Opinions
This World AIDS Day, we must protect access to HIV medicines
We stand on the precipice of ending the epidemic

As a physician who has worked with patients living with HIV since the AIDS crisis in the 1980s, I’ve seen the darkness and the light.
Back then, it was a scary, anxious time—not only for patients, but also for clinicians. We lacked effective medical treatments. Patients swallowed handfuls of pills. These complex regimens often worked only for short periods of time and brought difficult side effects. Contracting HIV seemed like a painful death sentence—and one that too often lacked dignity, as many morticians then refused to embalm those who had succumbed to the disease.
Today, the reality is much brighter. I now regularly counsel my patients who contract the virus to plan on living a full life into their golden years. With longer lives, more people now access prescription HIV drugs from Medicare than ever before. While we still lack a cure, we stand on the precipice of ending the epidemic because we know people cannot transmit the virus through sex when they have undetectable levels of HIV. This incredible step forward—a concept known as U=U, or undetectable equals untransmittable—is due in large part to the steady supply of a wide variety of antiretroviral medications. So long as patients have access to quality care and the right medicine, HIV is now a manageable disease.
One important but unsung hero in this progress? An obscure federal law with long, bipartisan support, known as the “six protected classes” policy. It mandates that Part D prescription drug plans cover “all or substantially all” medications in six protected classes. It helps Medicare beneficiaries with some of the most serious health conditions: not only HIV, but also cancer, epilepsy, and those at risk of organ transplant rejection. Now that policy is under threat because pharmacy benefit managers—or the drug middlemen who decide which drugs your plans include and your pharmacy carries—are pressing the federal government to weaken the policy to pad their bottom lines.
For those living with HIV, the stakes could not be higher. Until we have a cure, patients must take drugs regularly and diligently for the rest of their lives. Thanks to decades of incredible innovation, there are now 23 different antiretrovirals in nine different drug classes available to those living with HIV. I have prescribed every single one. Sometimes, I’ll prescribe from nine different two- or three-drug single tablet co-formulated combinations to find the most effective option for a patient.
While patients have more options, they still face challenges adhering to their regimen. Some experience a gap in coverage due to loss of insurance or a switch in plans. Copayments can become a financial barrier. Others might experience side effects or have conditions making a particular medication unsuitable.
These antiretroviral medications are not interchangeable. If a patient doesn’t take the exact medicine they need, they risk side effects, problematic medication interactions, and possibly developing resistance to HIV. If the virus comes back, it is genetically unforgiving. Now resistant to an entire class, the virus steals precious options for the patient, particularly those who have been living with HIV for decades. To overcome this, I need—my patients need—every single option at their disposal. The only way I can keep my patients maximally suppressed, living well, feeling good, and able to live a full, healthy life is if they have access to the full range of drugs.
We have come a long way. Over the past decade, we have driven new deaths down by 70 percent and new infections down by 40 percent worldwide. But this progress is not guaranteed. If we eliminate the number of antiretrovirals available to patients, the danger of a backslide into resistant strains of the virus is real.
As we recognize World AIDS Day, let us not only remember the millions this disease has taken, but let us also recommit ourselves to the 40 million people worldwide living with HIV and many more who are at risk of contracting it.
Let’s protect this critical federally protected drug class policy that has delivered so much progress. We can’t slide back into darkness. We must keep pushing forward into the light.
Dr. James A. Sosman is a recognized leader in the field of HIV/AIDS medicine and serves as medical director for the Midwest AIDS Training and Education Center.

Donald Trump has held the presidency for less than six months in 2025. But already, trans people have been defaced, demoralized, and fatigued. On June 18, the Supreme Court upheld a ban on gender affirming care for trans youth in nearly half of U.S. states. This ensures that trans youth do not have access to hormone blockers that prevent them from becoming their hated gender.
The Trump administration has also ensured that Medicaid can no longer provide subsidized and insurance-covered care to trans adults. In addition to this, Trump’s White House has banned trans people from the military and has stripped all government agencies and universities of having Diversity, Equity, and Inclusion (DEI) departments. Even progressive minded institutions like Yale (my alma mater) and Harvard have stripped themselves of DEI. Trump’s cruelty knows no bounds.
This month, former president Obama stated over Instagram that Trump’s administration was becoming more and more like an autocracy. Recently, a tourist was stripped of his U.S. visa when federal agents discovered a JD Vance meme on his phone.
ICE is raiding more and more immigrant families–immigrants who provide critical labor to our U.S. fields and other important industries. Immigrant children are forced to stand testimony and defend themselves–without a lawyer–in court. The United States, in other words, is becoming more and more like a fascist state. Look no further than Trump’s removal of the Kennedy Center board, and his ban of a Pride event at the Kennedy Center. During his campaign years, Trump held queer events for “LGB” folk — but made sure to drop the “T”, because it is becoming all too apparent that he is cruel to trans people.
In a past article I wrote for the Blade, I stated that not enough trans people are scared in the U.S. right now. Other countries, including European countries, are quickly warning their trans citizens against traveling to the U.S., citing the fact that we are a hostile place for folks like them. Unfortunately, this is true.
Trans people have to start looking to move to sanctuary states right now. In fact, we have already been doing this for many years: trans citizens have been fleeing red, conservative states–states where men shoot trans women (and trans men). But now is the time to do so more than ever. Check out outcoast.com for a useful list of some sanctuary cities for trans people in the U.S. right now. But other cities not on the list, including my college town of New Haven, Connecticut, are also welcoming places for trans people.
Transgender Americans have to take into consideration the fact that Trump and his cronies have sought to overthrow us in just less than six months’ time. They are trying to make us weak, vulnerable, up for the taking. Yet we have to stand strong amid all the attacks from Republican lawmakers. One has to question the fact that ICE is starting to use social media to go after any naysayer — and deliberate whether ICE will be going after trans Americans in two or three years to come. If Trump is doing so much damage to the trans community already, what will be happening in 2028? A move to Canada can surely be on the horizon.
Transgender Americans need to be scared right now. But more than just scared, we need to be taking action.
Isaac Amend is a writer based in the D.C. area. He is a transgender man and was featured in National Geographic’s ‘Gender Revolution’ documentary. He serves on the board of the LGBT Democrats of Virginia. Contact him at [email protected] or on Instagram at @literatipapi.
Opinions
Felon-in-Chief either has dementia or is just plain dumb
Trail of gaffes raise questions about Trump’s fitness for office

Some ask why I often write about the felon in the White House. It’s because we should never stop highlighting his outrageousness, how he is destroying our country, and creating havoc in the world. His gaffes are often venal, and in most cases just his way of insulting someone. Recently it’s again obvious he either has dementia, or is just plain dumb. Clearly, he is being manipulated by some corrupt aides and personally motivated by vindictiveness. He asked the president of Liberia how his English is so good, apparently not knowing that English is the language of Liberia.
He was asked who stopped the shipments of weapons to Ukraine, didn’t know, or remember. Then appears to forget, or doesn’t know, only two countries actually came to final tariff deals with the U.S. He went to Iowa to tout his disgusting bill and used the term “Shylock,” the name of the Jewish character in the “Merchant of Venice,” clearly used today as an anti-Semitic slur, and lied saying he never heard of it that way. Then he said Putin was a hero in World War II, when he wasn’t born until after the war ended. Now he thinks we should change the Department of Defense back to Department of War. He often forgets where he is in speeches.
This is the man who occupies the most powerful office in the world. He is an embarrassment to the nation. He uses the presidency to get back at his perceived enemies, doing it openly. He is a grifter, enriching himself using the power that comes with being president of the United States. Others are helping, or excusing him. House Speaker Johnson was asked about the president taking grift, and said contrary to his attacks on Biden, who he said did it secretly, what Trump is doing is OK, since he is doing it publicly. Yes, he is doing it publicly, taking a jet from Qatar and cutting deals to build hotels in the Middle East. He said he wants to build a resort in Gaza after removing all the Palestinians. While enriching himself and his friends, in the process he is screwing the American people.
Trump is making policy based on personal interests. Like framing his threat to slap a bruising 50 percent tariff on Brazil as a quest for justice for his friend and ally, far-right former President Jair Bolsonaro. Then he upped the ante based on a recent BRICS meeting, one of Trump’s top foreign policy targets, a coalition of emerging economies that includes founding members Brazil, Russia, India, and China, as well as South Africa and six other countries that have joined the group in recent years. They are stronger based on the felon’s policies.
I keep writing about this felon because he is always doing something outrageous. The MAGA Republicans in Congress keep supporting him, willingly screwing their constituents. The MAGA Log Cabin Republicans, supporting Trump, recently honored four MAGA members of Congress, all of whom are opposed to the Equality Act. One, Sen. Joni Ernst (R-Iowa), when asked by her constituents why she supported taking away their Medicaid, said “It doesn’t matter you will die anyway.” That is the attitude of the felon in the White House and all his MAGA supporters.
I am not blind to the fact that there has always been racism, sexism, homophobia, anti-Semitism, and Islamophobia, in our society. But for many years we worked hard to ensure those feelings couldn’t be voiced in the public square. If someone did voice them, they were called out for it. Then during Trump’s first term, from the day he came down that escalator to announce his candidacy and called out people in derogatory terms, he gave others tacit permission to do the same. If he could do it, then why couldn’t they? And things only got worse from there.
Trump took hold of the Republican Party and rational Republicans simply dropped like flies afraid to criticize him. It became clear nearly 35% of the Republican Party became a Trump cult, and no Republican could win without their votes. So today, the Republican Party supports a sick, old, lying felon, a racist, homophobe, misogynist, found liable for sexual assault, whose closest allies produced Project 2025, the blueprint for destroying democracy.
So that is why I will always write about him, and urge others to do the same. We must all speak out every day, until we rid ourselves of this despot in our midst.
Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist. He writes regularly for the Blade.
Opinions
Pride must be inclusive, intentionally intersectional
Organizers of local UK Pride led anti-Israel, pro-Houthi slogans

There are a lot of conversations in the LGBTI community about Prides becoming “too commercial,” but what about grassroots, leftist radical Prides? Well, the idea of community-organized, grassroots Prides is amazing, but unfortunately, it is very human to make mistakes.
While big LGBTI Prides that are organized with help from businesses are trying to be inclusive, grassroots Prides have sometimes gone too far in their attempts to create an “edgy,” rebellious atmosphere. Some slogans that have been used at “independent” Prides create more problems than they solve, making these events non inclusive and unacceptable for a large part of the LGBTI community.
I believe in intersectionality. I was one of the very few activists in Russia who began writing and speaking about the need for intersectional approaches in the LGBTI community — speaking up for neurodivergent, disabled, non-white, Muslim, and Jewish LGBTI people. In the U.K., I’m part of various groups supporting LGBTI refugees.
And this is why I see that some modern attempts by Western LGBTI activists to be mindful of different forms of oppression have actually excluded people from Pride and divided the LGBTI community. I’ve seen these tendencies across Europe, the U.S., and the U.K.
Personally, I’ve never felt less included at a Pride than I did last weekend at a local U.K. Pride, where the crowd was forced to yell: “Death to the IDF (Israel Defense Forces),” “From the river to the sea, Palestine will be free,” and “Yemen, Yemen made us proud, turn another ship around.”
The last slogan, about Yemen, didn’t even catch on with the crowd — probably because most people at the Pride had no idea why they should be proud of Yemen. And the truth is, they shouldn’t. The slogan refers to Iran-backed Houthi rebels in Yemen, who have hijacked and fired missiles at dozens of commercial and military ships in the Red Sea, supposedly to “protect” Palestinian rights.
Let me make it clear: I have no problem with the “protecting Palestinian people” part of the story. I believe that there are many war criminals in the current Israeli administration, and the bombing of Gaza refugee camps is unacceptable, no matter what.
But at the same time, I couldn’t understand why we were being asked to support attacks on commercial ships or show solidarity with the Houthi rebels, who, according to Amnesty International, are not only responsible for the deaths of dozens of LGBTI people, but are also extremely authoritarian and prone to sectarian violence.
If we’re speaking from an intersectional perspective, I know how triggering those slogans must have been for many Sunni Muslims (and yes, most Muslims from Gaza are Sunni), as well as for LGBTI refugees from Yemen and Iran who may have lost loved ones to the Houthis or the Iranian regime that support them. And I am sure there were likely some queer Iranians at that Pride.
The chanting about the Israel Defence Forces was also extremely disturbing — not only because there were likely Jewish queers at the Pride, some of whose relatives may even oppose Israeli actions in Gaza and support a two-state solution, but who served in the Israeli army due to conscription laws. But the problem is, I’ve never heard people at a Pride chant in support of Ukrainian people, or Chechens, or Uyghurs, or Yazidis — despite the fact that all of them have survived genocide. I’ve never heard queer people at Pride yelling “death to Russian occupiers,” even when Russian missiles destroyed Ukrainian schools and shelters in Mariupol, bombed Aleppo, persecuted Crimean Tatars, or wiped out entire Chechen villages.
China built concentration camps for Uyghurs, but no one is promoting the death of the Chinese government. Moreover, China, Russia, and Assad’s Syria are more homophobic than Israel. So, what is the reason for yelling “Death to the IDF” but not, for example, calling for the Russian government’s collapse or the end of the Chinese Communist Party? There are only two logical explanations:
• It is either antisemitism or ignorance about other wars except for the one that is going on in Gaza. Both reasons are quite bad.
• It is not intersectionality. It is anti-intersectionality, because it erases every other war survivor who isn’t Palestinian from LGBTI community. It also alienated LGBTI Jewish people because only Jewish State had a “special” hatred for war crimes that atheists and Christian don’t have.
It’s also an attempt to turn the LGBTI movement into an ideological club instead of a group fighting for the rights of a specific marginalized community.
Another triggering thing I saw at this Pride was the glorification of socialism. But not all LGBTI people are socialists, and not all countries that called themselves “socialist” have been LGBTI-friendly.
I couldn’t even imagine what a queer person from North Korea, or a gay man who was imprisoned in the Soviet Union for being gay must have felt when hearing calls for a socialist revolution at Pride. It must have been devastating. Pride should feel like a free, anti-authoritarian space.
Pride also needs to focus on the real problems LGBTI people face. In the U.K., the Supreme Court ruled that only cis women can be considered real women. Thousands of trans kids have lost access to hormone therapy. LGBTI books are being censored in libraries. The government is cutting benefits for disabled people: LGBTI disabled people will be among the first to be harmed, because they face double stigma and more challenges finding employment, even when they are able to work.
But none of this was the main point at Pride. For some reason, we were asked to repeat pro-Palestinian slogans more often than slogans defending trans people or LGBTI people with disabilities.
The organisers were so obsessed with Palestine and socialism that, if I weren’t already involved in LGBTI activism, I might have assumed the LGBTI community has no real problems left — and that now we just campaign about unrelated political issues.
But that would be a false impression.
LGBTI people are under attack in countries around the world — from U.S. to Russia to the U.K. Moreover, far-right ideologies are rising across the West. Yes, it’s important to understand the international context, but now, more than ever, it is equally important to unite against the global rise of fascism and not divide the movement based on economic ideology or international political views.
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