couldn't get access to treatment or care they need.”
Deal plays don't ask, don't tell about (gay) sex
Public health and LGBT advocates also want state leaders to fix policy that currently hamstrings researchers' abilities to better understand teenagers' sexual behaviors. Doing so, those advocates know, would make prevention funding available. School officials could also revisit sex ed curriculums to ensure that LGBT students are learning about positive sexual health in a classroom setting.
Each year, Georgia passes up more than $400,000 in CDC funding because Deal did not want students to answer sex questions on the federal agency's Youth Risk Behavior Survey. The biannual questionnaire is randomly administered at high schools and is completely anonymous. In addition to asking about tobacco use and bicycle safety, the survey includes questions about sexual activity; specifically, the age a student first had sex, number of partners, and sexual orientation.
“The governor does not think Georgia parents want their children asked such explicit questions,” Deal Spokesman Brian Robinson said to WXIA/11 Alive in 2013.
“If the state is going to take this cavalier attitude that we're not going to meet these requirements, then the state should come up with the funding on its own,” Graham says. “Those are the tradeoffs that need to happen.”
Deal won't fund prevention efforts
But HIV prevention needs more funding. Although the state is finally allocating cash for the AIDS Drug Assistance Program, which helps get a person making $35,000 per year or less access to medication, it could do more. Currently the state allocates no money for prevention, relying entirely on federal funds for that. According to the Kaiser Family Foundation, Georgia received approximately $19 million in federal funding from the CDC in 2013.
If you're inclined to credit Deal with ending the state's waiting list for ADAP – it was the nation's longest as recently as 2012 – that was accomplished with federal money, not by action from him. When LGBT activists wanted to discuss ADAP funding, he couldn't be bothered then, either.