Opinions
The struggle to maintain access to lifesaving HIV meds
Trump proposing dangerous changes to Medicare Part D
When I was diagnosed with HIV in 1985, there were no medications to treat it. Not one. I never imagined that the medical community would achieve the advancements in HIV treatment and prevention we see today. In fact, President Trump actually proposed a plan in his State of the Union address to end the HIV epidemic in America by 2030. This lofty goal would be thwarted, however, by proposed changes to Medicare Part D that jeopardize the advancements we’ve made in the fight against HIV.
I have lived with HIV for almost 35 years. I’ve dealt with more doctors, stubborn insurers, and drug formulations than I care to count. But I do it to stay alive. What other choice do I have?
By 1995, 10 years after I contracted the virus, AIDS claimed as many as 50,000 lives per year. Today, fewer than 7,000 people die from HIV related causes. And recent data shows that although there are nearly 19,000 people living in Baltimore with HIV and 15,000 in D.C., less than a quarter of all new D.C. HIV diagnoses develop into an AIDS diagnosis within three months. This means that approximately 80% of these individuals newly diagnosed with HIV are taking steps to control and reduce their viral loads.
Becoming an “empowered” patient with consistent and unimpeded access to my medications through Medicare Part D has kept me alive. Had I not been relentless in my pursuit of the latest research, drug trials, and newly approved treatment regimens — while also educating my own providers — I likely would have been counted among the nearly half million Americans who perished from AIDS between 1981 and 2000.
For many years after my diagnosis, insurance companies rejected my prescriptions or tried to force me to rely upon medications that had been proven ineffective. When I became disabled due to HIV, my newfound access to Medicare Part D changed all of that.
Medicare Part D and its protections against insurer interference finally brought some certainty to my treatment plan. With reliable access to effective medication, I was suddenly free to divert my time and energy away from day to day survival and focus it towards my friends, my family, and a better quality of life.
Unfortunately, the Trump administration is proposing a change to Medicare Part D in a way that would remove many of these certainties. The change — in the name of reducing drug pricing — removes the protected class status for HIV medication and would expose hundreds of thousands of people living with HIV to “step therapy” and “prior authorization.”
Step therapy allows insurers to require Part D enrollees living with HIV to prove that less effective medications don’t work before agreeing to cover more effective, but more expensive treatments, as determined by our doctor. Prior authorization forces doctors to pre-clear prescriptions for certain HIV medication with insurers before the insurer agrees to cover the costs, a time consuming and complicated process that delays treatment.
As someone who has failed multiple drug categories over the years, I know these changes are dangerous because they would force me to fail on one medication before trying another. I need highly customized, effective therapies to keep my viral load in check. When a viral load is rendered undetectable, I cannot transmit HIV to someone else. Successful treatment, then, also prevents new HIV infections.
Interfering with access to effective treatment formularies for Medicare Part D enrollees under the guise of pricing reductions will cause more harm than good. In fact, a recent study published in the American Journal of Managed Care estimates that there would be 16,200 more cumulative deaths by 2025 if more restricted treatment options are allowed to take effect.
The priorities for people living with HIV are stark. First you pay your insurance premiums, then you pay your prescription costs, and then you pay for food and housing. That is how important our medications are to our survival. For us, failure is not an option. We must fight this new proposal that would end guaranteed access to the treatments we need to stay alive.
Mark S. King is an award-winning author, and HIV/AIDS advocate who has been involved in HIV causes since testing positive in 1985. His blog, My Fabulous Disease, was awarded the NLGJA’s “Excellence in Blogging” honor in 2014 and 2016.
Opinions
Thank you Mayor Bowser for protecting people of D.C.
Paving BLM Plaza an unfortunate, but necessary, step
It has been difficult to watch as Mayor Muriel Bowser has walked a tightrope to protect the people of D.C. Thus far, she’s doing it very well. She has to deal with both President Felon, his Nazi sympathizing best friend and co-president, and their MAGA acolytes in Congress.
People must understand, even in the best of times, D.C. is beholden to the president and Congress. Even after home rule was granted in 1974, we haven’t had budget or legislative autonomy. Congress gets to review everything our mayor and Council do. We can pass laws, and Congress can override them. They get a 30-day review of everything. So again, in the best of times, it isn’t easy for any mayor to deal with this. Clearly, these are not the best of times.
This past week the mayor and Council members walked the halls of Congress to explain to members, if you force D.C. back to its 2024 budget, which the continuing resolution (CR) does, it screws with the city, to the tune of $1.1 billion, but doesn’t save the federal government a dime. This is all D.C. taxpayers’ money. It will force major cuts, about 16% in D.C. personnel services, across the board. Cuts to the areas even Trump says he wants strengthened, like police and Metro.
The CR has now passed both the House and Senate, without an exemption for D.C., and has been signed by the president. One Republican, who admitted publicly she didn’t realize an exception for D.C. was left out of the CR, was Sen. Susan Collins (R-Maine), chair of the Appropriations Committee. She then spoke with the mayor about this. The mayor also spoke with Sen. Schumer, who then negotiated for D.C. prior to his voting for the CR. The deal included Collins introducing a bill to exempt D.C. from the CR immediately after it passed. This bill passed the Senate unanimously. The mayor thanked Collins, as well as Sens. Patty Murray, Angela Alsobrooks, Tim Kaine, Chris Van Hollen, and Mark Warner for their help in advancing the measure to restore D.C.’s Fiscal Year 2025 approved budget. In speaking of the bill, Collins said the president supported the legislation, as did the chair of the House Appropriations Committee. I hope it will be passed by the House when they return. The mayor did her job for the people of the District.
I felt Congress’s control over D.C.’s legislation first-hand when we were trying to pass same-sex marriage. I sat with others, at the time, Councilmember Catania, and Council Chair Gray, to figure out what could get passed that Congress would approve. While the D.C. Council had the votes to pass marriage equality, it was decided to first pass a law saying D.C. would recognize same-sex marriages from other states where it had been approved. Once Congress let that law stand, the Council passed marriage equality for the District. More recently, we have seen Congress balk at a crime bill passed by the D.C. Council, and then the mayor proposed a new bill, more to their liking, and it was passed. Not easy for the mayor, and Council, to deal with. But it is the mayor who is the face of the city, and much of this falls on her shoulders.
Now the mayor has agreed to pave over Black Lives Matter Plaza. In Trump’s first term, Mayor Bowser stood up to him in many ways, large and small. He was just as nasty, but hadn’t made the direct threats to take over the city that he is making now. Part of that is because the people around him now are both smarter, and more venal. So, the threats are real. But his staff is talking to the mayor, and she has figured out giving in to small items, could save the city. One such thing is Trump’s demand, that Black Lives Matter Plaza be removed. There is also the threat from Congress to withhold funds if it is not removed. Many, including me, hate to see it go. Interestingly, in talking to some people, many in the District, including many of our young people, they don’t know, or no longer remember, what the mural meant, and why it is there. But enough of us do remember it came about after the brutal and senseless murder of George Floyd. It was a major symbol of resistance, and demand to reduce police violence against the African-American community.
Also, at that time, the slogan ‘defund the police’ was on the lips of many. Trump’s response was to use what most called excessive force, to clear the way from the White House, through Lafayette Park, when he walked with the chairman of the Joint Chiefs of Staff, General Milley, and Secretary of Defense Esper, to get a photo holding a Bible, which everyone knows he never read, in front of St. John’s Church. Milley later apologized for participating in this spectacle. But Trump got his photo op, which was the purpose of the whole episode.
So today, Mayor Bowser is having the plaza paved over to keep the city from losing so much more. She is doing this to try to keep Trump from his threatened executive order, which will do more harm to the District. The mayor also agreed to take down specific tent encampments, set up by the homeless, offering other shelter to them. We know she would never pave over BLM plaza if the threats weren’t serious. The mayor has said the plaza will eventually have another mural, done by school children, to celebrate the 250th anniversary of the country, that will be celebrated in 2026. That is if we still have a country by then.
The District faces serious budget issues in the coming years because of the mass layoffs of federal workers, and declining revenue from income and property taxes. Those will be there regardless of what Congress does to deal with D.C.’s budget through Sept. 30. We are clearly under the thumb of the MAGA Republicans, who today unfortunately control our country.
Again, I am thankful that my city is being led by Mayor Bowser. She has brought us through difficult times before. She brought us through the first Trump administration, and through the COVID pandemic. Was everything the way each resident would have liked? No. But what she did, and is doing, is done to keep our city free, and to keep our people safe, and healthy. On behalf of many, thank you Mayor Bowser. Know that we stand with you, and you can count on our continued support.
Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist.
Opinions
Trump declares war on universal human rights
Conservatives in Africa have applauded anti-LGBTQ US policies
The Universal Declaration of Human Rights, adopted by the United Nations, protects and promotes the inclusion of vulnerable and marginalized groups by recognizing that all people are born free and equal. It guarantees rights without discrimination based on, but not limited to, sex, gender, or any other social status. It was adopted by states at a global level immediately after the horrors of World War II, to ensure such atrocities and the events that led up to it do not occur again. The UDHR ensures everyone’s right to live safe, free from discrimination, hate and violence and to be treated with dignity under the law.
The United States, indicating that it would be withdrawing from the UN, puts a question mark on human rights protection. The continuous protection and priority of democratic and constitutional human rights is under threat. As we have witnessed, the US is one of the largest contributors to the UN’s budget, and its withdrawal places global human rights protections in question, especially with regard to access to health services. Will this move give power and rise to human rights violations? What will be the long-term impact on grassroots community movements? Are vulnerable and marginalized groups safe?
Over the past few weeks, the world has witnessed a disturbing shift in leadership, one that not only rolls back protections for everyone, including vulnerable and marginalized groups, but also has the potential to fuel hate, spread misinformation, disinformation, division, and violence. Donald Trump’s return to power has been marked by an alarming series of executive orders targeting immigrants, migrants, LGBTIQ+ people and women all under the guise of “realigning American values.”
Erasing identities
Trump’s position on gender diversity has found eager supporters, including many in Africa who advocate for a rigid, binary definition of gender. His Jan. 20, 2025, executive order, “Defending Women from Gender Ideology and Extremism and Restoring Biological Truth to the Federal Government,” was nothing short of an attack on transgender people and all persons who choose to live in a manner where they are not defined and boxed in by their attributed gender. This order spreads disinformation by claiming that gender identity is false and deceitful, legitimizing hate speech. By insinuating that gender diversity is a threat it creates an environment where transphobia will likely thrive without any consequences. With one stroke of the pen, Trump reinforced conservative, exclusionary gender norms and gave legitimacy to those who seek to erase transgender identities.
The consequences of this executive order are slowly being felt far beyond the US.
In Nigeria, conservative leaders have hailed Trump’s decision as validation of their own laws, which according to reports, already criminalize same-sex sexual activity between men and between women, and gender expression for transgender persons. A 2024 report by Nigerian advocacy group, the Initiative for Equal Rights, highlighted that LGBTIQ+ people already face regular discrimination and violence. These executive orders are likely to result in a rise of hate crimes towards gender-diverse persons. Framing gender identity as a “dangerous ideology,” Trump is not only spreading disinformation but also legitimizing hate speech and possibly creating a global ripple effect that threatens the safety and dignity of transgender and gender-diverse people.
Xenophobia in full swing
Transgender people are not the only ones under attack. Immigrants and migrants are also targeted as Trump endlessly signed his executive orders. One of his over 80 executive orders is the realigning of the US refugee admissions program, which frames migrants and refugees as threats to national security, thereby potentially reinforcing dangerous xenophobic rhetoric. Trump has long pushed the false narrative that migrants are a burden on resources, a danger to public safety, and a threat to the so-called “true American identity.” This rhetoric does more than just close borders. It dehumanizes refugees, fuels violence against migrants, which directly goes against the essence of the human rights protection mechanisms such as the Universal Declaration of Human Rights and the International Convention on the Protection of the Rights of All Migrant Workers and Members of their Families, which protects the rights and dignity of migrants.
Misogyny over human rights, right?
Trump’s disregard for women’s rights is nothing new.
A 2018 article in the Guardian reported how Donald Trump’s attitudes and policies have undermined women’s rights through derogatory remarks, sexual misconduct allegations, and policy rollbacks. The reinstatement of the Global Gag Rule, and its cuts in funding for health services, is likely to disrupt essential sexual and reproductive health services of many women around the world. It will leave women who are already on the margins of exclusion, further exposed to human rights violations such forced pregnancies due to denial of safe abortion and contraceptive services.
An Afrobarometer report from December 2023 revealed that gender-based violence remains a top concern in Africa, with 14 percent of respondents stating that violence against women and girls is “very common” in their communities. Trump’s policies and rhetoric only serve to exacerbate these realities, reinforcing harmful stereotypes, restricting bodily autonomy, and undermining decades of progress in advancing women’s rights. The leader of the free world’s rhetoric and actions reinforces systems that discriminate against women and disregards the protection of all women.
Bradley Fortuin is a consultant at the Southern Africa Litigation Center and a social justice activist. This article was first published in Modern Ghana and Botswana Gazette.
Opinions
This is fascism, not child protection
Hungarian government is trying to ban public Budapest Pride march
Pride is not just a protest. Pride is a movement.
The Hungarian government is trying to restrict peaceful protests with a critical voice by targeting a minority. Therefore, as a movement, we will fight for the freedom of all Hungarians to protest!
Hungarians are a freedom-loving nation. We know that if the government tries to ban protests with critical voices, they will face resistance from the whole of society. That is why we need a scapegoat, a distraction, another wave of hatred. A little bedbuging. They lie to their voters about a child protection measure, but there is no child protection in this bill.
Just two days after the anniversary of the Hungarian revolution and war of independence of 1848, many people were outraged by the hypocrisy of the government’s attempt to strip us of our hard-won freedoms. The slogan of the 1848 revolution against the Austrian Empire was “Liberty, Equality, Fraternity,” defying oppression and censorship. When Pride organizers and participants stand up for their own freedoms, they are standing up for the rights of all Hungarians. It is a new level of fascism when only those who support those in power are allowed to march in the streets of a country.
If the government tries to restrict the right of citizens to demonstrate peacefully by means of made-up rules, it will be that any demonstration can be banned for any fictitious reason. We will not allow future generations to grow up in such a country. We are at home, we will be here, and we will work to make Hungary a freer country.
The LGBTQ community has been a target of attacks from the ruling parties for years. If attempts are made to ban demonstrations for the rights of the LGBTQ community, there is no guarantee that peaceful demonstrations by groups that the governing parties call the enemy, “the bedbugs,” will not be banned, on the false grounds of child protection.
As members of the LGBTQ community, it is part of our lives from childhood that we have to defend ourselves, that we have to fight for acceptance and equal rights. Even though those in power try to dehumanize us, we LGBTQ people are all human beings who want freedom, safety and equal rights. The pride march is one of the most visible parts of this struggle, but equally as important is the resistance we wage every day to lead a free, authentic and happy life in our own country.
It would never occur to a democratic leader to restrict the fundamental rights of those who disagree with them. Elected representatives should not work for their own self-interest, but for all citizens.
We are asking Viktor Orbán’s government: How will they guarantee that all Hungarian citizens, including LGBTQ people, can live and protest freely? If they cannot guarantee this, it is an admission of their own incompetence.
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