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Obama vs. Bush: Who’s done more on HIV/AIDS?

Lifting of HIV travel ban initiated by previous administration

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Who’s done more on HIV/AIDS: George W. Bush or President Obama? (Bush photo public domain; Obama photo Blade photo by Michael Key)

HIV/AIDS advocates from around the world are descending on D.C. for the 19th International AIDS Conference with a shared goal: to eliminate a disease that has taken the lives of more than 25 million people worldwide.

Despite unity on this goal, politics inevitably plays a role in the response to the epidemic and advocates have widely differing views on who has done more in recent years to combat HIV/AIDS both at home and abroad: former President George W. Bush or President Obama.

Some praise the Obama administration for laying out a comprehensive plan and bumping up domestic funding to confront the epidemic, while others yearn for the Bush days because of the global initiatives the Republican president started despite his reputation for anti-gay policies.

Jim Driscoll, a gay Nevada-based HIV/AIDS activist who served on the Presidential Advisory Council on HIV/AIDS during the Bush administration, is among those who believes Bush did more to stop the epidemic.

“I never sat down and had a one-on-one conversation with him, but people who did talked about how open he was to doing things on AIDS and how interested he was in that subject,” Driscoll said. “There wasn’t anything the community asked him to do that I was involved in that he didn’t do.”

Those who say Bush has done more for HIV/AIDS identified three major initiatives under the Bush administration: the start of a program called the President’s Emergency Plan for AIDS Relief, or PEPFAR, to confront the global AIDS epidemic; streamlining fund allocation under the Ryan White Care Act to consider people who have HIV infection without full-blown AIDS; and allowing the first-ever rapid HIV tests to be used outside medical offices.

Driscoll, a Republican who’s backing GOP presumptive nominee Mitt Romney in the upcoming presidential election, recalled the process by which Bush approved rapid testing and said it was praised by many — with the exception of some Food & Drug Administration officials whom he overruled.

“It was a big step forward, and George Bush actually personally had a lot to do with that,” Driscoll said. “The president actually overruled FDA, and I was in the room when this was announced. There were about 100 people in the room, I think. I remember still that when he announced his approval of rapid testing … everybody in the room gave him a standing ovation except for the three people from FDA, who sat glumly. They didn’t applaud or anything.”

The AIDS Drug Assistance Programs under Bush didn’t see the waiting list levels that have been seen under the Obama administration. Under Obama, the waiting list last year reached an all-time high of 9,928 low-income people awaiting HIV drugs. That number has since dropped to about 2,000 today, according to the administration.

That’s not the only complaint that’s been lodged against Obama, who’s been criticized for reducing the global AIDS program that was set up by Bush. In his most recent budget request to Congress, the White House cut the program by half a billion dollars.

Michael Weinstein, president of the AIDS Healthcare Foundation, said HIV/AIDS was a “higher priority” for Bush than it is for Obama, citing the ADAP waiting list and the distinction in PEPFAR as a key difference between the presidents.

“We had practically no global AIDS program prior to President Bush taking office, and before he left office, they approved a $48 billion plan for PEPFAR, which Sen. Obama voted to authorize and enact,” Weinstein said. “This year, President Obama for the first time in the history of the program asked for less money for global AIDS than we had last year, and there’s $1.4 billion in unspent money in PEPFAR.”

However, the president’s most recent budget request includes an increase for domestic programs against HIV/AIDS: a $75 million increase for Ryan White and an increase of $67 million for ADAP from last year to eliminate waiting lists by 2013.

As for PEPFAR, the White House has maintained that the program is doing more with less by using generic drugs and shipping commodities more cheaply. On World AIDS Day, Obama announced he would fully fund the balance of the administration’s three-year, $4 billion pledge to the Global Fund to Fight AIDS, Tuberculosis, and Malaria.

Shin Inouye, a White House spokesperson, defended the administration’s work on HIV/AIDS by citing achievements as well as plans set into motion to confront the epidemic.

“President Obama and his administration are unwavering in their commitment to addressing the issue of HIV/AIDS — on both the domestic and global fronts,” Inouye said. “These include steps such as establishing and implementing the first comprehensive National HIV/AIDS Strategy, lifting the HIV entry ban, and strengthening the impact and sustainability of PEPFAR and the Global Fund to Fight AIDS, Tuberculosis, and Malaria.”

Obama’s signature legislative achievement, the Affordable Care Act, is also slated to have significant impact on people living with HIV. The Medicaid expansion under the health care reform law is expected to significantly expand coverage because half the people living with HIV already receive care through the program.

Carl Schmid, deputy executive director of the AIDS Institute, said Obama has “definitely” done more on HIV/AIDS — at least on the domestic front — in part because of his willingness to talk about how the disease impacts gay men.

“They are over 60 percent of the epidemic,” Schmid said. “Focusing on this community that has been ravaged by HIV, allowing a discussion and making gay people more acceptable — this could really turn the tide on HIV prevention for gay men. We have a president who is focusing on the community [and directing] resources that are more in line with how the epidemic is.”

In comparison, Bush took flak from HIV/AIDS advocates for not taking action on the epidemic in ways that might upset his conservative base. Among his actions: promoting abstinence-only sex education, opposing federal funds for needle exchange programs and remaining silent on gay men and condoms for much of his administration.

Michael Rajner, a gay Fort Lauderdale-based HIV/AIDS advocate who’s living with AIDS and has been selected as a delegate for the Democratic National Convention, said he thinks Obama has “absolutely” done more to fight HIV/AIDS based on a more science-based approach he’s taken against the disease.

“The difference between Republican and Democrat — in this case, George W. Bush and President Obama — is really the difference in thought, whether they’re going to be addressing HIV/AIDS through ideology or through science, and President Obama has certainly embraced the issues of science,” Rajner said.

One achievement often attributed to Obama is the lifting of the regulatory travel ban that prevented HIV-positive foreign nationals from entering the country — a move that enabled the International AIDS Conference to take place in the United States. But this process actually started under the Bush administration. Under Bush’s leadership, Congress repealed a law that barred HIV-positive foreign nationals from entering as part of the legislative package authorizing PEPFAR.

Schmid said he was “intimately involved” in the process under which Bush starting lifting the HIV travel ban.

“Credit goes to George Bush’s administration and the Congress for lifting the travel ban in reauthorization of PEPFAR,” Schmid said. “There still was a process at HHS, and Obama finished that process. It wasn’t completed in time, unfortunately, under President Bush, but they definitely lifted it congressionally.”

Driscoll said Bush should be commended because he accomplished work on HIV/AIDS despite being beholden to social conservatives who elected him to office.

“Every president, every politician is limited by his constituents, by the people who put him in office, who voted for him and the people he would depend upon to do the same thing should he run again,” Driscoll said. “You have to consider what a president does in terms of the limitations that are imposed. I think, given, the limitations that George Bush’s constituencies imposed, he showed real leadership.”

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Commentary

When a church fears the rainbow

Puerto Rico pastor objected to Pride symbols outside congregation

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(Washington Blade photo by Michael Key)

There are moments when an incident stops being merely a local story and begins to reveal something much deeper. What happened on June 28 outside One Church, in Comerío, Puerto Rico, belongs in that category.

I do not know who painted the rainbow colors on the asphalt and on a roadside guardrail. I do not know what motivated them, and it is not my place to justify their actions. If someone believes a law was broken, there are authorities and legal mechanisms to address that. That is not the point of this reflection.

The point is the words that followed.

Hours after those colors appeared, Pastor Jorge J. Santiago Reyes went live on social media. He said he felt threatened. He described what happened as a physical attack against his church. He appeared angry and disappointed. He called those who painted the rainbow “cowards” and “charlatans.” He expressed frustration with the support that, according to him, the municipal government of Comerío has shown toward the LGBTQ community, and with those who support posts related to that community. He repeated several times that the people responsible had “crossed the line.” He ended his message by saying, “These charlatans have to be stopped.”

As I listened to his words, I stopped thinking about the paint.

I began thinking about fear.

There is one phrase the pastor repeated again and again: “They crossed the line.” Yet he never explained what that line was. If he was referring to a possible violation of the law, that is for the authorities to determine. If he meant respect for property, there are also procedures to deal with that. But when that line remains undefined and the message begins to associate a rainbow with a threat, the question changes. It is no longer only about a guardrail or a road. It becomes a question about what boundary, in the pastor’s view, was actually crossed.

Paint can be erased.

A brush can cover the asphalt and return a guardrail to its original color.

What does not disappear so easily is the meaning of those colors.

And perhaps that is where the real conflict begins.

It is significant that this happened precisely on June 28, the day when the LGBTQ community remembers a history marked by exclusion, violence, and the struggle for dignity. What represents memory, hope, and the possibility of living without hiding for millions of people was presented by others as a threat.

I do not know why someone painted that rainbow. I do not need to know in order to ask whether those were the words society should expect from a pastor.

A religious leader may feel hurt, frustrated, or angry. What he cannot forget is the responsibility that comes with every public expression. His words do not end when a livestream ends. They move beyond the space of his church, reach people who may never share his faith, and help shape the way others see those who think differently. When a pastor calls other people “charlatans” and “cowards,” says they “have to be stopped,” and turns a rainbow into evidence of an attack, he is no longer speaking only from frustration. He begins to build a discourse that can feed rejection toward a community far larger than the people responsible for that act.

There was another moment in the livestream that caught my attention. The pastor reminded viewers how much he has served Comerío, how much he has accompanied his community, and how much he has worked for it. I have no reason to question that service. I am sure many people can testify to the good he has done.

That is precisely why it was difficult to hear.

Pastoral vocation is not about reminding a town of everything one has done for it when conflict appears. Service does not lose its value when it goes unrecognized; it loses something when it becomes an argument to claim a moral position from which to speak down to others. A person who serves does so because that is the nature of the calling, not because that service grants authority to discredit those who think differently.

As a pastor, that part of the message left me deeply uneasy. Not because I expect ministers of God to be perfect. We are not. But because our words carry weight, we are called to speak with greater responsibility. Some expressions build bridges. Others raise walls. Some words invite encounter. Others end up justifying rejection.

The paint will disappear. A brush will be enough to cover the asphalt and return the guardrail to its original color.

The words will not disappear as easily.

They will remain recorded in a video, shared again and again on social media, and remembered by those who heard them. They will remain long after the last trace of paint has been erased.

When this episode is remembered, it probably will not be because of the rainbow that appeared outside One Church, in Comerío, Puerto Rico.

It will be because of the words a pastor chose to use when speaking about it.

And that difference changes everything.

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ACLU says trans athletes ruling is narrower than many believe

‘Narrow decision focused on the unique context of sports’

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Pro Equal Protection protesters outside of the Supreme Court in early 2026. (Washington Blade Photo by Michael Key)

The Supreme Court’s decision Tuesday to uphold state laws barring transgender girls from competing on girls’ school sports teams represents a setback for transgender rights, but attorneys who argued the case say the ruling is considerably narrower than many initial reactions suggested.

Shortly after the decision was released, attorneys with the American Civil Liberties Union — which represented the plaintiffs in the case — held a press call to explain what they described as the limited scope of the Court’s opinion. While the ruling allows states to exclude transgender girls from girls’ school sports teams, they said it stops well short of creating a nationwide ban or dismantling broader legal protections for transgender people.

Joshua Block, senior counsel with the ACLU’s LGBTQ & HIV Project, said the majority intentionally confined its analysis to school athletics.

“[The majority] issued a narrow decision focused specifically on the unique context of sports. It didn’t issue a broader decision saying that Title IX in general didn’t protect transgender students. It didn’t say that other states couldn’t make a different policy choice and allow transgender girls to participate with cisgender girls, and it didn’t issue a sweeping ruling saying that under the Constitution it’s perfectly fine to discriminate based on transgender status.”

Block said one of the opinion’s most significant takeaways is that it leaves decisions about transgender participation in school sports largely in the hands of states.

“It leaves the rest of the legal rights of transgender people where the court found them.”

He stressed that the ruling authorizes states to adopt restrictions but does not require them to do so.

“It’s very important to emphasize that this isn’t a national mandate to ban trans athletes everywhere. It’s a fight that’s going to continue state by state, school by school … it really says that a state may discriminate, not that they must discriminate. States, schools, and athletic associations should be taking every step to ensure that athletic opportunities exist for transgender girls.”

Beyond athletics, Block said the opinion’s most important legal consequence may lie in its treatment of the Equal Protection Clause.

“What the court said is that even applying that heightened standard, we’re going to establish what’s effectively a new rule of the Equal Protection Clause, saying that you can’t bring this sort of as-applied challenge to a law that is valid for most people.”

Even so, he argued that the Court repeatedly framed transgender participation in sports as a policy issue for state governments rather than a constitutional mandate.

“Over and over and over again it talks about how states may exclude transgender girls, not that they must, and over and over and over again it says that this is a policy question that should be decided by the people in their different communities and their representatives.”

Block also rejected the idea that the ruling endorses the Trump administration’s broader efforts to restrict transgender rights.

“I have no doubt that the Trump administration will try to declare victory and say that this decision supports the lawless policies they’re pursuing, but I think anyone reading the decision can see otherwise.”

The White House nonetheless celebrated the decision, calling it a victory that would “protect women and girls.”

“The Court’s decision is a landmark victory for common sense, biological reality, and for the millions of women and girls who deserve a level playing field. By upholding laws protecting female athletic competition, the Court confirmed that states may preserve the fairness, safety, and equal opportunities that Title IX was enacted to guarantee.”

Medical researchers and LGBTQ advocates dispute the administration’s characterization of the evidence. A 2021 study published in the Journal of Sports Medicine found no scientific evidence for supporting these laws that categorically ban transgender women from participating in women’s sports.

Critics have also argued that enforcement of such laws could create new risks for athletes. Researchers have warned that sex-verification requirements may expose students to invasive examinations and discrimination.

A 2016 USA Today investigation found that at least 368 young gymnasts reported experiencing sexual abuse over a 20-year period. More than 100 coaches and gymnastics officials were accused of abuse, yet USA Gymnastics failed to track predatory coaches, allowing many to continue working with children. LGBTQ advocates argue that requiring athletes to undergo genital inspections or other forms of sex verification could place young athletes at even greater risk.

Advocacy organizations said the decision, while limited legally, will have significant real-world consequences for transgender youth.

Chris Mosier, a transgender athlete and board member of Point of Pride, said the ruling extends beyond sports.

“The Supreme Court’s decision today isn’t driven by fairness or dignity in sports. It’s an attack on our community’s right to live freely and authentically in every part of our lives. Young people, regardless of whether they’re cis or trans, deserve the joy of sports: to build friendships, to move their bodies and have fun on the field. To every trans athlete out there: you have a community standing behind you. No politician or law can take away your joy or power. We will get through this as our community has always done: together.”

Brian K. Bond, CEO of PFLAG National, emphasized that states remain free to adopt inclusive policies despite the Court’s decision.

“The Court rules best when it listens to the needs of marginalized people: trans people belong, on and off the field. While we celebrate the Court’s decision to uphold the Fourteenth Amendment and affirm that every person born in the United States is a citizen, the Court today added an asterisk to allow discrimination against transgender student athletes. Our country has been here before, and frankly, you would think this Court would have learned.”

“For PFLAG families, today’s decision in BPJ means that transgender athletes can continue to be affirmed for who they are in places where the law allows – and invigorates our LGBTQ+ and allied community to expand those protections. The parents, families, allies and LGBTQ+ people of PFLAG will continue to advocate for our trans loved ones to have the freedom to be themselves, everywhere. Trans people belong, and deserve to have access to the benefits of sport like everyone else.”

Allen Morris, policy director at the National LGBTQ Task Force, called the decision “devastating” but noted that it does not establish a nationwide sports ban.

“Today’s decision is devastating and the impact to clear. While this is not a nationwide ban on transgender participation in sports, the Court has given states a legal pathway to attempt to discriminate against trans individuals from full participation in school sports and all aspects of life.”

“This ruling is not just about sports: it’s about valuing and protecting the safety, security and constitutional rights of transgender people. By allowing states to draw a categorical line based on “biological sex,” the majority has chosen deference to exclusion and political beliefs over transgender students’ lived realities. There is already a dangerous rise in state-based violence growing across the country, and we’re overcoming this issue at each turn.”

Melanie Willingham-Jaggers, CEO of GLSEN, said the decision sends a broader message about transgender students’ place in schools.

“We are deeply disappointed by the outcome of this decision. This ruling represents another significant setback for transgender youth across the country, limiting their ability to fully engage in school life. Exclusion from these spaces shapes not only athletic access, but the broader message about who should be valued and included in our schools and societal ecosystem.”

“School sports are much more than competition. They are about belonging, forming a community, and the opportunity to grow and thrive alongside peers. Preventing youth from taking part in everyday activities undermines these fundamental values. We continue to see efforts to regulate discrimination under the guise of fairness, despite the lack of evidence that inclusive policies harm women’s sports. Access to these experiences is critical to students’ well-being and development.”

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EXCLUSIVE: Pressley rips State Department over LGBTQ rights rollbacks abroad

Massachusetts Democrat sent letter to Marco Rubio on Tuesday

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U.S. Rep. Ayanna Pressley (D-Mass.) is pushing back against Secretary of State Marco Rubio's anti-LGBTQ foreign policy. (Photo public domain)

Massachusetts Congresswoman Ayanna Pressley sent a letter to Secretary of State Marco Rubio urging the Trump-Vance administration to take urgent action to defend LGBTQ people across the globe, including in countries that are violating international human rights protections for LGBTQ individuals, putting at risk the safety of civilians and U.S. citizens working, living, and traveling abroad.

The letter, which the Washington Blade got an exclusive preview of prior to its sending, criticizes the Trump-Vance administration’s foreign policy direction at the State Department, arguing that it has moved to roll back LGBTQ protections that have long been part of the U.S.’s global human rights posture.

“Criminalizing LGBTQI+ individuals undermines democracy globally, as well as U.S. national security. Thus, we urge the State Department to take adequate measures to speak out against this criminalization and protect U.S. citizens abroad, including your staff, who may be detained or harmed under such laws, policies, and practices,” Pressley, a Democrat who represents roughly three-fourths of Boston and much of the city’s suburbs, said. “U.S. civilians, diplomatic personnel, military members, and nonprofit workers on the ground providing health care and disaster support will be affected and have their safety threatened if the U.S. does not take action. Even U.S. citizens perceived as being part of the LGBTQI+ community and traveling or living in those countries may be used as bargaining chips. This is a serious U.S. national security concern.”

In the letter, Pressley underscores what she describes as a global escalation in criminalization and violence against LGBTQ people, noting that one-third of countries still criminalize consensual same-sex sexual relationships and that 12 countries impose the death penalty. She argues that these conditions make LGBTQ travelers, diplomats, and aid workers particularly vulnerable, and calls on the State Department to reassert U.S. leadership in defending human rights abroad.

“Every person deserves to live authentically, yet several countries are violating international human rights laws that protect LGBTQI+ individuals,” she said. “One-third of countries around the world criminalize same-sex consensual acts between adults, and 12 countries allow LGBTQI+ people to be executed for being themselves.”

She also invokes the role the U.S. has played in promoting democratic values internationally, arguing that LGBTQ rights should remain central to that mission.

“Historically, the United States has played a critical diplomatic role in promoting democracy and freedom for all individuals, including LGBTQI+ persons. The U.S. should be a world leader promoting human rights domestically and globally.”

In a separate statement included in the letter, Pressley emphasized both the moral and national security implications of the issue, warning that anti-LGBTQ laws abroad are endangering lives and require a coordinated U.S. response.

“Every person deserves to show up as their true, authentic selves here in the United States and in countries across the globe — and that includes our LGBTQI+ community members,” she said.

“However, we are witnessing a deeply concerning rise in human rights violations and criminalization of LGBTQI+ individuals in other countries, endangering the lives of civilians and U.S. citizens. It is incumbent upon the United States to protect our LGBTQI+ siblings at home and abroad not only for our national security but for the safety and freedom of LGBTQI+ people everywhere.”

The letter goes on to press the State Department for concrete action, including a public reaffirmation of U.S. commitments to LGBTQ human rights, the restoration of LGBTQ analysis in annual country reports, and clearer guidance for Americans traveling abroad. It also seeks clarity on whether the department is tracking cases of U.S. citizens detained or harmed under anti-LGBTQ laws and what proactive steps are being taken to warn and protect LGBTQ travelers.

While she is not a member of the Foreign Affairs Committee, Pressley remains highly active in international affairs and global policy.

While the letter focuses on current policy, it also lands in the broader context of Secretary of State Marco Rubio’s long anti-LGBTQ record. Rubio, a former senator from Florida, has consistently opposed same-sex marriage, calling the federal Respect for Marriage Act, which he voted against, a “stupid waste of time.” He has also expressed support for efforts to overturn Obergefell v. Hodges, the U.S. Supreme Court decision that legalized same-sex marriage nationwide.

During his time in the U.S. Senate and as a Florida political leader, Rubio has a long anti-LGBTQ track record. He defended state policies that LGBTQ advocates say target queer and transgender people, including Florida’s Parental Rights in Education law — commonly known by critics as “Don’t Say Gay” or “Don’t Say Trans” — which restricts classroom discussion of sexual orientation and gender identity.

He has also drawn criticism for his voting record, including a 0/100 score from the Human Rights Campaign’s Congressional Scorecard, reflecting opposition to expanding federal civil rights protections for LGBTQ people and for opposing adoption rights for same-sex couples.

Now serving as secretary of state, Rubio has overseen changes at the State Department that LGBTQ advocates say have reduced visibility and protections for transgender people, including the removal of trans-specific references from parts of the department’s public-facing materials and travel guidance. He has also been linked to broader restructuring efforts involving U.S. foreign assistance programs, including the U.S. Agency for International Development, which has historically supported global HIV prevention and LGBTQ rights initiatives in regions such as sub-Saharan Africa, Central Asia, and Latin America.

Those cuts and shifts, critics argue, have weakened programs like PEPFAR — credited with saving millions of lives worldwide — and reduced U.S. support for LGBTQ communities facing persecution abroad. The program is credited with saving at least 25 million lives.

Pressley’s own record stands in contrast, with a 100/100 on HRC’s Congressional Scorecard and a long history of legislative and advocacy work centered on LGBTQ equality. In recent years, she has secured federal funding for The Pryde, an affordable housing development for LGBTQ seniors in Boston, and has repeatedly pushed for expanded civil rights protections, including support for the Equality Act and the Equal Rights Amendment.

She has also advanced policy efforts aimed at LGBTQ survivors of violence, trans, and nonbinary individuals navigating credit and legal systems, and broader protections under housing and civil rights law — framing her work as part of a sustained effort to ensure LGBTQ people are included in federal policy at every level.

U.S. Rep. Ayanna Pressley (D-Mass.), center. (Photo courtesy of Ayanna Pressley’s office)
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