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Obama vs. Bush: Who’s done more on HIV/AIDS?

Lifting of HIV travel ban initiated by previous administration

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Who’s done more on HIV/AIDS: George W. Bush or President Obama? (Bush photo public domain; Obama photo Blade photo by Michael Key)

HIV/AIDS advocates from around the world are descending on D.C. for the 19th International AIDS Conference with a shared goal: to eliminate a disease that has taken the lives of more than 25 million people worldwide.

Despite unity on this goal, politics inevitably plays a role in the response to the epidemic and advocates have widely differing views on who has done more in recent years to combat HIV/AIDS both at home and abroad: former President George W. Bush or President Obama.

Some praise the Obama administration for laying out a comprehensive plan and bumping up domestic funding to confront the epidemic, while others yearn for the Bush days because of the global initiatives the Republican president started despite his reputation for anti-gay policies.

Jim Driscoll, a gay Nevada-based HIV/AIDS activist who served on the Presidential Advisory Council on HIV/AIDS during the Bush administration, is among those who believes Bush did more to stop the epidemic.

“I never sat down and had a one-on-one conversation with him, but people who did talked about how open he was to doing things on AIDS and how interested he was in that subject,” Driscoll said. “There wasn’t anything the community asked him to do that I was involved in that he didn’t do.”

Those who say Bush has done more for HIV/AIDS identified three major initiatives under the Bush administration: the start of a program called the President’s Emergency Plan for AIDS Relief, or PEPFAR, to confront the global AIDS epidemic; streamlining fund allocation under the Ryan White Care Act to consider people who have HIV infection without full-blown AIDS; and allowing the first-ever rapid HIV tests to be used outside medical offices.

Driscoll, a Republican who’s backing GOP presumptive nominee Mitt Romney in the upcoming presidential election, recalled the process by which Bush approved rapid testing and said it was praised by many — with the exception of some Food & Drug Administration officials whom he overruled.

“It was a big step forward, and George Bush actually personally had a lot to do with that,” Driscoll said. “The president actually overruled FDA, and I was in the room when this was announced. There were about 100 people in the room, I think. I remember still that when he announced his approval of rapid testing … everybody in the room gave him a standing ovation except for the three people from FDA, who sat glumly. They didn’t applaud or anything.”

The AIDS Drug Assistance Programs under Bush didn’t see the waiting list levels that have been seen under the Obama administration. Under Obama, the waiting list last year reached an all-time high of 9,928 low-income people awaiting HIV drugs. That number has since dropped to about 2,000 today, according to the administration.

That’s not the only complaint that’s been lodged against Obama, who’s been criticized for reducing the global AIDS program that was set up by Bush. In his most recent budget request to Congress, the White House cut the program by half a billion dollars.

Michael Weinstein, president of the AIDS Healthcare Foundation, said HIV/AIDS was a “higher priority” for Bush than it is for Obama, citing the ADAP waiting list and the distinction in PEPFAR as a key difference between the presidents.

“We had practically no global AIDS program prior to President Bush taking office, and before he left office, they approved a $48 billion plan for PEPFAR, which Sen. Obama voted to authorize and enact,” Weinstein said. “This year, President Obama for the first time in the history of the program asked for less money for global AIDS than we had last year, and there’s $1.4 billion in unspent money in PEPFAR.”

However, the president’s most recent budget request includes an increase for domestic programs against HIV/AIDS: a $75 million increase for Ryan White and an increase of $67 million for ADAP from last year to eliminate waiting lists by 2013.

As for PEPFAR, the White House has maintained that the program is doing more with less by using generic drugs and shipping commodities more cheaply. On World AIDS Day, Obama announced he would fully fund the balance of the administration’s three-year, $4 billion pledge to the Global Fund to Fight AIDS, Tuberculosis, and Malaria.

Shin Inouye, a White House spokesperson, defended the administration’s work on HIV/AIDS by citing achievements as well as plans set into motion to confront the epidemic.

“President Obama and his administration are unwavering in their commitment to addressing the issue of HIV/AIDS — on both the domestic and global fronts,” Inouye said. “These include steps such as establishing and implementing the first comprehensive National HIV/AIDS Strategy, lifting the HIV entry ban, and strengthening the impact and sustainability of PEPFAR and the Global Fund to Fight AIDS, Tuberculosis, and Malaria.”

Obama’s signature legislative achievement, the Affordable Care Act, is also slated to have significant impact on people living with HIV. The Medicaid expansion under the health care reform law is expected to significantly expand coverage because half the people living with HIV already receive care through the program.

Carl Schmid, deputy executive director of the AIDS Institute, said Obama has “definitely” done more on HIV/AIDS — at least on the domestic front — in part because of his willingness to talk about how the disease impacts gay men.

“They are over 60 percent of the epidemic,” Schmid said. “Focusing on this community that has been ravaged by HIV, allowing a discussion and making gay people more acceptable — this could really turn the tide on HIV prevention for gay men. We have a president who is focusing on the community [and directing] resources that are more in line with how the epidemic is.”

In comparison, Bush took flak from HIV/AIDS advocates for not taking action on the epidemic in ways that might upset his conservative base. Among his actions: promoting abstinence-only sex education, opposing federal funds for needle exchange programs and remaining silent on gay men and condoms for much of his administration.

Michael Rajner, a gay Fort Lauderdale-based HIV/AIDS advocate who’s living with AIDS and has been selected as a delegate for the Democratic National Convention, said he thinks Obama has “absolutely” done more to fight HIV/AIDS based on a more science-based approach he’s taken against the disease.

“The difference between Republican and Democrat — in this case, George W. Bush and President Obama — is really the difference in thought, whether they’re going to be addressing HIV/AIDS through ideology or through science, and President Obama has certainly embraced the issues of science,” Rajner said.

One achievement often attributed to Obama is the lifting of the regulatory travel ban that prevented HIV-positive foreign nationals from entering the country — a move that enabled the International AIDS Conference to take place in the United States. But this process actually started under the Bush administration. Under Bush’s leadership, Congress repealed a law that barred HIV-positive foreign nationals from entering as part of the legislative package authorizing PEPFAR.

Schmid said he was “intimately involved” in the process under which Bush starting lifting the HIV travel ban.

“Credit goes to George Bush’s administration and the Congress for lifting the travel ban in reauthorization of PEPFAR,” Schmid said. “There still was a process at HHS, and Obama finished that process. It wasn’t completed in time, unfortunately, under President Bush, but they definitely lifted it congressionally.”

Driscoll said Bush should be commended because he accomplished work on HIV/AIDS despite being beholden to social conservatives who elected him to office.

“Every president, every politician is limited by his constituents, by the people who put him in office, who voted for him and the people he would depend upon to do the same thing should he run again,” Driscoll said. “You have to consider what a president does in terms of the limitations that are imposed. I think, given, the limitations that George Bush’s constituencies imposed, he showed real leadership.”

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National

Top 10 LGBTQ national news stories of 2025

Trump, Supreme Court mount cruel attacks against trans community

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(Washington Blade photos by Michael Key)

President Trump’s anti-LGBTQ agenda dominated national news in 2025, particularly his cruel attacks on trans Americans. Here are our picks for the top 10 LGBTQ news stories the Blade covered in 2025.

10. Trump grants clemency to George Santos

George Santos (Washington Blade photo by Michael Key)

President Donald Trump granted clemency to disgraced former Long Island Rep. George Santos. Santos was sentenced to 87 months in federal prison after pleading guilty to wire fraud and aggravated identity theft and had served just 84 days of his more than seven-year sentence. He lied to both the DOJ and the House Ethics Committee, including about his work and education history, and committed campaign finance fraud.

9. U.S. Olympics bans trans women athletes  

The United States Supreme Court decided in 2025 to take up two cases — Little v. Hecox and West Virginia v. B.P.J.— both of which concern the rights of transgender athletes to participate on sports teams. The cases challenge state laws under the Equal Protection Clause of the 14th Amendment, which prevents states from offering separate boys’ and girls’ sports teams based on biological sex determined at birth. Both cases are set to be heard in January 2026. The developments follow a decision by the United States Olympic & Paralympic Committee to change eligibility rules to prohibit transgender women from competing in women’s sporting events on behalf of the United States, following Trump’s Executive Order 14201, “Keeping Men Out of Women’s Sports.”

8. FDA approves new twice-yearly HIV prevention drug

The U.S. Food and Drug Administration on June 18 approved a newly developed HIV/AIDS prevention drug that needs to be taken only twice a year, with one injection every six months. The new drug, lenacapavir, is being sold under the brand name Yeztugo by pharmaceutical company Gilead Sciences. According to trial data, 99.9 percent of participants who received Yeztugo remained HIV negative. This emerging technology comes amid direct cuts to HIV/AIDS research measures by the Trump–Vance administration, particularly targeting international HIV efforts such as PEPFAR. 

7. LGBTQ people erasedfrom gov’t reports

Politico reported in March that the Trump–Vance administration is slashing the State Department’s annual human rights report, cutting sections related to the rights of women, people with disabilities, the LGBTQ+ community, and more. Members of Congress objected to the removal of the subsection on “Acts of Violence, Criminalization, and Other Abuses Based on Sexual Orientation, Gender Identity or Expression, or Sex Characteristics (SOGIESC)” from the State Department’s Annual Country Reports on Human Rights Practices.

In a Sept. 9 letter to Secretary of State Marco Rubio, U.S. Reps. Robert Garcia (D-Calif.), Julie Johnson (D-Texas), and Sarah McBride (D-Del.) urged the department to restore the information or ensure it is integrated throughout each report, noting that the reports serve as key evidence for asylum seekers, attorneys, judges, and advocates assessing human rights conditions and protection claims worldwide.

6. Trump admin redefines ‘sex’ in all HHS programs

President Trump took office in January and immediately unleashed a torrent of attacks on trans Americans. (Blade photo by Michael Key)

The Trump administration canceled more than $800 million in research into the health of sexual and gender minority groups. More than half of the National Institutes of Health grants scrapped through early May involved studies of cancers and viruses that disproportionately affect LGBTQ people.

The administration is also pushing to end gender-affirming care for transgender youth, according to a new proposal from the Department of Health and Human Services, NPR reported. The administration is considering blocking all Medicaid and Medicare funding for services at hospitals that provide pediatric gender-affirming care. “These rules would be a significant escalation in the Trump administration’s attack on access to transgender health care,” said Katie Keith, director of the Center for Health Policy and Law at Georgetown University.

5. FBI plans to label trans people as violent extremists

The Human Rights Campaign, Transgender Law Center, Equality Federation, GLAAD, PFLAG, and the Southern Poverty Law Center condemned reports that the FBI, in coordination with the Heritage Foundation, may be working to designate transgender people as “violent extremists.” The concerns followed a report earlier this month by independent journalist Ken Klippenstein, who cited two anonymous national security officials saying the FBI is considering treating transgender subjects as a subset of a new threat category.

That classification—originally created under the Biden administration as “Anti-Authority and Anti-Government Violent Extremists” (AGAAVE) — was first applied to Jan. 6 rioters and other right-wing extremists. Advocates said the proposal appears to stem from the false claim that the assassination of Charlie Kirk was committed by a transgender person.

4. Pentagon targets LGBTQ service members

Defense Secretary Pete Hegseth undertook a series of actions targeting LGBTQ service members in 2025. (Blade photo by Michael Key)

Acting in agreement with the growing anti-LGBTQ sentiment from the Trump administration, during a televised speech to U.S. military leaders at Marine Corps Base Quantico in late September, Defense Secretary Pete Hegseth denounced past military leadership for being too “woke,” citing DEI initiatives and LGBTQ inclusion within the Department of Defense. During the 45-minute address, Hegseth criticized inclusive policies and announced forthcoming directives, saying they would ensure combat requirements “return to the highest male standard only.”

Since 2016, a Navy replenishment oiler had borne the name of gay rights icon Harvey Milk, who served in the Navy during the Korean War and was separated from service under other than honorable conditions due to his sexuality before later becoming one of the first openly LGBTQ candidates elected to public office. In June 2025, the ship was renamed USNS Oscar V. Peterson.

The U.S. Air Force also announced that transgender service members who have served between 15 and 18 years would be denied early retirement and instead separated from the military without benefits. Transgender troops will be given the option of accepting a lump-sum payout offered to junior service members or being removed from service.

In February, the Pentagon said it would draft and submit procedures to identify transgender service members and begin discharging them from the military within 30 days.

3. Trump blames Democrats, trans people for gov’t shutdown

Republicans failed to reach an agreement with Democrats and blamed them for the government shutdown, while Democrats pointed to Republicans for cutting health care tax credits, a move they said would result in millions of people paying significantly higher monthly insurance premiums next year. In the White House press briefing room, a video of Democrats discussing past government shutdowns played on a loop as the president continued to blame the Democratic Party and “woke” issues, including transgender people.

“A lot of good can come from shutdowns. We can get rid of a lot of things. They’d be Democrat things,” Trump said the night before the shutdown. “They want open borders. Men playing in women’s sports. They want transgender for everybody.”

2. Supreme Court joins attacks on LGBTQ Americans

(Washington Blade photo by Michael Key)

The U.S. Supreme Court issued multiple rulings this year affecting LGBTQ people. In Mahmoud v. Taylor (6–3), it ruled that public schools must give parents advance notice and the option to opt children out of lessons on gender or sexuality that conflict with their religious beliefs. The case arose after Montgomery County, Md., schools added LGBTQ-inclusive storybooks to the elementary curriculum.

In June, the court upheld Tennessee’s ban on gender-affirming care for transgender minors, protecting similar laws in more than 20 states. Lawmakers and advocates criticized the ruling, and a coalition of seven medical associations warned it strips families of the right to direct their own health care.

The Court also allowed the Trump administration to enforce a ban on transgender military personnel and to implement a policy blocking passports with “X” gender markers, with the federal government recognizing only male and female designations.

1. Trump inaugurated for second time

President Donald Trump became the 47th president after winning Wisconsin, securing 277 of the 270 electoral votes needed. His guidebook, Project 2025, outlined the Republican Party’s goals under his new leadership, with a particular focus on opposing transgender rights.

Trump nominated openly gay hedge fund executive Scott Bessent as U.S. Treasury Secretary, a role he eventually assumed. Bessent became the highest-ranking openly gay U.S. government official in American history.

U.S. Treasury Secretary Scott Bessent (Washington Blade photo by Michael Key)

Honorable mention: The war on rainbow crosswalks escalates around the country

Florida Gov. Ron DeSantis (R) ordered state transportation officials to remove a rainbow-colored crosswalk in Orlando next to the Pulse gay nightclub, where 49 mostly LGBTQ people were killed in a 2016 mass shooting. The move follows a July 1, 2025, announcement by U.S. Transportation Secretary Sean Duffy that, with support from President Trump, the department adopted a “nationwide roadway safety initiative” that political observers say could be used to require cities and states to remove rainbow street crosswalks.

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Federal Government

Holiday week brings setbacks for Trump-Vance trans agenda

Federal courts begin to deliver end-of-year responses to lawsuits involving federal transgender healthcare policy.

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While many Americans took the week of Christmas to rest and relax, LGBTQ politics in the U.S. continued to shift. This week’s short recap of federal updates highlights two major blows to the Trump-Vance administration’s efforts to restrict gender-affirming care for minors.

19 states sue RFK Jr. to end gender-affirming care ban

New York Attorney General Letitia James announced on Tuesday that the NYAG’s office, along with 18 other states (and the District of Columbia), filed a lawsuit to stop U.S. Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. from restricting gender-affirming care for minors.

In the press release, Attorney General James stressed that the push by the Trump-Vance administration’s crusade against the transgender community — specifically transgender youth — is a “clear overreach by the federal government” and relies on conservative and medically unvalidated practices to “punish providers who adhere to well-established, evidence-based care” that support gender-affirming care.

“At the core of this so-called declaration are real people: young people who need care, parents trying to support their children, and doctors who are simply following the best medical evidence available,” said Attorney General James. “Secretary Kennedy cannot unilaterally change medical standards by posting a document online, and no one should lose access to medically necessary health care because their federal government tried to interfere in decisions that belong in doctors’ offices. My office will always stand up for New Yorkers’ health, dignity, and right to make medical decisions free from intimidation.”

The lawsuit is a direct response to HHS’ Dec. 18 announcement that it will pursue regulatory changes that would make gender-affirming health care for transgender children more difficult, if not impossible, to access. It would also restrict federal funding for any hospital that does not comply with the directive. KFF, an independent source for health policy research, polling, and journalism, found that in 2023 federal funding covered nearly 45% of total spending on hospital care in the U.S.

The HHS directive stems directly from President Donald Trump’s Jan. 28 Executive Order, Protecting Children From Chemical and Surgical Mutilation, which formally establishes U.S. opposition to gender-affirming care and pledges to end federal funding for such treatments.

The American Medical Association, the nation’s largest and most influential physician organization, has repeatedly opposed measures like the one pushed by President Trump’s administration that restrict access to trans health care.

“The AMA supports public and private health insurance coverage for treatment of gender dysphoria and opposes the denial of health insurance based on sexual orientation or gender identity,” a statement on the AMA’s website reads. “Improving access to gender-affirming care is an important means of improving health outcomes for the transgender population.”

The lawsuit also names Oregon, Washington, California, Colorado, Connecticut, Delaware, the District of Columbia, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, New Mexico, Pennsylvania, Rhode Island, Vermont, and Wisconsin as having joined New York in the push against restricting gender-affirming care.

At the HHS news conference last Thursday, Jim O’Neill, deputy secretary of the department, asserted, “Men are men. Men can never become women. Women are women. Women can never become men.”

DOJ stopped from gaining health care records of trans youth

U.S. District Judge Cathy Bissoon blocked an attempt by the Department of Justice (DOJ) to gain “personally identifiable information about those minor transgender patients” from the University of Pittsburgh Medical Center (UPMC), saying the DOJ’s efforts “fly in the face of the Supreme Court.”

Journalist Chris Geidner originally reported the news on Dec. 25, highlighting that the Western District of Pennsylvania judge’s decision is a major blow to the Trump-Vance administration’s agenda to curtail transgender rights.

“[T]his Court joins the others in finding that the government’s demand for deeply private and personal patient information carries more than a whiff of ill intent,” Bissoon wrote in her ruling. “This is apparent from its rhetoric.”

Bissoon cited the DOJ’s “incendiary characterization” of trans youth care on the DOJ website as proof, which calls the practice politically motivated rather than medically sound and seeks to “…mutilate children in the service of a warped ideology.” This is despite the fact that a majority of gender-affirming care has nothing to do with surgery.

In United States v. Skrmetti, the Supreme Court ruled along party lines that states — namely Tennessee — have the right to pass legislation that can prohibit certain medical treatments for transgender minors, saying the law is not subject to heightened scrutiny under the Equal Protection Clause of the Fourteenth Amendment because it does not involve suspect categories like race, national origin, alienage, and religion, which would require the government to show the law serves a compelling interest and is narrowly tailored, sending decision-making power back to the states.

“The government cannot pick and choose the aspects of Skrmetti to honor, and which to ignore,” Judge Bissoon added.

The government argued unsuccessfully that the parents of the children whose records would have been made available to the DOJ “lacked standing” because the subpoena was directed at UPMC and that they did not respond in a timely manner. Bissoon rejected the timeliness argument in particular as “disingenuous.”

Bissoon, who was nominated to the bench by then-President Obama, is at least the fourth judge to reject the DOJ’s attempted intrusion into the health care of trans youth according to Geidner.

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Israel

A Wider Bridge to close

LGBTQ Jewish group said financial challenges prompted decision

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U.S. Rep. Debbie Wasserman Schultz (D-Fla.) speaks at the Capital Jewish Museum in D.C. on June 5, 2025, after A Wider Bridge honored her at its Pride event. A Wider Bridge has announced it will shut down. (Washington Blade photo by Michael K. Lavers)

A Wider Bridge on Friday announced it will shut down at the end of the month.

The group that “mobilizes the LGBTQ community to fight antisemitism and support Israel and its LGBTQ community” in a letter to supporters said financial challenges prompted the decision.

“After 15 years of building bridges between LGBTQ communities in North America and Israel, A Wider Bridge has made the difficult decision to wind down operations as of Dec. 31, 2025,” it reads.

“This decision comes after challenging financial realities despite our best efforts to secure sustainable funding. We deeply appreciate our supporters and partners who made this work possible.”

Arthur Slepian founded A Wider Bridge in 2010.

The organization in 2016 organized a reception at the National LGBTQ Task Force’s Creating Change Conference in Chicago that was to have featured to Israeli activists. More than 200 people who protested against A Wider Bridge forced the event’s cancellation.

A Wider Bridge in 2024 urged the Capital Pride Alliance and other Pride organizers to ensure Jewish people can safely participate in their events in response to an increase in antisemitic attacks after Hamas militants attacked Israel on Oct. 7, 2023.  

The Jewish Telegraphic Agency reported authorities in Vermont late last year charged Ethan Felson, who was A Wider Bridge’s then-executive director, with lewd and lascivious conduct after alleged sexual misconduct against a museum employee. Rabbi Denise Eger succeeded Felson as A Wider Bridge’s interim executive director.

A Wider Bridge in June honored U.S. Rep. Debbie Wasserman Schultz (D-Fla.) at its Pride event that took place at the Capital Jewish Museum in D.C. The event took place 15 days after a gunman killed two Israeli Embassy employees — Yaron Lischinsky and Sarah Milgrim — as they were leaving an event at the museum.

“Though we are winding down, this is not a time to back down. We recognize the deep importance of our mission and work amid attacks on Jewish people and LGBTQ people – and LGBTQ Jews at the intersection,” said A Wider Bridge in its letter. “Our board members remain committed to showing up in their individual capacities to represent queer Jews across diverse spaces — and we know our partners and supporters will continue to do the same.”

Editor’s note: Washington Blade International News Editor Michael K. Lavers traveled to Israel and Palestine with A Wider Bridge in 2016.

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