By the end of the proclamation, our “president” has done the unthinkable. He has written (or approved) seven paragraphs about the HIV/AIDS epidemic, remembering “those who have died and those who are suffering” and celebrating the decrease in HIV infections from 2008 to 2014 for “saving an estimated $14.9 billion in lifetime medical costs,” all without once mentioning LGBT people.
He did so without mentioning the countless gay deaths, the countless deaths of trans women of color, and the countless communities his administration targets that are at greater risk of infection since he stepped in the Oval Office.
Since silence still equals death, let's remedy this situation. Here are 21 truths Trump erased on World AIDS Day.
1. Transgender women have the highest HIV rates in the country.
The health needs of trans women of color often go unaddressed. Trans women have some of the highest rates of HIV transmission in the U.S. Despite this fact, trans women are often miscategorized as men who have sex with men. This erasure is worsened by a lack of legal protections in the U.S.
“In the majority of the states in the U.S., it’s legal to discriminate on the basis of gender identity,” says JoAnne Keatley, director of the Center of Excellence for Transgender Health at the University of California, San Francisco. “You can deny a person employment or you can terminate someone who is transitioning on the job merely because they are transgender.” Read more here.
2. The majority of people living with HIV in the U.S. are gay and bi men.
In 2016, gay and bisexual men accounted for 67 percent of all HIV diagnoses, according to the Centers for Disease Control and Prevention. To put the data in perspective: In 2014 gay and bisexual men made up roughly 2 percent of the U.S. population but accounted for 70 percent of new HIV infections. Approximately 492,000 sexually active gay and bisexual men are at high risk for HIV — especially in communities of color.
We’re failing the transgender HIV epidemic — thanks in part to transphobic policies pushed by Trump.
In most HIV studies, trans folks have been counted as their sex assigned at birth, discounting their identities and leaving them invisible to public health officials and advocacy organizations working toward HIV prevention, treatment, and care. Misgendering is widespread among Republican politicians, including Virginia Del. Bob Marshall, who was beaten by Danica Roem, one of the first trans candidates to win elective office. Marshall misgendered her throughout her campaign.
Donald Trump’s ongoing crusade against transgender service members (most recently blocked by yet another federal judge, so trans people can stay in the military for now and the armed forces must allow transgender recruits starting January 1) is transphobia from the highest office in the land, emboldening transphobic hate in a country where many trans women struggle to find competent doctors and compassionate care.
4. Half of black gay and bi men in the U.S. will test HIV-positive in their lifetime.
The CDC released these alarming statistics early last year following a comprehensive study showing that gay and bisexual men remain the most at-risk demographic for HIV infection. Read more here.
5. Across all racial groups, African-Americans are hit hardest with HIV.
According to the CDC, in 2015, 17,670 African-Americans were diagnosed with HIV in the United States. More than half of them were gay or bisexual men (38 percent of whom were aged 13 to 24). Forty-eight percent of those diagnosed with AIDS were African-Americans.
6. 1 in 6 gay and bisexual men with HIV are unaware they are positive. Erasure will worsen that number.
People who don’t know they have HIV cannot get the medicines they need to stay healthy and prevent transmitting HIV to their partners. Therefore, they may transmit the infection to others without knowing it.
7. AIDS wiped out an entire generation of queer artists — an incalculable tragedy for all LGBT Americans.
Read this devastating recollection of the toll the epidemic took on queer artists in one writer’s remembrance of Robert Mapplethorpe. We lost painters and musicians, film stars and writers, poets and composers. That’s a massive loss of talent the creative world has worked to reckon with.
8. Trump’s erasure echoes Ronald Reagan’s complicity in the deaths of thousands of people from AIDS.
9. Trump’s conservative base in red states boasts the nation’s highest HIV rates.
The Deep South is rife with poverty and sex-phobic, anti-LGBT attitudes that worsen the spread of the virus. None of the sSouthern states with the highest infection rates require schools to provide LGBT-inclusive education in health classes. Most have abstinence-based sex education in public schools, which has shown to be ineffective in preventing sexually transmitted infections.
Also, many Southern states have a widespread lack of access to health care. Since the Supreme Court ruled that states could choose whether to expand Medicaid, Alabama, like most of the Bible Belt, decided not to. Cuts to Medicaid would disproportionately hit rural hospitals, which depend largely on funding from the program. These and other factors contribute to health crises like the one happening in Atlanta — half of Atlanta’s newly diagnosed HIV patients already have AIDS. Read more here.
10. In 2013, one third of Hispanics/Latinos diagnosed with HIV lived in the South.
Undocumented Hispanics/Latinos face even greater hurdles to proper care, often having to depend on free community health clinics that do not offer comprehensive HIV services.
11. Anti-LGBT attitudes in the GOP are worsening the HIV/AIDS epidemic.
The Republican Party at the state and national levels has long been an enemy of LGBT rights. Many right-wingers see HIV and AIDS as a punishment from God, so having the disease creates a stigma and barrier to adequate treatment.
12. Trump’s white nationalism is worsening the epidemic for black Americans — the population hit hardest.
Last year the CDC, using the first comprehensive national estimates of lifetime risk of HIV for several key populations, predicted that if current rates continue, one in two African-American gay and bisexual men will have contracted the virus. That compares with a lifetime risk of one in 99 for all Americans and one in 11 for white gay and bisexual men. To offer more perspective: Swaziland, a tiny African nation, has the world’s highest rate of HIV, at 28.8 percent of the population. If gay and bisexual African-American men made up a country, its rate would surpass that of this impoverished African nation — and all other nations. Read more in The New York Times.
13. The wife of Trump’s ex-health secretary wants to “quarantine” people with HIV.
“What are we legally able to do? I don’t want to say the 'quarantine' word, but I guess I just said it,” said Betty Price, wife of Tom Price, Donald Trump’s former Health and Human Services secretary, in a video of a study committee meeting on barriers to adequate health care.
“Is there an ability, since I would guess that public dollars are expended heavily in prophylaxis and treatment of this condition, so we have a public interest in curtailing the spread,” she said. “Are there any methods, legally, that we could do that would curtail the spread?” Read more in The Guardian.
14. The anti-science GOP is worsening HIV/AIDS in America.
If Reagan was remembered for his inaction on the plague, the Trump administration may be remembered for explicitly dismantling the AIDS safety net and for enacting anti-LGBT policies that will make the virus move more freely between people.
Troublingly, Vice President Mike Pence believes in abstinence-only education, which is known to foster higher rates of sexually transmitted infections. And Pence wrote in 2002 that “Congress should support the reauthorization of the Ryan White Care Act,” the main federal support for combating HIV and AIDS, “only after completion of an audit to ensure that federal dollars were no longer being given to organizations that celebrate and encourage the types of behaviors that facilitate the spreading of the HIV virus.” Read more in The Guardian.
15. Trump’s ongoing crusade against undocumented Latino and Hispanic Americans is killing them.
According to the CDC, Latinos represent approximately 17 percent of the U.S. population but account for an estimated 21 percent of people living with HIV (263,900 in 2013) and an estimated 24 percent of all people with newly diagnosed infections.
16. Trump’s vow to repeal Obamacare will worsen the AIDS epidemic.
Under current law, health care providers can no longer refuse coverage to those with preexisting conditions — and that includes HIV.
Moreover, Section 1557 of Obamacare prohibits health care providers and insurers from discriminating on the basis of gender. The Obama administration has issued a rule interpreting that provision to ban discrimination in health care against gender-nonconforming and transgender people, including for the purposes of transition-related care and gender-affirmation surgery. Another rule ensures that low-income people with HIV or AIDS can obtain lifesaving medication.
These protections from discriminations may disappear, however, if Trump succeeds in his promise of dismantling the Affordable Care Act.
17. Pre-exposure prophylaxis (PrEP) is one of the most valuable tools we have to end AIDS.
PrEP, the daily dosage of a medication, is up to 99 percent effective at preventing HIV when taken by HIV-negative folks. Experts have said it has already helped reduce HIV rates in San Francisco, New York, and London. Truvada is so far the only drug approved for use as PrEP. To learn more about PrEP, click here.
18. Treatment as prevention is another — leading the CDC to agree this year that Undetectable=Untransmissable.
When you’re undetectable, meaning the HIV in your system cannot be detected by common tests, you are unable to transmit the virus. Not only are you the healthiest you can be with HIV, you are also a key part of the prevention of its spread. The less people have access to lifesaving medication, the greater the spread of the virus becomes. To learn more, click here.
19. Abstinence programs don’t work in cutting down pregnancy (or HIV) — yet Trump has funded them and slashed sex education.
In August, Trump abruptly cut funding to the Obama-era Teen Pregnancy Prevention Program, which gave $89 million a year to 81 organizations across the United States to prevent teen pregnancies in states with above-average rates.
20. Young people are at risk for HIV.
CDC: In 2015 youth ages 13 to 24 accounted for 22 percent of all new HIV diagnoses in the U.S. Most new diagnoses occur among gay and bi men. Young gay and bi men of color are especially affected. All this should reveal a striking truth: HIV prevention efforts aren’t reaching young men having sex with men, who are extremely at risk of new infection and are least likely of any age group to be linked to care with a suppressed viral load (vital to staying healthy with HIV). LGBT erasure in national dialogue about HIV will make these numbers worse.
21. Those who use needles are at risk for HIV — as Vice President Mike Pence knows well.
As governor of Indiana, Vice President Mike Pence dragged his feet lifting a ban on needle exchange programs in his state following one of the biggest outbreaks of HIV in decades in 2015, with more than 20 new cases being diagnosed every week at its height. Only after pressure did he cave to a partial lifting — which many health workers on the ground felt was ineffective. Pence is a deeply religious man with clear conservative, antigay views — he’s also the one who suggested defunding the Ryan White CARE Act, which has allowed countless HIV-positive people (including me) to get in care, and using its federal funds for dangerous “gay conversion therapy.” Read more here.