When Anti-Equality Means Anti-HIV

As a teenager in Western Illinois, the educational content I received on sexual health consisted of what can best be described as “MadLibs Sex Ed” - sheet after sheet of entire sections of a book, meticulously handwritten by my teacher with various words replaced by blanks. It stands to reason then that my functional knowledge of this content also had some gaps. In the years since, my world has drastically shifted as has the world around me. I came out, transitioned, and found my footing as a queer and trans health advocate, all the while access to comprehensive sex ed has remained polarized despite gains made in HIV prevention and treatment such as PrEP and U=U (Undetectable=Untransmittable). It is amongst this backdrop that I learned that the great State of Iowa had recently put a sweeping bill into law - SF 496 - that, under the guise of parental rights, eliminates the requirement of age-appropriate information about HIV/AIDS and HPV.

To say this is concerning is an understatement. By eliminating the mandate of HIV education, the state of Iowa is essentially choosing the path of willful ignorance on behalf of its young people. The State of Iowa would have one believe that young people are either too young to safely know about sexuality or are certain to have a parental figure able to competently have “the talk” with them in such a way that the necessary content will be covered. The reality is that the Centers For Disease Control and Prevention’s (CDC’s) Youth Risk Behavior Survey from 2021 found that 1 in 5 high school students is currently sexually active, and among those, only 52% used a condom the last time they had sex and less than 7% had been tested for HIV or STIs.  Additionally, In the United States, 20% of new HIV diagnoses in 2020 were among young people aged 13-24. Earlier this month, Iowa Public Radio noted that despite national new HIV infection rates falling overall, Iowa’s new infection rates have remained steadfast. It would seem that now is not the time to stand down on HIV education efforts.   

Truly comprehensive sex education empowers individuals with accurate and evidence-based information about HIV transmission, prevention, and treatment. By teaching individuals about how HIV is transmitted, the importance of condom use, regular HIV testing, and the use of PrEP and nPEP, comprehensive sex education equips folks with practical skills to protect themselves and their partners from HIV transmission and unintended pregnancy. Additionally and equally importantly, comprehensive sex ed, when done well, stresses the importance of communication, negotiation, and consent, which are essential elements in fostering healthy relationships throughout the lifespan and even outside of sexuality-based contexts.


It is also important to note that the same law that eliminates the requirement of HIV education also eliminates any mention of sexual orientation or gender identity through the sixth grade. As a queer and trans person raised in a similar environment, I spent my childhood and adolescence staring out across the corn and soybean fields, intensely aware that I was different yet with no feasible outlet (or Internet) to understand why. This bill (and the onslaught of others like it elsewhere in the U.S.) targets the exploration of sexual orientation and gender identity and hopes to harken back to the bad ol’ times when access to information was limited and supportive resources were scarce. Interestingly, this bill also includes mechanisms to make it easier to ban books in schools and explicitly prohibits students from serving on committees that determine or provide recommendations concerning banning books and other materials from school libraries. Because not only do we want young people under-informed about their bodies and their options, we also want to make sure they don’t dare have agency about what happens in their school - yet we hope for them to be good and engaged citizens. How interesting and perfectly sensible!  

What happens next is both predictable (in that some of us have lived it before) and preventable. In the Mad Lib, SF 496 of it all, young people will not get access to the information they need to make sound decisions or to feel less isolated. There will still be gay young people or trans young people - just less understood by their peers and less likely to see themselves in the literature at their schools. There will be more young people who become HIV positive and unknowingly transmit it to others, and because removal of HIV education means removal of HIV testing information, there will be more people who have no idea about what testing means, how frequently to do it, and where one can do it. Therein lies the work for HIV advocates. The State of Iowa has created a “tough row to hoe” as they say in my hometown, but I take solace in the fact that whether overlooking the cornfields, the beaches of my adopted home, or the haze of a city elsewhere in the world, HIV advocates don’t give in and they don’t give up.

Riley Johnson

Riley Johnson is a frequent speaker and consultant on the barriers to health care experienced by transgender people. In 2014, Riley co-founded RAD Remedy, an effort to connect queer and trans people to accurate, safe, respectful, and comprehensive care in order to improve individual and community health. In 2016, Riley moved from Chicago to Saint Petersburg, FL and soon thereafter began serving on the Florida Comprehensive Planning Network, the advisory body to the Florida Department of Health HIV/AIDS Section. He served as Statewide Transgender Representative and Community Co-chair of FCPN for four years each and remains active as Transgender Alternate and a member of the Medication Access Committee. His research interests and investments frequently concern the relationship of activism and policy, resilience within trans communities, and the evolution of community-created harm reduction and safer sex messages. Professionally, Riley is an administrator at a pediatric therapy company, and outside of his work life, he delights in spending time with his wife, their two small children, and a horde of chosen family scattered throughout the world.

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