National
‘HIV will never be curable,’ doctor tells forum
“Get tested, listen to the experts, and lead the responsible life,” declared Michael Pistole, the sexagenarian sexologist and sometime wisecracking medical doctor speaking at a meeting on surviving the AIDS and hepatitis C viruses.
“Hepatitis C can be cured, but HIV will never be curable, since it gets into your DNA,” Pistole said.
Speaking before a group of about 100 doctors, nurses, patients and other community members gathered at the Hotel Palomar for dinner and a “Survival Forum,” Pistole summed up his message of safer sex this way: “Realize it’s not just you, it’s the rest of the world.”
Pistole’s message was punctuated by quips and risqué double-entrendres, to put people at ease and lighten the serious message about how exposure to HIV is still a real fear, while peppering the audience with sobering facts and figures underscoring that reality.
“Yes, it’s a controllable situation — with antiretroviral drugs — and you can live a normal lifespan, long enough in fact to die from something else, but we have to accept the fact that [HIV is] just like herpes, that will also never be cured, and you can’t take a vaccine for the common cold either.”
As for a vaccine to prevent exposure, he said, “I’d like to think we could get a vaccine for HIV but with the complexity of the virus, I’m not sure.” Hepatitis B, for example, has a vaccine, he pointed out, but hepatitis C does not.
As his slideshow continued, the audience could literally read the writing on the wall — currently 1.1 million adults and adolescents exposed to the virus in this country, with pockets of greater exposure according to race, ethnicity and gender.
For example, per 100,000 people in the U.S. in 2006, the most recent year for such data, there were an estimated 395 white males and 63 females exposed to the virus, compared to 2,388 African-American males and 1,122 females, and 883 Hispanic males and 263 females. Exposure rates per 100,000 people were estimated for 2006 at 220 among Asian males and 46 females and 340 American Indian and Alaska Native males and 127 females.
Pistole, 64, is an internal medicine specialist in private practice in the Washington, D.C., metropolitan area where he has been caring for HIV and hepatitis C patients since 1982. Exposure to the viruses continues, said Pistole, with risky sexual behavior rampant now in cities like D.C. where the incidence of virus carriers is skyrocketing, especially among African Americans.
According to Pistole, of total new infections recorded in 2006, 46 percent were African American, 36 percent were white, and 18 percent Hispanic, with approximately the same such proportions for men, but strikingly for women it was 61 percent African American versus 23 percent white. The highest risk factors remain IV drug use and male-to-male sexual contact, which had been decreasing as a cause of exposure but is now edging up again, said Pistole.
Among his other observations is what he called the antiviral “drug of the month” phenomenon, spurring some patients to say, “I want to try it,” something Pistole said should be discouraged by doctors.
Following his address, Pistole took questions and comments from the audience, including a memorable exchange with Michael Sainte-Andress, a 60-year-old resident of Logan Circle diagnosed with HIV in 1986.
“It’s very important to develop empowerment,” Sainte-Andress said. “You are the captain of your ship and everyone else on board is a deck hand.”
Pistole replied that “the doctor is not the captain of your ship, but he can be a little bit more than a deckhand. He can be on board as your engineer.”
Sainte-Andress is a local actor who recently played the role of Leonato in the Folger Theatre production of “Much Ado About Nothing.”
The event was sponsored by Peter Metaxotos, sole proprietor of Alpha Drugs, the Dupont Circle pharmacy at 1638 R Street, N.W., Suite 260. The next such forum, Survival Forum VIII, will be held in January with a transgender summit planned for March.
National
Anti-trans visa ruling echoes Nazi regime destroying trans documents
Trump administration escalates attacks on queer community
The Lemkin Institute for Genocide Prevention and Human Security earlier this month released its third Red Flag Alert for the United States about the Trump administration’s anti-trans legislation. As the Lemkin Institute shared in the press release, “the Administration has moved from identifying transgender people as as threat to the family and to the nation’s military prowess to claiming that transgender people constitute a cosmic threat to the spiritual health of the nation and the great direct threat to the US national security in the world.”
The news came the same day that the State Department issued a new rule, “Enhancing Vetting and Combatting Fraud in the Immigrant Visa Program.” Under this new guidance, all visa applicants are required to disclose their “biological sex at birth” during all stages of the process, “even if that differs from the sex listed on the applicant’s foreign passport or identifying documentation.”
This rule also orders that applicants to the green card lottery program share their passport information, so in knowingly collecting passport information that the agency knows will not match a person’s biological sex at birth, it’s creating grounds to deny trans peoples’ biases on the basis of “fraud,” Aleksandra Vaca of Transitics explains.
As is written in the new ruling, “the Department is replacing ‘gender’ with ‘sex’ in accordance with E.O. 14168, Defending Women From Gender Ideology Extremism and Restoring Biological Truth to the Federal Government, which provides that the term ‘sex’ shall refer to an individual’s sex at birth. Only male and female sex options are available for entrants completing the Diversity Visa entry form.”
Along with outright denying the existence of nonbinary, genderqueer and gender expansive people, this policy creates a precedence for trans people to be stripped of their visas and deported because under 8 U.S.C. § 1182(a)(6)(C)(i), any foreigner found to have obtained or possess a visa “by fraud or willfully misrepresenting a material fact” will have their visa revoked and face deportation.
By requesting information on “biological sex at birth,” the State Department is forcing a mismatch between documents and enabling officials to accuse trans, nonbinary, and gender expansive immigrants of fraud. Thus, trans and nonbinary immigrants can have their visas revoked and can be deported, and information gathered from immigrants during the visa request process can be added to federal databases and used by immigration authorities, including ICE agents.
With the Supreme Court’s decision this past year allowing ICE officers to use racial profiling, Vaca argues that “now, The Trump administration has given ICE the reason it needs. Under this rule, ICE agents now have the enforcement rationale to assert that trans people–especially those belonging to racial minority groups–are more likely than cis people to have ‘misrepresented’ themselves during the visa process, and therefore, are more likely to enter the country ‘unlawfully.’”
This would enable ICE agents to target trans individuals specifically for being trans. If the goal of this were unclear, a day later the Trump administration released its statement for Women’s History Month 2026, writing that “we are keeping men out of women’s sports, enforcing Title IX as it was originally written and ensuring colleges preserve–and, where possible, expand–scholarships and roster opportunities for female athletes. We are restoring public safety and upholding the rule of law in every city so women, children, and families can feel safe and secure.”
And this is not the first time that ICE has targeted and harmed trans and nonbinary immigrants. Last June, Vera reported that ICE is not including trans people in detection in their public reports, and back in 2020, AFSC reported that trans people held in ICE detention faced “dreadful, ugly” conditions.
While it seems like a new development in Trump’s anti-trans escalation, it echoes a deeply upsetting history of denying and destroying transgender people’s documents following members of the Nazi party seizing power in 1933.
In the early 20th century, Weimar, Germany was an epicenter for gender affirming care with Maganus Hirschfeld’s Institute for Sexual Science. One of the first book burnings of the rising Nazi regime destroyed the Institute’s extensive clinical records and library on trans health and history by Nazi students and stormtroopers. In doing so, the Nazis effectively destroyed the world’s first trans health clinic and one of the richest and most comprehensive collective of information about trans healthcare.
Similarly, the Nazi government invalidated or refused to recognize what was called “transvestite passes,” or passing certificates that allowed trans people to avoid arrest under Paragraph 175 which prohibited cross-dressing. During the Weimar Republic — the regime that preceded the Third Reich — recognized and affirmed the identities of trans people (in limited ways) with specific documentation that helped prevent them from arrest. Invalidating and disregarding these passes allowed police and Nazi officials to target trans people and harass, extort and arrest them, and the record of passes themselves helped officials target trans people.
The changes to visa guidelines — alongside Kansas’s move to revoke trans drivers’ licenses last month — is reflective of this escalation of violence against trans people during the Nazi’s rise to power, which scholars like Dr. Laurie Marhoefer is just beginning to uncover. And along with the revocation of identification documents this past week, a recent Fourth Circuit Court ruled that states can deny Medicaid coverage for gender-affirming surgery.
The Fourth Circuit Court decision affirmed the Supreme Court’s decision in Skrmetti, which ruled that bans on gender affirming healthcare for young people are constitutional. This ruling extends this ban to include adult healthcare bans, allowing West Virginia’s exclusion of Medicaid coverage for adult gender affirming healthcare to take full effect. Even more upsetting was what the ruling itself said, calling gender affirming healthcare “dangerous.”
As was written in the Fourth Circuit Opinion, “it’s not irrational for a legislature to encourage citizens ‘to appreciate their sex’ and not ‘become disdainful of their sex’ by refusing to fund experimental procedures that may have the opposite effect.”
In reality, what this ruling and the opinion reflect, is the next step in government regulation and oversight over marginalized peoples’ bodies. From the overturn of Roe v. Wade, which removed federal protection of access to abortion, this next step represents the denial of people’s access to vital, lifesaving care–and to be clear, gender affirming care is not just for trans, nonbinary, and intersex people. It’s a dangerous escalation and one that echoes previous violence against trans people under fascist regimes; the Lemkin Institute is right to raise concern.
Pennsylvania
Pa. House passes bill to codify marriage equality in state law
Governor supports gay state Rep. Malcolm Kenyatta’s measure
The Pennsylvania House of Representatives on Wednesday passed a bill that would codify marriage equality in state law.
House Bill 1800 passed by a 127-72 vote margin. Twenty-six Republicans voted for the measure.
The Republican-controlled Pennsylvania Senate will now consider the bill that state Rep. Malcolm Kenyatta (D-Philadelphia), who is the first openly gay person of color elected to the state’s General Assembly, introduced. Democratic Gov. Josh Shapiro supports the measure.
“Here in Pennsylvania, we believe in your freedom to marry who you love,” said Shapiro on Wednesday. “Today, the House has stepped up to protect that right.”
BREAKING: The Pennsylvania House just passed @RepKenyatta's bill to codify marriage equality into law in PA — and they did it with broad bipartisan support.
— Governor Josh Shapiro (@GovernorShapiro) March 25, 2026
Here in Pennsylvania, we believe in your freedom to marry who you love. Today, the House has stepped up to protect that…
Florida
DeSantis signs emergency bill that restores Fla. ADAP funding
Temporary funds to last through June 30
After the Florida Department of Health made huge cuts to the AIDS Drug Assistance Program in January, Republican Gov. Ron DeSantis has signed emergency legislation restoring HIV access to more than 12,000 Floridians.
Two months ago, as the Washington Blade reported, the Sunshine State cut the vast majority of those in ADAP by shifting the income levels required for eligibility — without following standard procedure when changing government policy outside of legislative or executive action.
The bill, signed by DeSantis on Tuesday, passed both chambers of the Florida Legislature unanimously and appropriates $30.9 million in emergency bridge funding through June 30, 2026. It restores Florida’s ADAP income eligibility to 400 percent of the Federal Poverty Level — the level it was prior to the January cuts. The legislation also requires the FDOH to submit detailed monthly financial reports to legislative leadership beginning April 1.
Under the old policy, eligibility would have been limited to those making no more than 130 percent of the federal poverty level, or $20,345 per year.
“For 10 weeks, 12,000 Floridians living with HIV did not know if they could fill their next prescription. Today, they can,” Esteban Wood, director of advocacy and legislative affairs at AIDS Healthcare Foundation, said in a statement.
The detailed reports now required to be sent to legislative leadership must include all federal revenues and expenditures, including manufacturer rebates; enrollment figures by county and insurance status; prescription utilization by drug class; and any projected funding shortfalls. This is the first time the Legislature has required this level of financial transparency from the program.
DeSantis signed the legislation one day after a Leon County Circuit Court judge denied AIDS Healthcare Foundation’s request for an injunction to block the significant changes the DeSantis administration is making to the program, which it claims faces a $120 million shortfall for calendar year 2026.
AIDS Healthcare Foundation, a national organization focused on protecting and expanding HIV healthcare access and prevention methods, filed a lawsuit over the change in eligibility, arguing the Florida Department of Health did not follow the laid out path for formally changing policy and was acting outside established procedures.
Typically, altering eligibility for a statewide program requires either legislative action or adherence to a multistep rule-making process, including: publishing a Notice of Proposed Rule; providing a statement of estimated regulatory costs; allowing public comment; holding hearings if requested; responding to challenges; and formally adopting the rule. According to AIDS Healthcare Foundation, none of these steps occurred.
The long-term structure of ADAP will be determined by the 2026–2027 fiscal year state budget, something that lawmakers have until June 30 to finish.
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