Another gay epidemic? Another gay health crisis? Haven't we suffered enough through the first one? Indeed. And the second "AIDS" epidemic of the early years of the 21st Century will make the first AIDS epidemic of the 1980s look like a bad case of the common cold.

No one could have seen the first epidemic coming. However, the second epidemic's coming is as easy to see as a stampede of rogue elephants. Both epidemics have much in common: A complex syndrome of diverse diseases and symptoms, multiple drug interactions that sometimes ravage the body more than the disease itself, pervasive destitution and homelessness, relentless wasting, weakening immune systems and the marginalization and invisibility of the patient. Both epidemics are associated with an almost certain death sentence and both epidemics demand research and support systems that provide quality of life and quality of care as we learn to live with a long-term chronic condition.

The profound difference between the two epidemics is the size and mortality rate of the patient population. As a result of the first wave, during the 1980s approximately 80,000 gay men died of AIDS. As a result of this second wave, an estimated 180,000 will most certainly die over the next ten years. Overall, the first 25 years the American AIDS epidemic swept away the hopes, dreams and futures of about 260,000 gay men; over the next 25 years, the second epidemic will sweep away the lives of close to 4.5 million gay men and women. These are astonishing and breath taking statistics.



At one time society simply wrote off AIDS patients because they were hopeless and were going to die anyway. Today, the gay community is doing the same, writing off gay elders because they are hopeless and going to die anyway. And many of you are thinking that it's outrageous to compare AIDS and aging. It's not so outrageous for the growing numbers of men who are living with AIDS and are now aging. And it's not so outrageous for the millions of gay elders who are being swept under the rug and condemned to 10, 20 or 30 years of destitution, loneliness, pain, abuse, hunger, chronic depression and tears. Dying isn't the issue, the issue is quality of life and quality of care over the years and in many cases, the decades of senior life.

After long productive lives that changed the heart of society and gave birth to a world of Ellen, Will & Grace, Christine Quinn, Barney Frank, Scissor Sisters and Anderson Cooper, we have abandoned the majority of these men and women much in the way society abandoned AIDS patients during the 80s. And that is most certainly outrageous and shameful beyond any words I can write.

What's wrong with us? And don't give me this bull that this is the way it is in America. We are gay men and women, a community that revolutionized patient advocacy and patient care. We forever changed the way America cares for its vulnerable.

The Champions

But the very good news is that as it was with the first gay health crisis, the second crisis has given rise to champions, heroic women and men who are paving the way, breaking down the doors and lighting a candle that the rest of us will follow--must follow-- and for the simple reason that unlike the first AIDS epidemic, we will each and every one of us be "HIV+". Aging and it's associated vulnerabilities spare no one except the dead.

Over the next few weeks we'll look at these heroines and heroes of gay elder advocacy. The women and men, the earth mothers and the white knights who are working tirelessly and at great emotional expense to themselves to revolutionize gay elder care and, even more astonishingly, likely build a model of care that will revolutionize elder care in America much in the way that AIDS advocacy revolutionized the overall world of patient advocacy. We'll closely examine their successes and progress and perhaps more importantly, we'll delineate how each and every one of us can help nurture and further those successes and progress.

We're going to spend time with New York's Amber Hollibaugh, the woman who heads the elder advocacy initiatives at the National Gay and Lesbian Task Force. We'll look at the remarkable accomplishment of the Task Force in changing attitudes and policy in Washington, raising awareness of the shortcomings of regulations and laws badly needed to support and protect gay senior throughout the nation.

We'll visit with Julie Kliska who runs the nation's largest community-based gay seniors program out of the Los Angeles Gay & Lesbian Center. Kliska runs astounding programs that offer counseling, legal support, social networking and some good plain and much needed fun. But Kliska's resources only allow her to reach about 600 of an estimated 75,000 Los Angeles gay elders in need.

We'll spend some time in Boston with Jim Campbell, the president of The National Association on HIV Over Fifty (NAHOF) looking at a rapidly growing population of men and women who are struggling with the challenges of aging on top of HIV. Among the many challenges is the lack of medical research exploring drug-drug interactions between advanced AIDS medications and the medications normally associated with the routine aspects of aging.

I'll take you to Brooklyn where we'll meet Regina Shavers, executive director of Griot Circle, an organization dedicated to providing support for lesbian, gay, bisexual, and transgender elders of color.

So Much Work And So Few Workers

So much needs to be done. Discrimination against gay elders in housing, the nursing home system and long term and assisted care facilities must be ended through legislation and regulation. Ironically senior citizens are protected from ageism in the workplace by law, but gay seniors can be terminated on the basis of sexual orientation in most of the nation. The majority of geriatricians and physicians and medical students in general frequently provide substandard medical care and even deny medical care outright to gay seniors. Furthermore, SAGE (Services and Advocacy for GLBT Elders, the nation's largest social service and advocacy group for gay seniors) reports that "as a result of stereotyping and a lack of training, physicians often ignore effective preventive care measure or treatment needs of LGBT seniors. LGBT seniors in turn often remain silent about their health concerns or symptoms--for fear of discrimination, neglect or abuse.

"Compounding the problem, physicians are often ignorant of research that identifies differential health risks and susceptibilities of LGBT senior in contrast to heterosexual seniors."

SAGE also sites a recent study that revealed that 96% of America's social service and care giving agencies for seniors "do not offer any services specifically designed for LGBT seniors. "The same study documented that 46 percent of the same Agencies reported that LGBT seniors would not be welcome at senior centers in their areas if their sexual orientation were known.

In another study reported by SAGE, 95 percent of staff at long term care facilities in the New York City area supported the right to privacy and sexual expression of their residents and 84 percent of the facilities offered in-service training on sexual privacy in general.

But only 13 percent of long-term care facilities reported that sensitivity to sexual orientation was included in their training, and only one facility required attendance at the session.

According to SAGE, "The finding is even more astounding considering that over 25 percent of the facilities--25 percent--reported they knew some of the residents were LGBT.

To put this into some perspective, 65 percent of these same facilities provide mandatory sensitivity training to staff on racial/ethnic diversity and 71 percent on cultural/religious diversity.

The task at hand is monumental, complex and obviously daunting. But anything short of a solution that provides for basic quality of life and quality of care needs for our gay elders (and one day you'll likely be among them) would be a crime against humanity on a scale equal to genocide or slavery.

Hollibaugh, Kiska and others are taking it on and they are doing miraculous and heroic work, but they and the community need our help. They need funding, they need volunteers, they need community involvement. These pioneers represent the birth of a movement not the resolution of the crisis. These folks represent a small army of visionaries who have mustered the resources and will to show us the way but many more of us will have to work together if we're to embrace the 99% of gay elders who still remain outside the fledgling support network.

Will we as a community demonstrate to the nation at large that as it was with AIDS, we take care of our own and we do it better and with more compassion? It' is time to take action, take to the streets and man the barricades yet again.

An elderly gay friend of mine who has been HIV+ since the formation of the Grand Canyon recently remarked that as a gay man he's never felt that he was growing old just increasingly invisible. He joked that when he was first diagnosed with AIDS back in the 80s he became invisible and untouchable. Over the years, as understanding and compassion replaced ignorance and fear, he was able to rejoin "life"; now he's growing old and it's the same bulls**t all over again." He reminded me of a scene in an old Anthony Quinn movie, "The Savage Innocents" (1960). In one of the most heart-breaking scenes, the Eskimo, Inuk, portrayed by Quinn, abandons his aged mother on the ice floe because she can no longer care for herself or contribute to the well-being of the family. The old lady drifts out on the Arctic sea quickly freezing to death, soon to be devoured by Polar Bears.

"I can walk into any bar in town and its as if I'm not even there.I've actually goosed men and had them look right past me wondering who had grabbed their ass as if I simply don't exist.. At the very least I deserve a disapproving look. Of course, I'm not even looking for sex; just conversation and a few minutes of diverse company. Imagine that we live In the largest gay city in the world, I'm surrounded by hundreds of thousands of gay men, but as an old gay man I have to attend special support group meetings in a "non-alcoholic, drug-free" environment just to have a decent conversation. Some days that t f***ing" ice floe sounds awfully appealing.

My dream and the dream of people like Amber, Regina and Jim is that we can prove my friend wrong.