Connect with us

Opinions

The intergenerational impact of aging with HIV

Dec. 1 is World AIDS Day

Published

on

World AIDS Day 2023 at the White House (Washington Blade Photo by Michael Key)

BY TERRI L. WILDER | Today, Dec. 1, 2024, the global HIV community marks the 37th annual World AIDS Day (WAD). Here in the U.S., the face of HIV looks quite different than it did on the first WAD in 1988. It is estimated that more than 50 percent of people living with HIV (PLHIV) in the U.S. are aged 50 and older — an age that must have seemed impossible to the countless young people diagnosed during the height of the epidemic. Some were diagnosed later in life, whereas others have lived with HIV for many years — in some cases, since birth. 

While their stories differ, PLHIV all face a common challenge: facing the impact of aging with HIV. The theme of WAD 2024 is “Collective action: Sustain and accelerate HIV progress.” A key to this progress is uplifting and understanding the real stories and lived realities of those growing older with HIV and using their experiences to guide proactive policy.

The spread of misinformation

In 1981, the first cases of what would later be identified as HIV (human immunodeficiency virus, the cause of AIDS) were reported. Three years later, Nathan Townsend was diagnosed with HIV at age 30.

When he got the call with the news, he was shocked. Early reports of HIV often suggested that only specific communities — most notably white gay men — were vulnerable to HIV. However, widespread misinformation contributed to the Black community later accounting for nearly half of all AIDS-related deaths, according to a 1999 CDC report.

Then, Nathan received more grim news: He was told by his doctors he only had two years to live. Believing he was going to die, Nathan purchased a casket and paid for his future funeral — one that thankfully didn’t come.

Today, Nathan is one of the growing number of older people  who live with HIV, with researchers estimating that 70 percent of those living with the virus will be 50 and older by 2030

The stigma of HIV diagnosis

As awareness of HIV grew in the late 1980s, many Americans expressed stigmatizing attitudes. A 1985 Gallup poll found that 28 percent of Americans reported that they or someone they knew had avoided places where gay men might be present because of HIV; by 1986, the percentage had grown to 44 percent.

This was the beginning of the endless stigma faced by those living with HIV — something Porchia Dees and Grissel Granados experienced.

Porchia was diagnosed at two months old through perinatal transmission and is part of the first generation of children born with HIV. Doctors indicated that Porchia wouldn’t live to see her fifth birthday. Fortunately, Porchia would prove them wrong.

Porchia still remembers the stigma she felt when she learned of her diagnosis in sixth grade from a social worker at the Children’s Hospital in Los Angeles. She recalled being pulled aside and asked if she was sexually active before being explicitly warned against having any sexual activity. The next time she heard about HIV was in a sex education class, which furthered the stigmatizing message that she would never live a “normal” life.

Today, Porchia is an advocate, changing people’s perspectives on what it means to live with HIV, but it does not come without challenges. At 38-years-old, Porchia is more focused on her health after witnessing long-term HIV survivors battle kidney failure, renal failure, bone density issues, cognitive issues, breast cancer, and shortened lifespans.

Grissel, another lifetime HIV survivor who acquired HIV through perinatal transmission, considers herself lucky that her mother explained the diagnosis to her at a young age. Despite her family’s support and honesty about HIV, a now 38-year-old Grissel still had to grow up with fear and uncertainty while now facing the fear of early mortality. 

Social isolation

When Rev. Claude Bowen was 33 years old, he received a phone call that would change his life: His HIV test came back positive.

Believing he only had two years to live, he hid himself away, self-medicating and isolating himself from his support systems. These coping mechanisms served as an escape from his reality. But eventually, he realized that this was his reality and wanted to fight. He started getting involved in HIV education and advocacy work after his best friend disappeared in the late 80s. He would soon get a phone call, learning his friend had died of complications related to HIV.

For the LGBTQ+ community, losing friends and chosen family during this time became all too common. From 1984-1986, over 42,500 people in the U.S. died from HIV-related causes, which doesn’t account for individuals who died from complications related to HIV whose families or loved ones asked that the cause of death not be disclosed. For older PLHIV, this devastating loss of community has contributed to social isolation and loneliness.

Living and aging with HIV

With access to care, HIV is no longer a death sentence, thanks to scientific advancements in medications and treatments. Whether in your 70s like Nathan or 38 like Portia, many health challenges now faced by people living with HIV are more related to aging than to HIV-related illnesses.

Aging with HIV comes with a greater risk of health problems from inflammation from the virus and the long-term use of HIV medications. Many people aging with HIV also face the “dual stigma” of ageism and HIV-related stigma, leading to high rates of anxiety, depression, and substance use disorders. Furthermore, many have lost friends and family to the HIV epidemic, leading to loneliness and increased risks of cognitive decline and other medical conditions in older adults, as found in a 2023 study from Frontiers in Aging Neuroscience.

Acknowledging the challenges that people aging with HIV face helps ensure they get the necessary support to live a fulfilling and thriving life.

Taking action

The Older Americans Act (OAA) funds aging services and supports for older people across the country to age-in-place. In 2024, the federal Administration for Community Living (ACL) issued new regulations ensuring that LGBTQ+ older people and older people living with HIV could have more equitable access to the programs funded under the OAA. Yet, there is still more work that could be done to ensure equitable access for those living with HIV. Congress is currently in the process of reauthorizing the law.  

While we face a challenging time in modern politics, we must urge our legislators to do whatever they can to ensure that the OAA and similar laws support PLHIV. And all of us must work with our state and area agencies on aging to robustly implement the latest OAA regulations, to ensure that all older people, including LGBTQ+ older people and those living with HIV, get the services and supports they need to remain independent.

States can also do more to protect people living with HIV by passing state-level LGBTQ+ and HIV Long-term Care Bills of Rights, as advocated for by activists and organizations, including SAGE, the world’s oldest and largest advocacy organization dedicated to improving the lives of LGBTQ+ elders. These laws ensure that LGBTQ+ older people and those aging with HIV receive equitable treatment in long-term care facilities. For instance, one long-term survivor, 82, who asked to remain anonymous for this piece, credits his doctor for his excellent treatment and care, saying, “It is tremendous to have someone in your corner that you can talk to openly and ask questions” without fear of judgment.

Finally, we must advance policies that address the needs of all those living with HIV and AIDS, no matter their ages.

The time is now

The impact of living with HIV is different for every generation. From lifetime survivors like Porchia and Grissel to those aging with HIV like Claude and Nathan, access to community support, services, and HIV-specific healthcare is essential for quality of life across generations. 

This WAD, HIV advocates, aging organizations, and stakeholders must stand with local legislators to ensure care, protection, and support for all PLHIV.

Terri L. Wilder (She/Her), MSW, is the HIV/Aging policy advocate at SAGE, the world’s oldest and largest advocacy organization dedicated to improving the lives of LGBTQ+ elders. In her role, she implements SAGE’s federal and state HIV/aging policy priorities. 

Terri has worked in HIV care since 1989, providing social services, directing education programs for clients and medical providers, and advocating for policy change. She is an experienced public speaker who has presented at conferences worldwide on various HIV topics. Terri is also an award-winning writer who has published on multiple HIV-related topics through The Body’s website, among others. Terri served on the New York Governor’s Task Force to End AIDS (EtE) and the New York Governor’s Hepatitis C Elimination Taskforce, where she contributed to the development of state plans to end the HIV epidemic and eliminate Hepatitis C. 

She is a member of the New York State Department of Health AIDS Advisory Council EtE Subcommittee, and the Minnesota Council for HIV/AIDS Care and Prevention (MCHACP). Terri has been recognized for her work through the POZ 100: Celebrating Women edition of POZ magazine (2017), as well as awards from the NYS DOH AIDS Institute, AIDS Survival Project, and Bridging Access to Care, Inc.

Advertisement
FUND LGBTQ JOURNALISM
SIGN UP FOR E-BLAST

Opinions

SAVE Act could silence millions of trans voters

New administrative barriers pose threat to voting rights

Published

on

Activists hold signs opposing the passage of the SAVE Act outside of the U.S. Capitol on March 18. (Washington Blade photo by Michael Key)

In Washington, debates over voting rights usually arrive loudly — through court rulings, protests, or sweeping legislation that captures national attention. 

The Safeguard American Voter Eligibility (SAVE) Act, now under debate in Congress, may reshape voting access in a quieter way — through paperwork. The bill would require Americans registering to vote in federal elections to present documentary proof of citizenship, such as a passport or birth certificate. Supporters argue the measure would strengthen election integrity and restore public confidence in the voting process. But for millions of eligible voters, particularly transgender Americans, the practical consequences could be far more complicated.

According to Gallup, about 1.3% of U.S. adults identify as transgender, representing roughly 3.3 million Americans. Far from disengaged politically, transgender voters participate in elections at high rates. Data released by Advocates for Trans Equality shows 75% of transgender respondents reported voting in the 2020 election, compared with 67% of the general population. Registration rates are also higher. 

This is a community that shows up for democracy. Yet the SAVE Act could place new administrative barriers directly in its path. Birth certificates, the document many supporters believe should verify citizenship are among the most difficult identity records for transgender Americans to update. According to data released by The Williams Institute at UCLA Law School  and the U.S. Transgender Survey, 44% of transgender adults had updated their name on government identification, but only 18% had successfully updated their birth certificates.

That gap matters.

If birth certificates become a central requirement for voter registration, millions of eligible transgender Americans could face bureaucratic obstacles that other voters rarely encounter. 

History offers a warning. According to the Bipartisan Policy Center, Kansas implemented a similar proof-of-citizenship law that blocked more than 30,000 eligible voters from registering before the Kansas Supreme Court struck it down as unconstitutional.

At the same time, evidence suggests voter fraud remains extraordinarily rare. Research cited by the American Immigration Council estimates fraud at roughly 0.0001% of votes cast. 

The question before lawmakers is not whether election security matters. It clearly does. The question is whether policies designed to solve a rare problem could intentionally disenfranchise legitimate voters.

The broader cultural debate surrounding gender identity often becomes emotionally charged, particularly when conversations turn to pronouns or language. Yet polling suggests the issue remains unfamiliar to many Americans. A 2022 YouGov poll found only 22% of Americans personally know someone who uses gender-neutral pronouns.

Meanwhile, the problems weighing on everyday Americans are far larger: rising grocery prices, health care costs, housing shortages, and economic struggles in both rural towns and urban neighborhoods. Yet, many conservatives choose to focus unnecessary time, energy, and resources litigating the use of pronouns.

A healthy democracy should be able to debate cultural questions without allowing them to become barriers to the ballot box.

So, what should transgender Americans, and allies, do in this moment? First, stay engaged politically. Contact legislators and explain how identification requirements affect real voters. Personal stories often reach policymakers in ways statistics alone cannot.

Second, document the impact. Write letters to local newspapers, share experiences publicly, and ensure the real-world effects of voting policies are visible.

Third, consider running for office. Local school boards, city councils, and state legislatures shape many of the rules governing elections. Finally, protest with discipline and purpose. The most transformative movements in history — from Mahatma Gandhi to Dr. Martin Luther King Jr. — were rooted in peaceful persistence and moral clarity.

The SAVE Act may ultimately pass, fail, or change significantly as Congress debates it. But the larger principle at stake should guide the conversation. America’s democracy has always grown stronger when more citizens can participate, not when the path to the ballot becomes harder to navigate. For transgender voters, and for the country as a whole, that principle remains the quiet foundation of the republic.


James Bridgeforth, Ph.D., is a national columnist on the intersection of politics, morality, and civil rights. His work regularly appears in The Chicago Defender and The Black Wall Street Times.

Continue Reading

Opinions

The frightening rise of antisemitism, Islamophobia

Trump, Netanyahu to blame for inflaming tensions

Published

on

Prime Minister of Israel Benjamin Netanyahu (Photo by palinchak/Bigstock)

We can lay the rise in antisemitism and Islamophobia directly at the feet of the felon in the White House, and the criminal at the head of the Israeli government. Both Trump and Netanyahu belong in jail, not leading their governments.

I am a proud Jewish, gay man, and the homophobia and antisemitism the felon in the White House is generating are truly frightening. I am assuming my Muslim friends are feeling the same way about the Islamophobia he is causing to rise. While people have always been racist, homophobic, Islamophobic, and antisemitic, Trump has given tacit permission, with his statements, actions, and now his war on Iran, for those feelings to be shouted in the public square, and in the worst-case scenarios, acted on with violent attacks. 

We can clearly attribute the rise in antisemitism around the world, to the actions of the right-wing, war criminal, leader of the Israeli government, Benjamin Netanyahu, and what he is doing to destroy Gaza, murdering innocent Palestinians, and now again bombing innocents in Lebanon.

This is all seeping into the politics of our nation. One organization promoting antisemitism and expecting it of the candidates they endorse, is the Democratic Socialists of America (DSA). They went so far as to take away an endorsement at one point, from one of their most ardent supporters, Rep. Alexandria Ocasio-Cortez (D-N.Y.), because she refused to fully support their anti-Zionist platform and their support of BDS. The DSA took issue with “[Ocasio-Cortez’s] votes, including a vote in favor of H.Res.888, conflating opposition to Israel’s ‘right to exist’ with antisemitism,” and a press release in April she co-signed that “support[s] strengthening the Iron Dome and other defense systems.” In their 2025 platform DSA called for a single state from the ‘river to the sea’ as the Palestinian right to resist, thereby eliminating the State of Israel. It goes with their support of BDS and anti-Zionist positions. It is fair to see that as antisemitism. 

I am a Zionist, in the sense of the term as coined by Theodor Herzl. I am a believer in, and supporter of, the State of Israel. I am also for a Palestinian state. I am opposed to what Israel’s current government, led by a war criminal, is doing. I had hoped he would have abided by what former President Biden said to him immediately after Oct. 7. “Don’t make the same mistake we did after 9/11. Temper your response.” But instead, Netanyahu has murdered Palestinians by the thousands, destroying Gaza. He was rightfully declared a war criminal and should be brought to justice. He has made things worse both for the people of Israel, and Jews around the world. He has been responsible for antisemitism around the world once again rearing its ugly head. Now, two and a half years after Hamas’s attack on Israel, he is still murdering Palestinians, and now again more people in Lebanon and Iran. He still denies the Palestinian people need a home, a state of their own. He promotes settlements on the West Bank that should be part of a Palestinian state and refuses to prosecute settlers who commit crimes against the Palestinian people there. 

My parents and relatives had to flee Hitler. Some came to the United States, and some immigrated to Israel. My father’s parents were killed in Auschwitz. I believed it could never happen again. But the felon in the White House, and criminal in Israel, are abusing me of that notion. Their policies of greed and corruption are leading to danger for all the people of the world. They are leading us into a third world war.  The felon is attempting to steal, yes steal, billions through his phony ‘Board of Peace’ where he is screwing the Palestinian people out of their homes in Gaza. It is insanity, and we are all suffering for it; Jews, Muslims, and the rest of the world, as we are thrown into war none of us wants. 

Now as I wrote, the DSA, tells people all Zionists are the enemy, without a definition of what a Zionist is. They expect their supporters not to recognize the State of Israel. They create antisemitism, and now in D.C. we have a candidate running for mayor, Janeese Lewis George, asking for, and getting their support. They also have in their platform to defund the police. Those things should frighten all the people of D.C. Any candidate who can run on the DSA platform must be deemed unacceptable to anyone who opposes prejudice and discrimination of any kind. One prejudice leads to others and gives rise to people feeling they can be open about not only their antisemitism, but their Islamophobia, racism, and sexism, as well. 

We need all the good voters in the District of Columbia to find these DSA positions unacceptable, and reject any candidate who solicits, and takes their endorsement. 


Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist.

Continue Reading

Botswana

The rule of law, not the rule of religion

Bonolo Selelo and Tsholofelo Kumile are challenging the Botswana Marriage Act

Published

on

(Bigstock photo)

Botswana was in a whole frenzy as religious and traditional fundamentalists kept mixing religion and constitutional law as if it were harmless. It is not. One is a private matter of belief between you and God, while the other is the framework that protects and governs us all. When these two systems get fused, the result is rarely justice. It results in discrimination. 

The ongoing case brought by Bonolo Selelo and Tsholofelo Kumile challenging provisions of the Botswana Marriage Act has reignited a familiar debate in Botswana. Some commentators insist that marriage equality violates religious values and therefore should not be recognized by law. It is a predictable argument. It is also fundamentally incompatible with constitutional governance.

Botswana is not a Christian state. It is a constitutional democracy governed by the Constitution of Botswana. That distinction matters. In a constitutional democracy, laws are interpreted in accordance with constitutional principles such as equality, dignity, protection, inclusion and the rule of law, rather than the doctrinal beliefs of any particular religion.

Religion has no place in constitutional law and democracy

The central problem with religious arguments in constitutional disputes is simple in that they divide, they other, they contest equality and they are personal. Constitutional law by contrast, must apply equally to everyone.

Botswana’s Constitution guarantees fundamental rights and freedoms under Sections 3 and 15, including protection from discrimination and the right to equal protection of the law. These provisions are not conditional on religious approval. They exist precisely to protect minorities from the preferences or prejudices of the majority.

Legal experts, such as Anneke Meerkotter, in her policy brief in Defense of Constitutional Morality, point out that constitutional rights function as a safeguard against majoritarian morality. If rights depended on whether the majority approved of a minority’s identity or relationships, they would not be rights at all. They would merely be privileges.

This principle has already been affirmed in Botswana’s jurisprudence. In the landmark decision of Letsweletse Motshidiemang v Attorney General, the High Court held that criminalizing consensual same-sex relations violated constitutional protections of liberty, dignity, privacy, and equality. This judgment noted that constitutional interpretation must evolve with society and must be guided by human dignity and equality. The court emphasized that the Constitution protects all citizens, including those whose identities, expressions or relationships may be unpopular. That ruling was later upheld by the Court of Appeal of Botswana in 2021, reinforcing the principle that constitutional rights cannot be restricted on grounds of moral disapproval alone. These decisions were not theological pronouncements. They were legal determinations grounded in constitutional principles.

The danger of religious majoritarianism

When religion is used to justify legal restrictions, the result is what constitutional scholars call “majoritarian moralism.” It allows the dominant religious interpretation in society to dictate the rights of everyone else. That approach is fundamentally incompatible with constitutional democracy. Botswana is religiously diverse. While Christianity is the majority faith, there are also Muslims, Hindus, traditional spiritual communities, Sikh and people who practice no religion at all. If the law were to follow the doctrines of one religious group, which interpretation would it adopt? Christianity alone contains dozens of denominations with different views on love, equality, marriage, sexuality, and gender. The moment the state begins to legislate on the basis of religious doctrine, it implicitly privileges one belief system over others. That undermines both religious freedom and constitutional equality. Ironically, keeping religion separate from constitutional law is what protects religious freedom in the first place.

Judicial independence is the cornerstone of Botswana’s governance system

The current case involving Bonolo Selelo and Tsholofelo Kumile is before the judiciary, where it belongs. Courts exist to interpret the Constitution and determine whether legislation complies with constitutional rights. Political and religious lobbying, as well as public outrage, must not influence that process.

Judicial independence is the cornerstone of Botswana’s governance system. According to the International Commission of Jurists, judicial independence ensures that courts can make decisions based on law and evidence rather than political or social pressure.

When governments, political, religious, or traditional actors attempt to interfere in constitutional litigation, they weaken the rule of law. Botswana has historically prided itself on having one of the most stable constitutional systems in Africa. The judiciary has played a critical role in safeguarding rights and maintaining legal certainty. The decriminalization case demonstrated this. Despite strong public debate and political sensitivity, the courts assessed the law according to constitutional principles rather than moral panic. The same standard must apply in the current marriage equality case.

This article was first published in the Botswana Gazette, Midweek Sun, and Botswana Guardian newspapers and has been edited for the Washington Blade. 

Bradley Fortuin is a consultant at the Southern Africa Litigation Center and a social justice activist.

Continue Reading

Popular