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Law Of Consequences: Gay Marriage Bans Increase HIV Infection Rates

By L. K. Regan

Actions have consequences. This is particularly true of political actions, the consequences of which will ripple through lives far distant from the original moment of law or policy-making. With this in mind, two Emory University Economists set out to examine one possible unintended but deadly consequence of laws banning same-sex marriage. Their question: Do such laws increase rates of HIV infection? Their answer: Yes.

Economics professors Andrew Francis and Hugo Mialon collaborated on a study to examine the effects of intolerance on the rate of HIV infections in the U.S. To measure tolerance, they used the results of the General Social Survey, a national survey conducted since 1973 that measures attitudes toward gays. As the authors point out, in the 1990s, as those attitudes became more tolerant, HIV rates slowed. Their theory, therefore, is that, "tolerance for homosexuals causes low-risk men to enter the pool of homosexual partners, as well as causes sexually active men to substitute away from underground, anonymous, and risky behaviors, both of which lower the HIV rate." In other words, being able to come out in the light of day may lead to more sex—but it actually leads to overall safer sex.

Tolerance is clearly a net good for HIV rates. But what is the impact of intolerance? As the authors point out, in the same period in which overall tolerance rose, bans on gay marriages or civil unions were passed. These bans have a two-way relationship to tolerance: "Tolerance may affect the passage of a ban, and conversely, a ban may affect tolerance. On one hand, intolerant attitudes may raise the demand for a law banning gay marriage; on the other hand, the passage of such a law may codify norms and, thereby, increase intolerance, since the law may send a signal that intolerance is prevalent in society." So, in the study, such bans act as "a proxy for intolerance," as the authors write, and as such allow them to calculate the impact of those laws on infection rates. This impact is fairly small—the study's results found an increase of four cases per 100,000. Still, that number is against the reduction of merely one in 100,000 cases brought about by increases in tolerance from the 1970s to the 1990s. As study author Mialon said, "Intolerance is deadly. Bans on gay marriage codify intolerance, causing more gay people to shift to underground sexual behaviors that carry more risk."

As the authors are clearly aware, this is a timely moment to point out that there are serious consequences to bans on gay marriage. Referring to the California Supreme Court's decision to uphold Prop 8, co-author Andrew Francis said, "Laws on gay marriage are in flux and under debate. It's a hot issue, and we are hoping that policymakers will take our findings into account." We are hoping so as well.