National
‘Fiscal cliff’ brings fears of devastating AIDS cuts
More than 12,000 HIV patients could lose access to care next year

AIDS Institute Deputy Executive Director Carl Schmid estimated that up to 12,000 people in ADAP could lose access to care. (Blade file photo by Michael Key)
Pending across-the-board cuts to federal programs have advocates concerned that up to 12,200 people living with HIV/AIDS in the United States could lose access to drugs and programs unless Congress takes action.
The anticipated cuts, set to take effect on Jan. 2, are the result of the Budget Control Act, legislation President Obama signed last year as part of a compromise to raise the limit on the nation’s debt ceiling. It would reduce continued funding for the U.S. government in 2013 and beyond by cutting an estimated 8.2 percent in the first year from discretionary federal programs — including HIV/AIDS programs.
Carl Schmid, deputy executive director of the AIDS Institute, said unless Congress acts to institute an alternative budget, the level of funding provided would be troublesome because “people wouldn’t be able to get their drugs.”
“The sequestration wasn’t ever to occur and within three months from now, it’s going to take place unless Congress acts,” Schmid said. “It would be devastating to our programs.”
Kimberly Crump, policy officer at HIV Medicine Association, said problems are already emerging because care providers aren’t sure what level of funding will ultimately be provided.
“It really hinders them in hiring staff and making decisions around personnel, around controlling costs of labs and accepting new patients, the hours that they can be open,” Crump said. “It’s going to really start to impact availability of services.”
Estimates for what these cuts would mean for people living with HIV/AIDS have varied widely. In a letter dated Sept. 19 to Congress, the AIDS Institute says the reductions to ADAP funding could mean wait lists for drugs would once again be extended and around 9,400 patients would lose access to medication.
“This would automatically create wait lists again, and extremely long ones,” Schmid told the Blade. “But it could be even more than that, we’re doing some further analysis, so some people are saying it’s like 10,000 to 12,000 people removed from the ADAP program if this sequestration goes through.”
The number is an estimate from the Department of Health & Human Services. In a June 29 letter to Congress, Ellen Murray, HHS assistant secretary for financial resources, writes that “approximately 12,150 fewer patients” would receive benefits from the AIDS Drug Assistance Program.
A July 25 report from the Senate Health, Education, Labor & Pensions Committee similarly estimates that 12,219 people in the United States receiving drugs from ADAP would lose access to medicine. The report details how many individuals would lose access for each jurisdiction in the United States. For example, the committee estimates 199 fewer people in D.C. would have access to drugs.
In the letter to Congress, the AIDS Institute spells out the reductions to four federal HIV/AIDS programs that would result from sequestration, which amounts to a total reduction of $538 million based on calculations from fiscal year 2012 levels:
• funding for HIV prevention at the Centers for Disease Control would be cut by $64 million;
• the Ryan White HIV/AIDS Program, which provides care to low income people with the disease, would be cut by $196 million, including $77 million in cuts from the AIDS Drug Assistance Program;
• AIDS research at the National Institutes of Health would be cut by $251 million;
• and the Housing Opportunities for People with AIDS, or HOPWA, program would be cut by $27 million.
One consolation is that funds for Medicare and Medicaid would largely be immune from cuts. Medicare would only be reduced by 2 percent — and those cuts wouldn’t come from programs for patients, but providers. Medicaid, under which 50 percent of people living with HIV/AIDS receive care, won’t see any cuts.
The Washington Blade reported in August 2011 at the time President Obama signed the Budget Control Act that the legislation could impact HIV/AIDS programs, and again reported on the issue when the congressional supercommittee established by the legislation failed to provide an alternative to across the board cuts, but cost estimates for reductions weren’t previously known.
But the cuts wouldn’t only affect domestic programs aimed at providing care to people with HIV, but global programs as well, including the President’s Emergency Plan for AIDS Relief, or PEPFAR, and U.S. contributions to the Global Fund to Fight AIDS, Tuberculosis and Malaria.
Chris Collins, director of policy for amfAR, said the sequestration — commonly referred to as the “fiscal cliff” — would have a “devastating impact” on programs aimed at confronting HIV/AIDS overseas.
“It would undercut multiple aspects of the global AIDS response from treating people, which we know has a potential for saving lives, but also to preventing infection, as well as programs to help kids who are vulnerable,” Collins said. “Sequestration sets us up for seriously backtracking in response to global AIDS just at the time when we have the ability to really accelerate progress.”
In a brief published Sept. 25, amfAR provides details on the problems that reductions to global AIDS initiatives would cause. As a result of projected decreases to U.S. government bilateral support, HIV/AIDS treatments for 276,500 people wouldn’t be available, potentially leading to 63,000 more AIDS-related deaths and 124,000 more children becoming orphans. The decrease in U.S. contributions to the Global Fund would result in an additional 100,000 people not being treated for HIV/AIDS.
In addition to HIV/AIDS programs, federal initiatives that more generally serve the LGBT community would also face cuts under the sequester. The U.S. Equal Employment Opportunity Commission, which earlier this year interpreted federal law to allow it to protect transgender workers from discrimination, would face cuts as would the Justice Department’s community relations service to fight hate crimes.
Laurie Young, the National Gay & Lesbian Task Force’s director of aging and economic security, said the sequester could have an impact on local LGBT community centers that rely on funds from the federal government.
“Any programs … that are funded out of the Older Americans Act — community health programs, community health centers — any of the programs that receive any kind of federal support could be affected by it,” Young said.
Young said the cuts could also affect U.S. governmental efforts in research, including data collection efforts for LGBT people on health surveys, which the Department of Health & Human Services began to implement last year upon requests from LGBT advocates.
HIV/AIDS advocates expressed dismay that the pending defense cuts under the sequester — which would reduce the Pentagon’s budget by an estimated $54.7 billion in 2013 — have received attention in the media, but other programs haven’t received significant attention.
Crump said big ticket items like defense and Medicare have greater “political clout” behind them, which makes other programs such as HIV/AIDS more vulnerable to cuts.
“It makes the non-defense discretionary budget more vulnerable to cuts when these other big ticket items have their champions talking about fencing off or protecting them,” Crump said. “That means we’re going to have to cut more steeply into these other annually funded programs.”
Government agencies that operate programs for people with HIV/AIDS referred the Washington Blade to the White House Office of Budget & Management, which issued a report on Sept. 14 detailing the extent of cuts to government programs.
“As the administration has made clear, no amount of planning can mitigate the effect of these cuts,” the report states. “Sequestration is a blunt and indiscriminate instrument. It is not the responsible way for our nation to achieve deficit reduction.”
Amid this fear, observers were generally optimistic that Congress would institute an alternative to the Budget Control Act to avoid the cuts to HIV/AIDS and other programs.
A Senate Democratic aide, who spoke on condition of anonymity, said an agreement to avoid the sequester would likely be reached after campaign season has concluded.
“As much as we like to piss on each other’s boots and do nothing, when there’s a gun to our head, we know it’s time to do something,” the aide said.
The aide predicted a proposal similar to previously proposed bipartisan debt reduction plans — those from the Simpson-Bowles Commission, the Domenici-Rivlin Task Force or the “Gang of Six” — would be enacted.
But even if an agreement is reached, concerns persist that Congress could enact a plan that would cut into HIV/AIDS funds even more so than the Budget Control Act — especially because another agreement on the debt ceiling must be reached in February when the limit will likely be reached.
Schmid said an alternative plan that Congress might come up with could reach into currently protected programs of Medicare and Medicaid to pay for budget reduction.
“We still have to come up with these cuts, and so they are looking at different ways,” Schmid said. “But Medicare and Medicaid will be back on the table again, and we are concerned about that as well.”
Young predicted that any plan Congress would enact for deficit reduction would cut funding for government programs, but it remains to be seen where those cuts would fall.
“There’s going to be some pain somewhere because the whole reason that the sequestration was enacted and passed was because of the rampant fears about the outrageous federal deficit,” Young said. “Now I could get on my soap box with you, but the reason that the deficit is the way it is today is because we’ve had 10 or 12 years of tax cuts, and in order to pay our bills we have to have money coming in.”
And Crump said if the election results in wins for Republicans, they may feel emboldened to pass a plan similar to what House Budget Committee Chair and Republican vice presidential nominee Paul Ryan has proposed, which she said would “cut even more deeply” than sequestration.
“There’s a looming series of threats to the whole health care environment that could very much impact the hope that the Affordable Care Act held for improving HIV care and access to care for people with HIV,” Crump said.
Netherlands
Dutch prime minister visits Stonewall Inn
Rob Jetten is the Netherlands’ first openly gay prime minister
Dutch Prime Minister Rob Jetten on Monday visited the Stonewall Inn in New York.
“The Stonewall Inn is not just a gay bar in New York, but the place where in 1969 riots took place as a reaction to years of discrimination and police violence,” wrote Jetten on X. “This is seen as the starting point of the global LGBTIQ+ emancipation and activism. Nowadays, the bar is a national monument, dedicated to the LGBTIQ+ rights movement.”
“For me, it is impressive and moving to be here tonight. And also fitting, because the defense of human rights is an important part of our foreign policy,” he added. “The Netherlands stands alongside the Stonewall Inn community when it comes to everyone’s right to live openly, safely, and with pride, no matter who you are or who you love.”
De Stonewall Inn is niet zomaar een gay bar in New York, maar de plaats waar in 1969 rellen plaatsvonden als reactie op jarenlange discriminatie en geweld van de politie. Dit wordt gezien als startpunt van de wereldwijde lhbtiq+-emancipatie en activisme. Tegenwoordig is de bar… pic.twitter.com/hJmFYjF91Z
— Rob Jetten (@MinPres) September 23, 2026
Jetten in February became the Netherlands’s first openly gay prime minister.
He opened last month’s World Pride Human Rights Conference in Amsterdam. Jetten also participated in a panel with former Irish Prime Minister Leo Varadkar, former San Marino Captain Regent Paolo Rondelli, and other current and former heads of government who are gay or lesbian.
Jetten is scheduled to speak to the U.N. General Assembly on Thursday.
National
For lesbian victims of domestic violence, competent care is scare
Heteronormative assumptions, funding cuts contribute to lack of resources for survivors
Uncloseted Media published this story on Sept. 22.
By EMMA PAIDRA | Claire, a 25-year-old Los Angeles resident, distinctly remembers the night she and her ex-girlfriend broke up.
“She was strangling me in a CVS parking lot,” Claire recalls, adding how she was gasping for air as bystanders looked on. “I made eye contact with one man who just kept walking, and we were right behind a car that was trying to reverse out of a parking spot. No one got out of the car. They didn’t honk; they didn’t do anything.”
Claire, who asked to use a pseudonym due to safety concerns regarding her ex, says she managed to fight her way out of her then-girlfriend’s grasp. It was at this moment in 2024 she realized things had reached a breaking point.
While research on intimate-partner violence has traditionally focused on opposite-sex couples, two recent reports found that queer women, like Claire, are not immune to this type of abuse. An international research review published last year in the Journal of Media Critiques found “IPV rates in same-sex relationships are comparable to or exceed those in heterosexual relationships,” with up to 46 percent of lesbians encountering such abuse, compared to 36 percent of straight women. A separate review published earlier this year found that nearly 27 percent of lesbians surveyed had experienced IPV.
Despite the prevalence of IPV in lesbian relationships, heteronormative and outdated assumptions have left many queer women feeling like they have nowhere to turn for competent services and support, according to experts, advocates and victims interviewed by Uncloseted Media.
“Queer folks are joining the conversation to say, ‘This is happening in our communities, too, and we need the same resources and support services that straight women are offered,’” Tori Stranges, a professor of women’s studies at the University of British Columbia, told Uncloseted Media.
A frequently overlooked problem
Stranges says the false notion that only men are domestic abusers can result in violent same-sex relationships not being taken seriously.
“People assume that violence is perpetrated by men against women,” she says, adding that this “has left queer people out of the conversation.”
“If it was a man that was doing all these things, and people heard and saw it, I’m sure I would have been taken seriously,” says Claire. “People saw a 5-foot-7 woman who didn’t look that strong — and above all, she was a woman. Men, especially, don’t really see that as a threat. So they’re like, ‘If I’m not threatened, then I’m sure it’s not a big deal.’”
Outdated assumptions about IPV can even result in victims themselves overlooking their abuse.
“When it comes to abuse in heterosexual relationships, there are national campaigns, there are resources that you can access,” Stranges says. “There are people coming into the school systems to talk about relationship violence. We don’t have similar recognition and the same conversations about queer people.”
Claire says the violence she was subjected to was paired with moments of intense affection, which made it harder for her to recognize the abuse.
“We would get into a fight, and she would physically abuse me, and then apologize. She was actually also very gentle with me sometimes,” Claire recalls. “That kind of cycle can be really addicting. I would always wait for the good parts.”
The role of mental illness
K.P., a 47-year-old lesbian living in Maine, was with her abusive ex-girlfriend for five years before ending the relationship in 2023. During their time together, K.P. says her ex, who struggled with panic disorders, ADHD and depression, experienced a decline in her mental health, which contributed to more frequent outbursts of rage. When it comes to the link between rage and violence, one 2022 meta-analysis found that “anger was a significantly stronger correlate of IPV perpetration for women than men.”
K.P., who was working from home at the time and felt like she had no escape, says her ex’s verbal abuse spiraled into physical violence.
“I was on the couch with my laptop, trying to work, and she was just being belligerent,” recalls K.P., who asked to be identified by only her initials because of safety concerns. “I tuned her out, but when she realized I wasn’t giving her the attention that she expected, she went to the kitchen, grabbed two knives and started coming at me.”
K.P. ran outside, trying to get away. Her ex ran after her and then chased her back inside to avoid being seen by neighbors.
Once inside, her partner hid her phone. K.P. used this brief window to message a co-worker on her laptop, asking him to call the police.
“I was confused and afraid,” K.P. told Uncloseted Media. “I’d never been chased with a knife before, let alone by someone who I cared about.”
Research shows LGBTQ people have higher rates of mental health conditions than their non-LGBTQ peers. A study published last year in JAMA Network Open found sexual and gender minorities had “significantly higher odds of at least four of 10 commonly diagnosed mental health conditions,” including post-traumatic stress disorder and bipolar disorder.
IPV may also contribute to negative mental health effects, with research finding that victims experience an increase in depression, anxiety and PTSD and a reduction in life satisfaction.
“After we broke up, I was messed up,” K.P. says. “It took me a good six or eight months to feel like I could breathe again.”
Trapped in a ‘double closet’
In addition to mental health, the stigma of being queer may affect a victim’s response to being in an abusive relationship. When Claire first came out to her family, she says they kicked her out of their home until she returned to the proverbial closet. They eventually accepted her sexuality, but Claire says the residual shame she carried afterwards led her to avoid the added stigma she feared she’d experience if she admitted to being in an abusive relationship.
“All of that combined made me feel so trapped. I just thought, ‘Oh my god, I’m being judged from every single angle,’” she says. “There was just nowhere to go.”
Letícia Yuki de Araujo Furukawa, a clinical psychologist specializing in supporting survivors of IPV, says this kind of thinking is not uncommon among queer women in abusive relationships.
“Sometimes lesbian women who are experiencing IPV relationships start to isolate themselves, to prevent themselves from the shame and judgment they think they are going to suffer,” she says.
Furukawa says this impulse is rooted in the layers of stigma queer women face.
“It comes down to two things that make it like a double closet: We have the closet of being a lesbian, and you have the other one that comes from being in a violent relationship.”
According to Furukawa, having a supportive family can decrease the risk of entering an abusive relationship. Unfortunately, strained familial relationships are common among queer people: A 2022 study in the Journal of Marriage and Family found that 32 percent of gay and lesbian adult children — compared to 22 percent of their heterosexual counterparts — were estranged from their fathers.
Because of the shame Claire faced from her family when she came out, she was reluctant to admit there was a problem in her relationship when her mother and sister expressed concern. She worried that if her family knew her lesbian relationship was abusive, they would stop accepting her queer identity.
“My mom and sister would say to me during the relationship that they thought my ex looked evil, and that I changed so much. I used to be such a bubbly girl, and my personality made a complete 180,” she remembers. “In my head, I was like, ‘I can’t admit that it’s true.’”
‘Gaps in, policy, care, and services’
When queer women have the courage to report IPV, some don’t receive the response they’re hoping for. When police arrived at K.P.’s home following the knife-wielding incident, she says they opened a case file and wrote an incident report but said there was nothing else they could do because her ex had fled the scene.
“It was a little frustrating that since my ex-girlfriend drove away, the police couldn’t do anything,” K.P. explains.
Laura Elizabeth, an assistant professor of criminal justice at Virginia Union University who researches IPV, says there may have been additional steps police could have taken to support K.P., including connecting her with resources for domestic-violence survivors.
“It is vital that [police] make the proper referrals, and that it not just be limited to handing the victim a brochure,” she says. “There needs to be an active discussion with victims about what their options are in terms of who they can reach out to, who can offer what services.”
Kimberley Jackson, an associate professor at the Arthur Labatt Family School of Nursing at Western University, says lack of research on same-sex domestic violence also impacts the support services available to lesbian victims.
“The intersection of IPV and the LGBTQ community is really not well understood,” Jackson told Uncloseted Media. “What we can tell you based on really limited evidence, is that there are huge gaps in policy, care and services. And with respect to shelters, we haven’t really moved the needle very far.”
One area in which shelters may be failing lesbian victims has to do with both the perpetrator and the victim being able to access the same shelter.
“This issue is further compounded in rural areas, where there’s likely only one shelter,” Jackson says. “There’s a chance they won’t be able to turn someone away, even if they’re the perpetrator.”
Jackson says queer victims of domestic violence who aren’t open about their sexuality may face additional obstacles.
“With respect to anonymity, in a lot of rural places, you’re going to know people in the community,” she says. “There are issues with accessing help if you’re worried about outing yourself.”
Calls for change
Experts and victims say LGBTQ training for shelter workers and law enforcement, as well as funding for research, could help prevent same-sex IPV and address the damage done by such abuse.
But under the Trump-Vance administration, these funding resources are slipping away. In March of last year, the administration canceled at least 68 grants, totaling nearly $40 million, that were focused on LGBTQ health. A second round of cuts followed two months later, during which $800 million worth of grants dedicated to researching LGBTQ health were terminated.
Rebecca Hobbs, co-executive director of Through These Doors, a domestic violence resource and advocacy center in Portland, Maine, says LGBTQ training materials are essential to ensuring shelters can support lesbian victims.
“LGBTQ people will not come to us unless they see themselves reflected in our materials,” Hobbs says. “We want our advocates to be well versed in understanding the additional barriers and challenges that LGBTQ people might experience.”
Advocates say police departments could also benefit from LGBTQ-awareness training.
The state of California and a number of large cities — including Atlanta, Chicago, Los Angeles, Houston, New Orleans, New York, Philadelphia and D.C. — have implemented some form of LGBTQ-sensitivity training.
But Greg Miraglia, founder and CEO of Out to Protect, a national organization supporting LGBTQ police officers and equipping all officers to serve queer people, says these programs are the exception, not the rule.
“Most other states do not require any type of LGBT awareness training,” Miraglia, a retired police officer who is based in California., told Uncloseted Media “There are over 18,000 law enforcement agencies out there, and I don’t think we’ve scratched the surface.”
“The problem comes about when law enforcement goes into a domestic violence incident with a same-sex couple without any training, carrying a lot of stereotypes that are common,” Miraglia adds. “They’re not picking up the fact that this is a couple that’s involved in an intimate relationship, and therefore domestic violence laws in that state apply.”
Claire says she wishes someone had intervened when her ex abused in the CVS parking lot and on her college campus. “The police had the biggest missed opportunity to intervene, as well as campus security,” she says. “A lot of our fights were in public, and she would get very loud. I made a promise to myself that if I ever saw anything like that in public, I would say something, because that’s all I needed at the time.”
National
Long-time DignityUSA executive director announces retirement
Marianne Duddy-Burke has been with LGBTQ Catholic group for decades
The executive director of the world’s oldest LGBTQ Catholic organization has announced she will retire once her successor has been chosen.
Marianne Duddy-Burke has been with DignityUSA for more than four decades. She has been the group’s executive director since 2007.
DignityUSA announced Duddy-Burke’s retirement on Sept. 17.
Duddy-Burke during her tenure has urged the Vatican to do more to welcome LGBTQ Catholics. She has also, among other things, championed marriage equality and advised the State Department on LGBTQ-specific issues. (The Trump-Vance administration’s decision to freeze nearly all U.S. foreign aid shortly after it took office in January 2025 has had a devastating impact on the global LGBTQ and intersex rights movement and efforts to fight HIV/AIDS around the world. A report that Outright International released earlier this month notes 90 percent of LGBTQ and intersex rights groups around the world have lost funding since 2025.)
Duddy-Burke met with Pope Francis in 2023.
She traveled to Rome in 2025 for the papal conclave to choose the Argentine-born pope’s successor. Pope Leo XIV, who was born in Chicago, succeeded Francis.
DignityUSA in the press release that announced Duddy-Burke’s retirement notes she expressed “particular appreciation to people who spoke honestly about the reality of being a queer Catholic or family member.”
“I have been inspired every day by your stories and have done my best to lift them up,” said Duddy-Burke. “It is your lives, your faith, your struggles, your hopes that I have strived to reflect in my work, and doing this has been a great honor.”
DignityUSA President Meli Barber praised Duddy-Burke.
“It is almost impossible to sum up the scope and depth of Marianne’s achievements and contributions to DignityUSA over her more than four decades of service,” said Barber. “Under her wisdom and leadership, DignityUSA has only grown in stature as an advocate for LGBTQIA+ Catholics and as a visionary thought leader for LGBTQIA+ ministry and spirituality.
“Marianne has been more than an extremely able executive director,” added Barber. “Her care for and ministry to chapters, her deep personal relationships with countless Dignity members, her connections to LGBTQIA+ Catholics around the world, the relationships she has built with other progressive Catholic organizations, her skill as a public representative, the respect with which she is universally regarded, and her tireless devotion to service all leave an indelible mark. It is not an exaggeration to say that she has shaped not only Dignity but a generation of LGBTQIA+ Catholics.”
Barber said DignityUSA will “soon begin a search for a new executive director.” Barber added Duddy-Burke “will assist with the transition.”
