Opinions
The state of HIV in Washington: 29 years later
From fear and despair to promising new treatments and hope
On April 4, 1983, AIDS entered the public arena of the District of Columbia.
On a Monday evening 29 years ago, Whitman-Walker held the first public forum on AIDS in D.C. At that time, Cabbage Patch dolls were a hit, people were watching M*A*S*H, and AIDS was destroying the gay male community. A panel of public health experts and advocates spoke to a full house at Lisner Auditorium of The George Washington University. The audience of predominantly gay men was driven to the forum after watching friends, lovers and colleagues die quickly and horribly from AIDS. And they were in a state of fear bordering on panic.
The forum that night probably did little to calm that fear. Think about what was happening in 1983. AIDS had only been recently named. The HIV virus had not been discovered yet. There was no test to see if someone was infected and there was no treatment. In fact, people were unsure if you could catch AIDS from a simple kiss. In short, there was almost no good news that night; only fear and despair for the future.
Today, on the eve of the 2012 International AIDS Conference, there is far more good news in the world of HIV/AIDS.
Since that forum in 1983, HIV testing has become standard operating procedure for many Americans, particularly those in groups at high risk for HIV, like gay or bisexual men. Successful treatments are keeping people with HIV healthy and alive for many years. And people are more knowledgeable about condom use and other safer sex practices.
Over the last few years, even more developments have brought new hope and optimism in the fight against HIV/AIDS, including the idea of using HIV medications to prevent HIV transmission, also known as “Treatment as Prevention.”
One of the best ways to reduce new HIV transmissions is by diagnosing people with HIV, getting them into care and on medications. These HIV medications can suppress the amount of virus in the person’s blood to very low levels, which make it much less likely for that person to transmit the virus. In fact, studies have shown successful treatment to reduce the risk of transmission by up to 96 percent. This same strategy is used to prevent the mother’s HIV from transmitting to the baby.
Another way HIV medications are used to reduce transmission is through HIV “post-exposure prophylaxis” or “PEP.” If a person has a needle stick at work or an unsafe sexual encounter they can take HIV medications for a month to prevent infection. This method is at least 80 percent effective if used within 72 hours of the potential exposure.
Recently, studies have shown HIV medications can be taken by individuals at high risk for HIV before they are exposed to the virus to protect them from infection. “Pre-exposure prophylaxis” or “PREP” is still undergoing clinical trials but seems to be very effective for certain populations at high risk for HIV, such as men who have sex with men and serodiscordant couples (where one partner has HIV and the other is HIV-negative).
All of these new “Treatment as Prevention” tools add to weapons in the fight against new HIV transmissions, but none are a magic bullet. Currently, in the District of Columbia, 70 percent of people diagnosed with HIV do not have a suppressed viral load. Why is this number so high? A large number of people in D.C. have HIV and do not know it. Others have been diagnosed with HIV but have not seen a doctor yet (often due to denial, stigma, etc.). And lastly, a good percentage of HIV-positive people on medication do not have a suppressed HIV viral load due to poor adherence to their medication regimen (often due to depression, addiction issues or competing priorities). We are lucky at Whitman-Walker to have comprehensive health care on site, including care teams, mental health practitioners, a pharmacy, and nurses that focus on patients’ barriers to care. Through this team model, 85 percent of our HIV patients on medications have a suppressed viral load.
Now that the health care community has more options in our fight against HIV, we have to figure out a comprehensive way to prevent new HIV transmissions from occurring. But the good news is that we are more knowledgeable about HIV transmission and there are more prevention options with known effectiveness.
So come join us in a Return to Lisner Auditorium on Tuesday, July 24, at 7 p.m. You will hear from leaders in the field that reducing the number of new HIV infections in Washington, D.C. is possible. You will learn about “Treatment as Prevention.” And we will all reflect on how far we have come in the past 29 years.
Dr. Ray Martins is chief medical officer of Whitman-Walker Health.
Opinions
ROSENSTEIN: Chavous for Democratic D.C. Council-at-Large
Committed to fighting for statehood for our 700,000 residents
Kevin Chavous said, “I’m running for D.C. Council At-Large because Washingtonians deserve leadership focused on improving their everyday quality of life. Throughout my career, I’ve worked on the practical business of city government, and public policy, focused on solving real problems, and making government work better for the people it serves.”
Kevin’s experience spans safer streets, affordable housing, early education and school readiness, workforce and economic opportunity, support for seniors, and the day-to-day operations of city government. The knowledge he brings to the office is grounded in experience, clear-eyed oversight, and a commitment to delivering results. His platform outlines his priorities and approach, but as he has said, “it’s not the end of the conversation. I believe the best solutions come from listening and working together.”
Kevin believes safe streets are the foundation of strong neighborhoods. He is committed to having Washingtonians feel secure in their neighborhoods, and working to ensure all public safety efforts are smart, fair, and effective. To Kevin that means an approach focusing on enforcement that works, prevention that matters, and a range of services to stop crime before it happens. Kevin supports smart, effective policing, with a focus on violent crime, and getting repeat offenders off the streets. To do this he will work to strengthen community policing with the aim of rebuilding trust in every community, which will improve neighborhood-level safety. He will introduce legislation to expand targeted mental health and crisis-response services. The goal again, to prevent violence before it occurs. He will work to see government coordinates youth diversion, workforce, and support programs, which can intervene early, and reduce recidivism.
Kevin understands housing stability is essential for families, seniors, and workers, to stay and thrive in D.C. His housing priorities focus on increasing the supply of affordable housing, helping people build long-term stability in the neighborhoods they call home. He will work to increase the affordable housing supply through zoning updates, ADUs, and adaptive reuse of vacant properties. He will submit legislation to strengthen programs that help first-time, and longtime homeowners, buy and then stay in their homes. He will work to expand permanent supportive housing and targeted rental assistance for vulnerable residents, and protect tenants ensuring housing laws are enforced clearly, and consistently.
Kevin believes “every child should enter school ready to learn, with the support needed to succeed from day one. Early investment pays lifelong dividends – for families and for the District.” He will work on the Council to expand early childhood education, and school-readiness programs, citywide. He supports quality and affordable childcare for all children, birth to three, including seeing students begin the school year healthy, by supporting access to medical and dental screenings for all children.
Kevin knows economic opportunity allows families and communities to thrive. He will fight to see D.C.’s growth creates real pathways to good jobs, strong local businesses, and long-term stability for residents in every ward. His approach connects workforce training, worker protections, and neighborhood investment, so that growth benefits the people who live here. He will work to expand job training, apprenticeships, and career pipelines tied to high-demand fields, including construction, healthcare, and infrastructure. He will fight to strengthen First Source and local hiring requirements, so D.C. residents benefit directly from major development projects such as the new RFK site. He will demand the government protect workers by enforcing wage, safety, and labor standards, and holding bad actors accountable. He will introduce legislation to invest more in neighborhood-based economic development, including small businesses, BIDs, and commercial-to-residential revitalization.
Kevin has spoken out for the seniors in our city saying, “seniors built this city – and D.C. must ensure they can age with dignity, security, and independence.” Kevin will work to expand property tax relief and housing supports, so seniors can age in place. He will work with the AG to strengthen protections against fraud, exploitation, and predatory practices targeting seniors. He will support and work to expand nutrition, transportation, and community-based programs, that reduce the isolation many seniors face.
Kevin’s experience working for the Council, in the oversight role he had, gives him a practical understanding of what works, what doesn’t, and how to fix it – without delay. He will use that experience as he works to strengthen agency oversight to ensure laws are implemented as intended, and to improve service delivery by fixing bottlenecks, and outdated processes. Ensuring clear standards and accountability in inspections, enforcement, and permitting. Kevin will demand government use technology responsibly to improve efficiency, while protecting residents from fraud and abuse.
For all these reasons and more, I support Kevin Chavous. The more includes the fact Kevin has spoken out clearly, about the need to fight the antisemitism, Islamophobia, racism, sexism and homophobia, all once again rearing their ugly heads in our society. He will fight to keep ICE out of our city, and to keep immigrants safe. He is committed to fighting for statehood for the 700,000 residents of the District of Columbia, while fighting for budget and legislative autonomy as we work toward statehood.
Again, I urge the voters of D.C. to cast their ballot for Kevin Chavous for DC Council-at-Large.
Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist.
The state of Tennessee has a long history of political discrimination against its 225,000 LGBTQ citizens. In 2019, a district attorney remarked that gay people should not receive domestic violence protections, and in 2023, for five months in Murfreesboro, homosexual acts in public were illegal, prompting a federal judge to have the ordinance removed.
In 2022, I briefly lived in Tennessee and played rugby with the LGBTQ-inclusive Nashville Grizzlies, who welcomed me with open arms as an ally, teaching me that rugby isn’t always about winning or losing – it’s about creating a safe, inclusive, and joyful space for people looking to feel welcome.
In Tennessee, where 87% of the LGBTQ community has experienced workplace discrimination, and where, each year, countless bills that target their identities are introduced, it can be difficult to feel welcome. The Nashville Grizzlies played rugby with the exuberance of newly liberated people who were finally able to be their authentic selves. I was inspired by their brotherhood.
When I read about the Charlie Kirk Act being passed last week, I felt a visceral need to write about it.
While the bill is presented as legislation that strengthens free speech and encourages greater public discourse on campuses, it would effectively allow a school to expel a student who felt compelled to walk out on a speaker with hateful views, forcing marginalized groups to sit through existentially harmful rhetoric.
And ironically, it doesn’t seem like free speech goes both ways — a Tennessee University administrator lost their job last year for sharing negative views on Charlie Kirk, and countless LGBTQ books have been banned not only in schools, but even in adult libraries.
We like to think that as time moves forward, progress is inevitable, but this isn’t always the case. In a 2023 study, 27% of LGBTQ Tennesseans and 43% of transgender people in the state have considered relocating, forcing them to reckon with leaving home in pursuit of a better life. Nashville Grizzlies Captain Ethan Thatcher told me, “I’ve thought about leaving Tennessee. Hard not to when the government does not want you here. What has kept me here is the Grizzlies community, and the thought that existence is resistance.”
Everybody in our country deserves to feel safe. I thought that was a core value of the American ethos, but apparently, in some states, certain groups are welcome while others are ostracized.
Tennessee Gov. Bill Lee should reject the Charlie Kirk Act.
Tyler Kania is a 2025 IAN Book of the Year nominated author and civil rights activist from Columbia, Conn.
Opinions
The latest Supreme Court case erasing LGBTQ identity
Chiles v. Salazar a major setback for movement
In its recent decision in Chiles v. Salazar, the U.S. Supreme Court invalidated Colorado’s law prohibiting licensed counselors from engaging in efforts to change the sexual orientation or gender identity of minors. The decision, which puts into question similar laws in 22 other states, relied on the First Amendment to hold that the law violates counselors’ free speech rights. But the decision also strikes a blow against LGBTQ dignity, a point the court’s opinion does not even address.
The eight-member majority, which included Justices Elena Kagan and Sonia Sotomayor, who usually side with LGBTQ groups, justified its reasoning by suggesting that the law was one-sided: it permitted treatment that affirms LGBTQ identity but forbade treatment that seeks to change it. But the law is one-sided, as Justice Ketanji Brown Jackson’s lone dissent pointed out, because the medical evidence only supports one side: reams of research show that “survivors of conversion therapy continue to suffer from PTSD, anxiety, and suicidal ideation.” And major medical associations all agree, no evidence demonstrates the efficacy of conversion efforts. This isn’t surprising. Medicine often take sides — some treatments work, and some don’t.
But particularly concerning is the vision of LGBTQ identity that undergirds the majority opinion when compared to the dissent. Justice Jackson’s dissent explains that LGBTQ identity is simply “a part of the normal spectrum of human diversity” — not something to be “cured.” By contrast, for the majority, how best to help LGBTQ minors is “a subject of fierce public debate.” That can hardly be the case if LGBTQ identity stands on equal ground with straight, cisgender identity, or if LGBTQ people are as deserving of safety, rights, and dignity.
Indeed, the LGBTQ rights movement only began in earnest when advocates in the 1960s decided to end the “debate” over gay identity. Until then, community leaders would routinely cooperate with psychiatrists who were interested in researching homosexuality as a medical condition. A new generation of activists, led by Frank Kameny, a key movement founder, began arguing that this got the issue upside down: Rather than wondering if they could be “cured,” LGBTQ people had to assert a right to their identity. As Kameny put it—“we have been defined into sickness.” Only once the case was made that it was society that had to change, and not LGBTQ people, could LGBTQ consciousness, LGBTQ pride and LGBTQ rights develop. Their activism led to the first Pride parade in New York, and the official declassification of homosexuality as a disease in 1973.
The Supreme Court’s conservatives don’t just want to reignite this half-century old medical “debate”; they also treat medical claims that undermine LGBTQ identity very differently from those who support it. Last year, in an opinion backingTennessee’s law that banned gender affirming care for minors, the court sympathetically marched through the reasons Tennessee offered for “why States may rightly be skeptical” of such care, and cited three times, in some detail, to “health authorities in a number of European countries” (that is, some Nordic countries and the UK) that had curbed pediatric care. It failed to mention that most of Western Europe and every major American medical association provides access to this care.
In Chiles, by contrast, the court cites none of the evidence that Colorado amassed that conversion therapy harms LGBTQ children. None of the countries that the court had invoked to justify anti-trans policies allow conversion therapy in their health care systems (indeed, one of them criminalizes such practices). So rather than cite medical evidence, the court simply asked — why trust medical evidence at all? “What if,” asks the court, “reflexive deference to currently prevailing professional views [does] not always end well?” and cites an infamous 1927 Supreme Court case, Buck v. Bell.
In Buck, the Supreme Court embraced eugenic reasoning, backing a eugenic state law that allowed the sterilization of individuals with mental disabilities, on the grounds that such disabilities were hereditary. As Justice Oliver Wendell Holmes opined, “three generations of imbeciles are enough.” Look at what happens when we listen to medical expertise, today’s court seems to say, as an excuse to disregard the LGBTQ-affirming medical evidence they don’t like.
But the court has missed the key lesson of Buck. The law at issue in Buckdiscriminated against a certain group, seeking, through sterilization measures, to erase it from existence. Indeed, LGBTQ people (whom doctors of the day would have referred to as sexual “inverts”) were exactly the kind of people that the eugenic program of Bucksought to eliminate. Conversion therapy seeks similar erasure.
The lesson of the 1960s LGBTQ rights movement remains as relevant today as it was then. Without an unapologetic LGBTQ identity, LGBTQ Pride, LGBTQ rights and the LGBTQ movement itself can all founder. By supporting only the anti-LGBTQ side in this medical saga — and by suggesting that LGBTQ existence is subject to medical debate at all — the court is reaffirming, rather than repudiating, minority erasure.
Craig Konnoth is a professor of law at University of Virginia School of Law.
