Opinions
The aging face of HIV
Within a few years, half with the disease will be 50 or older
By DANIEL TIETZ
As we convene from around the world to discuss the future of HIV prevention and treatment here in Washington, we must recognize that AIDS is not confined to young people. Thanks to improved anti-retroviral drugs, HIV is increasingly a chronic, manageable disease for those with access to care and treatment. The CDC has estimated that within the next few years more than half of all Americans with HIV will be age 50 or older. In New York City alone, as of 2010, more than 43 percent of people with HIV are in that age group. The face of HIV is greying, which brings with it its own set of challenges. Here are just a few of the stories of the older adults with which my organization, ACRIA, works.
Douglas says: “I’m dealing with HIV, depression, kidney cancer, high blood pressure, lipodystrophy, and now my doctor tells me my cholesterol is going up.” He acknowledges that he hasn’t always dealt well with his conditions, sometimes refusing to take all his drugs (numbering in the double digits) when he gets tired of doing so. He has yet to tell his doctor about this, and is unable to work due to the side effects of his medications.
David, an African-American man, remained HIV negative at age 50. But, as he says, “I could count on both hands the number of people I wanted to invite to a birthday bash,” most of his past friends and partners having succumbed to AIDS before they turned 30. He spent his 50th birthday alone at home with his godson. Having been burned out by the loss of most of his gay peers, he has become a “reclusive, mature gay man.” He lives a life of “self-imposed isolation,” suffering from poor eating habits, strange sleeping hours, and incontinence. He chooses not to date because he deems explaining these issues not worth the hassle.
These are just a couple of examples — and each one illustrates a real problem. Douglas, like many older adults with HIV, has not only HIV but also a variety of other medical conditions, some of which may be more challenging now than dealing with HIV. David is HIV-negative, but he faces the same problem of isolation that many of those aging with HIV face. Many older persons, moreover, wrongly assume that AIDS is a young person’s disease, and that their age can somehow protect them.
All of these problems have solutions, but only if health and services providers and policymakers alike work together to solve them. Primary care providers whose patients include older adults with HIV must be trained to ensure that they are prepared to help patients confront their multiple chronic illnesses, and that they adhere to a treatment regimen that will keep them in the best possible health, as difficult as it may be. That includes addressing depression and other mental health issues, which our research has found to be the most consistent predictor of non-adherence to HIV treatment.
It also includes helping patients to discuss risky behaviors in a nonjudgmental space; if patients feel they will be subjected to harsh criticism, rather than advice, for the slightest bit of disclosure, they are less likely to discuss such behavior openly, rendering it all the more difficult to reduce. ACRIA has created an ad campaign based on this non-moralistic approach with the slogan “Have Sex? Age is Not a Condom.” And as David’s story shows, these older adults are more likely to become depressed when they’re isolated and lack social support networks. Without intervention, they’re unlikely to remain in good health. These adults need opportunities to socialize with their peers — and we need to endeavor to ensure they have them.
These are not the only challenges that older adults with HIV face. But these issues, and others, are why this week, at the International AIDS Conference in Washington, D.C., ACRIA, SAGE and GMHC, together with several international partners, will host a satellite conference on HIV and aging, sponsored by the MAC AIDS Fund. At this conference, we will describe and address HIV and aging as a truly global issue. Scientists, health and services providers, activists, policy makers, and older adults with HIV will speak, as will a panel of older adults with HIV. Together, we are working to create a world in which AIDS is universally recognized as a disease that people over 50 get — and in which we unite to ensure that they get the care and services they need.
Daniel Tietz is executive director of AIDS Community Research Initiative of America. Reach him via acria.org.
Commentary
Disillusioned about democracy? Think of it as a community garden
May 17 is the International Day Against Homophobia, Transphobia, and Biphobia
A short walk from where I live, there is a community garden. People of all ages can participate in designing its areas and learn how to cultivate plants. Together, they build and maintain the space for the benefit of the entire community.
Democracy works the same way. It flourishes when people can bring their energy, knowledge, and presence to the common ground. It works precisely because most of us want to nurture neighborhoods where every life can flourish — no matter where we live, the color of our skin, or the food we enjoy on our tables.
But today, reactionary political movements and governments worldwide are poisoning our gardens with the invasive weeds of their authoritarian policies and exclusionary legislation. According to the CIVICUS Monitor, 73 percent of the world’s population lives in countries where governments repress fundamental civil society freedoms.
By now, we know the playbook. Whenever authoritarians seize our common garden, they drive out those they deem dispensable first. Very often, LGBTI people, racialized persons, and migrants are at the forefront of weathering the storm.
Only half a century ago, the wins that our movement has obtained seemed unthinkable. But those advances are always on the line, always one election away from the strongman of the hour deciding to unravel them.
On May 17, 1990, the World Health Organization removed homosexuality from the International Classification of Diseases (almost 30 years later, also in May, the removal of “gender identity disorder” followed.) The world celebrates this anniversary every year as the International Day against Homophobia, Transphobia, and Biphobia. This was a milestone in the global struggle for the rights of LGBTI people. Back then, 114 countries and territories worldwide still criminalized consensual same-sex sexual acts. Today, still 65 of them maintain those laws.
Progress has been steady. But in 2025, for the first time in years, that number started to grow again. Burkina Faso introduced a criminalizing law for the first time in its history. Trinidad and Tobago reversed recent gains. Senegal further tightened the threat after years of intensifying violence.
The obsession of legislators and policymakers with people’s bodies has translated into paroxysmal attacks against trans and intersex folks — from the 771 bills currently under consideration in the United States, to the disgraceful and misguided policy of the International Olympic Committee reintroducing sex testing and banning trans and intersex women athletes from competing in the female category.
And isn’t it ironic, really, that legislators worldwide put so much effort into driving LGBTI people out of public spaces, when at least 61 UN member states still have legal barriers that prevent civil society organizations working on sexual, gender and bodily diversity issues from formally registering and operating?
Political scientists Phillip Ayoub and Kristina Stoeckl, writing in the “Journal of Democracy”, show that illiberal governments deliberately deploy state-sponsored LGBTI-phobia to mobilize constituencies and frame liberal democracy as a cultural threat. These governments weaponise democratic pluralism for endless culture wars.
The playbook passes from one authoritarian to the next, activist Rémy Bonny showed. What started in Russia in 2013, with a law against the “promotion of non-traditional sexual relationships,” has grown into a pattern that illiberal leaders worldwide use to silence opposition and gain international influence amongst conservatives.
What makes this strategy particularly vicious is how it pits discriminated groups against one another. Time and again, reactionary people in power speak of “protecting women” just to attack trans and intersex people — manufacturing conflict among communities that, in fact, share a common struggle to protect the freedom to decide over their own bodies.
Whenever governments need to distract the public from their failures to create a better garden for everyone, they need a scapegoat. More often than not, it is LGBTI folks. Often, it is those fighting for safe abortions or against racism. Some other times, it is those advocating respectful relations with our land and natural resources. But the attacks never stop at a single movement. Case in point? Only 10 days ago, a government caved in to foreign influence and cancelled the largest global gathering on human rights in the digital age.
At ILGA World, we serve and work with LGBTI communities globally. We know that time and again, LGBTI people have resisted these pests, rolled up their sleeves alongside all the good people caring about their communities, and sown the seeds of change.
This year, the world will join to celebrate May 17 under the theme “At the heart of democracy.” Because, as disillusioned with the concept as people may be, deep down most of us believe that we all deserve a space where we can feel safe and thrive. And together, we can contribute to the beautiful, shared community garden that we deserve.
Julia Ehrt (she/her) is the Executive Director at ILGA World and a widely respected LGBTI activist and community leader.
Before joining ILGA World, she was the Executive Director of Transgender Europe, where she contributed significantly to how trans issues are perceived and debated today in Europe and beyond. She served as a founding Steering Committee member of the International Trans Fund (ITF) until 2019 and as a board member of the Association for Women’s Rights in Development (AWID) for six years. She is a member of the board of directors of the Astraea Lesbian Foundation for Justice, and a signatory to the Yogyakarta Principles plus 10.
Julia holds a PhD in mathematics and lives with her partner and child in Berlin and Geneva.
Commentary
‘Live Your Pride’ is much more than a slogan
Waves Ahead forced to cancel May 17 event in Puerto Rico
On May 5, I spoke by phone with Wilfred Labiosa, executive director of Waves Ahead, a Puerto Rico-based LGBTQ community organization that for years has provided mental health services, support programs, and safe spaces for vulnerable communities across the island. During our conversation, Labiosa confirmed every concern described in the organization’s public statement announcing the cancellation of “Live Your Pride,” an event scheduled for Sunday in the northwestern municipality of Isabela. But beyond the financial struggles and organizational challenges, what stayed with me most was the emotional weight behind his words. There was pain in his voice while describing what it means to watch spaces like these slowly disappear.
This was not simply the cancellation of a community event.
“Live Your Pride” had been envisioned as a celebration and affirming gathering for LGBTQ older adults and their allies in Puerto Rico. In a society where many LGBTQ elders spent decades hiding parts of themselves in order to survive, spaces like this carry enormous emotional and social significance. They become places where people can finally exist openly, without fear, apology, or shame.
That is why this cancellation matters far beyond Isabela.
What is happening in Puerto Rico cannot be separated from the broader political climate unfolding across the U.S. and its territories, where programs connected to diversity, inclusion, education, mental health, and LGBTQ visibility increasingly find themselves under political attack. These changes do not always arrive through dramatic announcements. More often, they happen quietly. Funding disappears. Community organizations weaken. Safe spaces become harder to sustain. Eventually, the absence itself begins to feel normal.
That normalization is dangerous.
For years, organizations like Waves Ahead have stepped into gaps left behind by institutions and governments, particularly in communities where LGBTQ people continue facing discrimination, social isolation, economic instability, and mental health struggles. Their work has never been limited to organizing events. It has involved accompanying people through loneliness, trauma, rejection, depression, aging, and survival itself.
“Live Your Pride” represented much more than entertainment. It represented visibility for LGBTQ older adults, many of whom survived decades of family rejection, religious exclusion, workplace discrimination, violence, and silence. These are individuals who came of age during years when living openly could cost someone employment, housing, relationships, or personal safety. Many learned to survive by making themselves invisible.
When spaces like this disappear, something deeply human is lost.
A gathering is canceled, yes, but so is an opportunity for healing, connection, recognition, and dignity. For many LGBTQ older adults, especially in smaller municipalities across Puerto Rico, these events are not secondary luxuries. They are reminders that their lives still matter in a society that too often treats aging and queer existence as disposable.
There are still political and religious sectors that portray the rainbow as some kind of ideological threat. But the rainbow does not erase anyone. It illuminates people and stories that society has often tried to ignore. It reflects the lives of young people forced out of their homes, transgender individuals targeted by violence, older adults aging in silence, and families that spent years defending their right to exist openly.
Perhaps that is precisely why the rainbow unsettles some people so deeply.
Its colors expose abandonment, hypocrisy, inequality, and fear. They force societies to confront realities that are easier to ignore than to address honestly. They reveal how fragile human dignity becomes when political agendas decide that certain communities are no longer worthy of protection, funding, or visibility.
The greatest concern here is not solely the cancellation of one event in one Puerto Rican town. The deeper concern is the message quietly taking shape behind decisions like these — the idea that some communities can wait, that some lives deserve fewer resources, and that safe spaces for vulnerable people are expendable during moments of political tension.
History has shown repeatedly how social regression begins. Rarely with one dramatic act. More often through exhaustion, silence, budget cuts, and the slow dismantling of organizations doing essential community work.
Even so, Waves Ahead made one thing clear in its statement. Although “Live Your Pride” has been canceled, the organization will continue providing mental health and community support services through its centers across Puerto Rico. That commitment matters because people do not survive on slogans alone. They survive because somewhere there are still open doors, trained professionals, supportive communities, and people willing to remain present when the world becomes colder and more hostile.
Puerto Rico should pay close attention to what this moment represents. No healthy society is built by weakening the organizations that care for vulnerable people. No government should feel comfortable watching community groups struggle to survive while attempting to provide services and compassion that public institutions themselves often fail to offer.
The rainbow has never been the problem.
The real problem is the discomfort created when its colors force society to confront the wounds, inequalities, and human realities that too many people would rather keep hidden.
Opinions
LGBTQ community must say NO to Janeese Lewis George
Mayoral candidate should disavow Jauhar Abraham
Unless she disavows the support, and words, of those like Jauhar Abraham, which she hasn’t done, the LGBTQ community should say a resounding NO to voting for Janeese Lewis George. I don’t know her personally, but I do know what Abraham said about my community, and I know George not only accepted his endorsement, but went to help celebrate his birthday with him.
Abraham called gay men ‘fags.’ He then ranted, including saying gay men, who he called ‘sissies,’ should not be allowed to teach his children in our public schools. We have spent too many years fighting for our rights and dignity as gay men, and have come too far, to have a mayor who will not call out that kind of language, and the person who uses it.
Another issue on which I criticized George is her asking for, and getting, the endorsement of the Democratic Socialists of America (DSA), a group that is considered antisemitic. The DSA calls for the abolishment of the State of Israel, from ‘The river to the sea’ and tells endorsed candidates they may not meet with any Zionist organization, among other things. Her response to being called out on this by Ron Halber of the Jewish Community Relations Council of Greater Washington, was to have a private meeting with some Jewish leaders, where she blamed the answers to the questionnaire she submitted asking for the DSA endorsement, on a staffer. She neither fired the staffer, nor said which statements the staffer made she disagreed with. She has never disavowed the positions of the DSA. No one at that meeting was satisfied, and the same week she headlined, with others, a DSA rally. She claimed she is only a member of the Metro DSA group, but you cannot be a member of the local group, without being a member of the national organization. She also said she is a member of the Democratic Party, and doesn’t always agree with all they say. Well, it’s simple. In both cases, tell us what you disagree with in both their platforms. She has refused to do this.
I want the next mayor of D.C. to be willing to take responsibility for what they do, and say. I never agree 100% with any politician I have supported, and never expect to. But I want honest politicians. When something gets screwed up in the mayor’s office, will George blame it on a staffer?
It is also clear she doesn’t fully understand the tightrope a D.C. mayor must walk because we are not a state. George is clearly trying to emulate the campaign Mamdani ran for mayor in New York City. It was a great campaign. Mamdani is a great speaker, and charismatic. He also had the benefit, George doesn’t have, to run against a totally flawed candidate. Mamdani deserved to win.
I also want my adopted city of D.C., having moved here in 1978, to succeed. But what we are seeing in New York as Mamdani tries to make good on his promises, is his needing the help of the governor, and the state legislature. What George apparently misses completely, is, we have no governor, or state legislature. In reality, our governor is the felon serving as president, and the state legislature is Congress. We have seen generally how unwilling they are to help, and in most cases would rather try to hinder us from moving forward. It requires the mayor to be a constant advocate, but while doing that, also walking a tightrope. While fighting for statehood, and in the meantime, budget and legislative autonomy, the mayor has to deal with what exists today. Even if Democrats win back Congress in 2026, and I think we will, the felon will be there for the first two years of our next mayor’s term. Because of that, it is even more crucial they understand how to deal with him. Whether it’s housing policy, our court system, the national guard, parks department, or a host of other agencies and issues, we don’t have full control.
So, for all these reasons, I urge the LGBTQ community, and all voters, to say NO to Janeese Lewis George. She is wrong for D.C. at this time. I urge voters to say YES to, and cast their ballot, for Kenyan McDuffie for mayor. All my reasons to vote for him can be found in a column I wrote previously for the Blade. Let’s make sure our city, a city we all love, moves forward for ALL of us.
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