Opinions
The intergenerational impact of aging with HIV
Dec. 1 is World AIDS Day
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.
Cuba
When impunity meets history
Raúl Castro indicted for alleged role in shooting down Brothers to the Rescue aircraft
The scene would have seemed impossible only a few years ago.
The name of Raúl Castro Ruz appearing formally inside a United States federal criminal indictment. Cuba’s former general of the Army, for decades one of the most powerful figures inside the Havana regime, accused in connection with the shootdown of the Brothers to the Rescue aircraft and the deaths of American citizens in 1996. And all of it unfolding in Miami, inside the Freedom Tower, on May 20.
That detail matters.
Because this indictment arrives at one of the most fragile and politically tense moments in recent relations between Washington and Havana. It comes as Cuba faces deep economic collapse, growing political exhaustion, mass migration, blackouts, and increasing public frustration both inside and outside the island. It also arrives on a date carrying enormous symbolic weight for Cuban exiles — the anniversary of the founding of the Cuban Republic in 1902.
But the true significance of this moment goes far beyond symbolism.
What happened in Miami represents something much larger: the collapse of the idea that certain men would never face accountability.
For decades, Raúl Castro embodied the permanence of revolutionary power in Cuba. Defense minister. Military strategist. The man who oversaw the armed forces for generations. One of the central architects of the Cuban political and security apparatus built alongside Fidel Castro. A figure many believed would leave this world untouched by any court, shielded forever by power, time, and history itself.
Today the image is very different.
Today his name appears inside the language of American criminal prosecution.
And that changes the historical dimension of this case completely.
Because this is no longer simply a political accusation voiced by the Cuban exile community. It is now a formal federal criminal indictment publicly announced by the United States government against one of the highest-ranking figures in the history of the Cuban regime.
The setting itself carried enormous meaning.
The Freedom Tower is not just another building in Miami. For generations of Cuban exiles it represents memory, displacement, survival, and the beginning of a new life after fleeing Cuba. Thousands of Cubans passed through those doors after escaping the revolution. Families arrived carrying fear, uncertainty, grief, and hope all at once. Announcing these charges from that location transformed the moment into something far deeper than a legal proceeding.
And the people witnessing it were not only members of the exile community.
Among those present were relatives of the young men killed nearly 30 years ago. Families who spent decades waiting to hear words they feared might never come. Families who carried the weight of loss while believing the men responsible would never be formally accused by any court.
That emotional weight still surrounds this case.
On Feb. 24, 1996, two civilian aircraft operated by Brothers to the Rescue were shot down over the Florida Straits by Cuban military jets. Armando Alejandre Jr., Carlos Costa, Mario de la Peña, and Pablo Morales were killed. The flights were connected to humanitarian rescue efforts searching for Cubans attempting to flee the island during the migration crisis of the 1990s.
Those aircraft were not military bombers.
They were not attacking Cuba.
They were civilian planes associated with rescue operations involving Cubans risking their lives at sea.
That reality has always shaped how this tragedy lives inside the memory of the Cuban exile community.
For many, this was never viewed simply as a geopolitical conflict between hostile governments. It was seen as the use of military force against civilians connected to humanitarian missions during one of the darkest chapters in modern Cuban migration history.
But for many Cubans, the indictment reaches far beyond the Brothers to the Rescue case itself.
It touches decades of unresolved pain tied to one of the central figures behind Cuba’s military and political system.
It reaches mothers who buried sons lost in compulsory military service or in distant wars they never chose to fight. Families who spent years believing promises that were never fulfilled. Political prisoners who disappeared into silence. Relatives who watched loved ones die trying to flee the island.
And for many LGBTQ Cubans, the moment carries another layer of historical weight.
Long before official campaigns promoting tolerance and inclusion emerged from within the Cuban government, there were years of persecution, fear, forced silence, and humiliation carried out under the revolutionary system itself.
The UMAP labor camps remain one of the deepest scars in modern Cuban history. Gay men, pastors, religious believers, artists, and others considered incompatible with the revolutionary ideal were sent away under the language of “re-education” and forced labor.
In recent decades, public gestures toward LGBTQ inclusion promoted by figures close to the Cuban leadership attempted to project an image of progress and openness to the international community. But for many survivors, and for many Cuban LGBTQ people, those gestures never erased the trauma or the historical responsibility tied to the same structures of power that once persecuted them.
For many, acknowledgment without accountability still feels painfully incomplete.
That is why this indictment resonates so deeply today.
Because it arrives while Cuba once again faces profound national crisis. The island is losing entire generations through migration. Public frustration continues to grow. Economic collapse shapes daily life. And the revolutionary narrative that once projected permanence and control appears increasingly eroded by reality itself.
Against that backdrop, the image emerging from Miami becomes even more striking.
A man once viewed as untouchable by history now formally accused by the United States government and legally transformed into a fugitive wanted by American justice.
History moves slowly until suddenly it does not.
And for many Cubans, both on the island and throughout the diaspora, what happened today inside the Freedom Tower felt like witnessing something they once believed they would never live long enough to see.
As a Cuban, as an immigrant, and as someone who has lived close to that pain, one thought keeps returning tonight:
Justice takes time.
But when it finally arrives, it arrives with history behind it.
David Trone’s commercials keep telling us what he has done for women. But apparently, he doesn’t trust them to fight for themselves, or he wouldn’t keep spending countless millions to defeat them.
Trone is trying to buy back his seat in Congress, this time running in a primary in Maryland’s 6th District against incumbent Democrat April McClain Delaney. Once again, Maryland voters should say a loud NO to David Trone. He is doing this after spending nearly $60 million trying to buy a United States Senate seat, which he thankfully lost to Angela Alsobrooks, now one of only two Black women in the United States Senate. Clearly, that was a blow to his ego, and now he is trying again to defeat another very competent woman. He has already spent close to $7 million on commercials attacking Delaney, telling us how much money he has spent on what he calls ‘good deeds.’ Delaney is accurately calling him out for working with Florida Gov. Ron DeSantis, and donating through his business, nearly $800,000 to Republicans, including MAGA ones. When he was buying his first seat in Congress, the Washington Post reported, “Wine retailer David Trone… has contributed more than $150,000 to Republicans in states across the country since 2000, according to a nonpartisan site that tracks money in politics. Most went to candidates and officeholders in states where he sought legislation or regulatory changes favorable to his company, Total Wine & More. Among the Republicans who received funds were Gov. Greg Abbott and Lt. Gov. Dan Patrick of Texas and North Carolina Gov. Pat McCrory.” The same Pat McCrory who signed anti-LGBTQ legislation and Abbott who wants to close all Planned Parenthood sites in Texas.
I urge voters in Maryland’s 6th, to speak out for, and vote for, April McClain Delaney. Join with me, and a host of others, who have endorsed her as of March 31. They include Sen. Angela Alsobrooks (D-Md.), Sen. Chris Van Hollen (D-Md.), Maryland Gov. Wes Moore (D), Rep. Nancy Pelosi (D-Calif.), Rep. Sarah McBride (D-Del.), and every Democrat in the Maryland U.S. House delegation.
McClain Delaney says, “Now, David Trone says I should step aside, so he can have his old office back after he ran for the Senate, lost, and has been sitting on the sidelines. He’s a distraction. This race isn’t about one man’s ego. … And as a member of team Maryland, I forged strong relationships with Governor Moore and the entire federal delegation, as well as with local leaders across the district.” She adds, “On behalf of my district, I stand up to bullies. That’s why I’ll continue to take on Trump’s assault on our government workers, defend our diverse community, protect choice and women’s reproductive rights, and work against inflation-creating tariffs.”
Again, this isn’t the first time Trone spent a fortune trying to get into Congress. It cost him about $25 million, and two tries, to win the first time. Then his ego had him give up the seat he bought to run for the U.S. Senate. Apparently he has unlimited amounts of money to spend and at nearly 72 thinks he needs to get back in by defeating a strong woman nearly 10 years younger, who is doing a great job. He is clearly not needed in Congress.
Trone always made the basis of his campaigns not taking any money from PACs, lobbyists, and big donors. Seems hypocritical considering he thought it was OK to influence others to build his own business. To give Trone credit he always runs on a very liberal platform, which is pro-LGBTQ, pro-women, and pro-equal and human rights for all. But then Democrats like April McClain Delaney, who he is now running against, has the same platform, and is doing a good job for her constituents.
Trone’s commercials are mostly about what he has done for women. But again, he clearly doesn’t trust women to do for themselves. He spent $60 million running against a great woman for U.S. Senate, and now is spending more millions running against another strong woman, trying to reclaim a House seat he gave up. Marylanders, make sure he loses again, by voting for April McClain Delaney for Congress.
Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist.
Opinions
Skipping Memorial Day crowds in Rehoboth Beach
After 30 years, I’ve become allergic to large gatherings
There are a lot of things about getting older that are great. I love retirement, love the cruises I take, time at my favorite coffee shops, both in D.C. and at the Coffee Mill in Rehoboth. Then there are some not so great things. I have had a few health issues, which luckily, I have fully overcome. Some issues you can do something about, others you can’t. One of the things I have come to realize is, I no longer enjoy big crowds, and this is something I can do something about. Just avoid them.
I have spent every holiday weekend since buying my place in Rehoboth, and that is going on 30 years, at the beach. I go for Christmas and New Year’s, Martin Luther King, Jr. weekend, President’s Day, Memorial Day, and Labor Day. Add a few extra holidays I may be missing like Veterans’ Day, if it falls on a weekend. This is the first year I won’t be there on Memorial Day, and it is by choice. Instead, will be staying in D.C. Some will ask why, and my simple answer is to avoid the crowds. I keep thinking of the crowds last Memorial Day and decided to see how it goes skipping it this year.
Don’t get me wrong, I am thrilled for all the businesses at the beach when they are swamped with people. And glad those people who want to be there are having a great time, and don’t mind when the lines to get into Aqua and Diego’s are around the block. Or when my favorite place for coffee, The Coffee Mill, has a line when I get there at 7 a.m. When you can’t get a reservation at the Pines or even Ava’s. But last year it finally occurred to me why I wasn’t having as much fun as I used to, and realized it was because I have become allergic to crowds. So, for the first time this year, I determined I was going to stay away and see how it feels. I may regret it after a few hours at home in D.C., or when seeing friends’ posts on Instagram and Facebook. But am going to take that chance. One thing I do regret missing is the incredible annual brunch thrown by my friend Robert, and his husband, but am determined to see what it feels like not being at the beach for the kick-off holiday weekend of the summer.
To wean myself away, I did go last weekend. Had a great time seeing friends. Had fun at Aqua each evening for happy hour; went to a great party at CAMP in honor of their new Executive Director Dr. Robin Brennan. I’ve had a chance to chat with her, and believe they made a great choice when hiring her. Then on Friday evening I went to the Washington Blade annual season kick-off party at Diego’s and met the new Steve Elkins Fellow, Thomas Weaverling, and am sure he will do a great job. It was wonderful to see Ashley Biden there accepting the award given posthumously to Beau Biden for all he did for the LGBTQ community. Then on Saturday I stopped in at Freddie’s Beach Bar for the Cloud Nine reunion. That brought back so many good memories. It was coordinated by the inimitable Fay Jacobs. It was back then when I did like crowds, the more the merrier, and remember dancing all evening on the small crowded dance floor. Some people at the reunion reminded me of all the years I hosted an annual Memorial Day party, actually the first 10 years I had my place at the beach. It was catered by the Blue Moon, when my friend Rob was there, and they brought the Champagne, hors d’oeuvres, and even a bartender. I just had to have fun, and I did. The thought of doing that today is a little overwhelming, and I think it is about age.
So, this year I will see how much I miss being at the beach for the holiday weekend. Then after my June trip to France, will decide whether I want to do the same for the Fourth of July. I kind of look forward to seeing what my thoughts on it are, and how it goes.
For those of you at the beach, I hope the place is a zoo, of the best kind, and you all have a fabulous time.
Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist.
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