National
Obama vs. Bush: Who’s done more on HIV/AIDS?
Lifting of HIV travel ban initiated by previous administration

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.”
Federal Government
Two very different views of the State of the Union
As Trump delivered his SOTU address inside the Capitol, Democratic lawmakers gathered outside in protest, condemning the administration’s harmful policies.
As President Donald Trump delivered his State of the Union address inside the U.S. Capitol — touting his achievements and targeting political enemies — progressive members of Congress gathered just outside in protest.
Their message was blunt: For many Americans, particularly LGBTQ people, the country is not better off.
Each year, as required by Article II, Section 3 of the Constitution, the president must “give to the Congress Information of the State of the Union.” The annual address is meant to outline accomplishments and preview the year ahead. This year, Trump delivered the longest State of the Union in U.S. history, clocking in at one hour and 48 minutes. He spoke about immigration, his “law and order” domestic agenda, his “peace through strength” foreign policy doctrine, and what he framed as the left’s ‘culture wars’ — especially those involving transgender youth and Christian values.
But one year into what he has called the “Trump 2.0” era, the picture painted outside the Capitol stood in stark contrast to the one described inside.
Transgender youth
In one of the most pointed moments of his speech, Trump spotlighted Sage Blair, using her story to portray gender-affirming care as coercive and dangerous. Framing the issue as one of parental rights and government overreach, he told lawmakers and viewers:
“In the gallery tonight are Sage Blair and her mother, Michelle. In 2021, Sage was 14 when school officials in Virginia sought to socially transition her to a new gender, treating her as a boy and hiding it from her parents. Hard to believe, isn’t it? Before long, a confused Sage ran away from home.
“After she was found in a horrific situation in Maryland, a left-wing judge refused to return Sage to her parents because they did not immediately state that their daughter was their son. Sage was thrown into an all-boys state home and suffered terribly for a long time. But today, all of that is behind them because Sage is a proud and wonderful young woman with a full ride scholarship to Liberty University.
“Sage and Michelle, please stand up. And thank you for your great bravery and who can believe that we’re even speaking about things like this. Fifteen years ago, if somebody was up here and said that, they’d say, what’s wrong with him? But now we have to say it because it’s going on all over, numerous states, without even telling the parents.
“But surely, we can all agree no state can be allowed to rip children from their parents’ arms and transition them to a new gender against the parents’ will. Who would believe that we’ve been talking about that? We must ban it and we must ban it immediately. Look, nobody stands up. These people are crazy. I’m telling you, they’re crazy.”
The story, presented as encapsulation of a national crisis, became the foundation for Trump’s renewed call to ban gender-affirming care. LGBTQ advocates — and those familiar with Blair’s story — argue that the situation was far more complex than described and that using a single anecdote to justify sweeping federal restrictions places transgender people, particularly youth, at greater risk.
Equality Virginia said the president’s remarks were part of a broader effort to strip transgender Americans of access to care. In a statement to the Blade, the group said:
“Tonight, the president is choosing to double down on efforts to disrupt access to evidence-based, lifesaving care.
“Rather than allowing families and doctors to navigate deeply personal medical decisions free from federal interference — or allowing schools to respond with nuance and compassion without putting marginalized children at risk — the president is instead advocating for reckless, one-size-fits-all political control.
“At a time when Virginians are worried about rising costs, economic uncertainty, and aggressive immigration enforcement actions disrupting communities and families, attacking transgender young people is a blatant political distraction from the real challenges facing our nation. Virginia families and health care providers do not need Donald Trump telling them what care they do or do not need.”
For many in the LGBTQ community, the rhetoric inside the chamber echoed actions already taken by the administration.
Earlier this month, the Pride flag was removed from the Stonewall National Monument under a National Park Service directive that came from the top. Community members returned to the site, raised the flag again, and filed suit, arguing the removal violated federal law. To advocates, the move was symbolic — a signal that even the legacy of LGBTQ resistance was not immune.
Immigration and fear
Immigration dominated both events as well.
Inside the chamber, Trump boasted about the hundreds of thousands of immigrants detained in makeshift facilities. Outside, Democratic lawmakers described those same facilities as concentration camps and detailed what they characterized as the human toll of the administration’s enforcement policies.
Sen. Ed Markey (D-Mass.), speaking to the crowd, painted a grim picture of communities living in fear:
“People are vanishing into thin air. Quiet mornings are punctuated by jarring violence. Students are assaulted by ICE agents sitting outside the high school, hard working residents are torn from their vehicles in front of their children. Families, hopelessly search for signs of their loved ones who have stopped answering their phones, stop replying to text… This is un-American, it is illegal, it is unconstitutional, and the people are going to rise up and fight for Gladys Vega and all of those poor people who today need to know that the people’s State of the Union is the beginning of a long fight that is going to result in the end of Republican control of the House of Representatives and the Senate in the United States of America in 2026.”
Speakers emphasized that LGBTQ immigrants are often especially vulnerable — fleeing persecution abroad only to face detention and uncertainty in the United States. For them, the immigration crackdown and the attacks on transgender health care are not separate battles but intertwined fronts in a broader cultural and political war.
Queer leadership

After delivering remarks alongside Robert Garcia, Kelley Robinson, president of the Human Rights Campaign, took the stage and transformed the freezing crowd’s anger into resolve.
Garcia later told the Blade that visibility matters in moments like this — especially when LGBTQ rights are under direct attack.
“We should be crystal clear about right now what is happening in our country,” Garcia said. “We have a president who is leading the single largest government cover up in modern history, we have the single largest sex trafficking ring in modern history right now being covered up by Donald Trump and Pam Bondi In the Department of Justice. Why are we protecting powerful, wealthy men who have abused and raped women and children in this country? Why is our government protecting these men at this very moment? In my place at the Capitol is a woman named Annie farmer. Annie and her sister Maria, both endured horrific abuse by Jeffrey Epstein and Ghislaine Maxwell. As we move forward in this investigation, always center the survivors; we are going to get justice for the survivors. And Donald Trump may call this investigation a hoax. He may try to deflect our work, but our message to him is very clear that our investigation is just getting started, and we will we will get justice for these survivors.”
He told the Blade afterwards that having queer leaders front and center is itself an act of resistance.
“I obviously was very honored to speak with Kelley,” the California representative said. Kelley is doing a great job…it’s important that there are queer voices, trans voices, gay voices, in protest, and I think she’s a great example of that. It’s important to remind the country that the rights of our community continue to be attacked, and then we’ve got to stand up. Got to stand up for this as well.”
Robinson echoed that call, urging LGBTQ Americans — especially young people — not to lose hope despite the administration’s escalating rhetoric.
“There are hundreds of thousands of people that are standing up for you every single day that will not relent and will not give an inch until every member of our community is protected, especially our kids, especially our trans and queer kids. I just hope that the power of millions of voices drowns out that one loud one, because that’s really what I want folks to see at HRC. We’ve got 3.6 million members that are mobilizing to support our community every single day, 75 million equality voters, people that decide who they’re going to vote for based on issues related to our community. Our job is to make sure that all those people stand up so that those kids can see us and hear our voices, because we’re going to be what stands in the way.”
A boycott — and a warning
The list of Democratic lawmakers who boycotted the State of the Union included Sens. Ruben Gallego, Ed Markey, Jeff Merkley, Chris Murphy, Adam Schiff, Tina Smith, and Chris Van Hollen, along with dozens of House members.
For those gathered outside — and for viewers watching the livestream hosted by MoveOn — the counter-programming was not merely symbolic. It was a warning.
While the president spoke of strength and success inside the chamber, LGBTQ Americans — particularly transgender youth — were once again cast as political targets. And outside the Capitol, lawmakers and advocates made clear that the fight over their rights is far from over.

U.S. Military/Pentagon
4th Circuit rules against discharged service members with HIV
Judges overturned lower court ruling
A federal appeals court on Wednesday reversed a lower court ruling that struck down the Pentagon’s ban on people with HIV enlisting in the military.
The conservative three-judge panel on the 4th U.S. Circuit Court of Appeals overturned a 2024 ruling that had declared the Defense Department and Army policies barring all people living with HIV from military service unconstitutional.
The 4th Circuit, which covers Maryland, North Carolina, South Carolina, Virginia, and West Virginia, held that the military has a “rational basis” for maintaining medical standards that categorically exclude people living with HIV from enlisting, even those with undetectable viral loads — meaning their viral levels are so low that they cannot transmit the virus and can perform all duties without health limitations.
This decision could have implications for other federal circuits dealing with HIV discrimination cases, as well as for nationwide military policy.
The case, Wilkins v. Hegseth, was filed in November 2022 by Lambda Legal and other HIV advocacy groups on behalf of three individual plaintiffs who could not enlist or re-enlist based on their HIV status, as well as the organizational plaintiff Minority Veterans of America.
The plaintiffs include a transgender woman who was honorably discharged from the Army for being HIV-positive, a gay man who was in the Georgia National Guard but cannot join the Army, and a cisgender woman who cannot enlist in the Army because she has HIV, along with the advocacy organization Minority Veterans of America.
Isaiah Wilkins, the gay man, was separated from the Army Reserves and disenrolled from the U.S. Military Academy Preparatory School after testing positive for HIV. His legal counsel argued that the military’s policy violates his equal protection rights under the Fifth Amendment’s Due Process Clause.
In August 2024, a U.S. District Court sided with Wilkins, forcing the military to remove the policy barring all people living with HIV from joining the U.S. Armed Services. The court cited that this policy — and ones like it that discriminate based on HIV status — are “irrational, arbitrary, and capricious” and “contribute to the ongoing stigma surrounding HIV-positive individuals while actively hampering the military’s own recruitment goals.”
The Pentagon appealed the decision, seeking to reinstate the ban, and succeeded with Wednesday’s court ruling.
Judge Paul V. Niemeyer, one of the three-judge panel nominated to the 4th Circuit by President George H. W. Bush, wrote in his judicial opinion that the military is “a specialized society separate from civilian society,” and that the military’s “professional judgments in this case [are] reasonably related to its military mission,” and thus “we conclude that the plaintiffs’ claims fail as a matter of law.”
“We are deeply disappointed that the 4th Circuit has chosen to uphold discrimination over medical reality,” said Gregory Nevins, senior counsel and employment fairness project director for Lambda Legal. “Modern science has unequivocally shown that HIV is a chronic, treatable condition. People with undetectable viral loads can deploy anywhere, perform all duties without limitation, and pose no transmission risk to others. This ruling ignores decades of medical advancement and the proven ability of people living with HIV to serve with distinction.”
“As both the 4th Circuit and the district court previously held, deference to the military does not extend to irrational decision-making,” said Scott Schoettes, who argued the case on appeal. “Today, servicemembers living with HIV are performing all kinds of roles in the military and are fully deployable into combat. Denying others the opportunity to join their ranks is just as irrational as the military’s former policy.”
New York
Lawsuit to restore Stonewall Pride flag filed
Lambda Legal, Washington Litigation Group brought case in federal court
Lambda Legal and Washington Litigation Group filed a lawsuit on Tuesday, challenging the Trump-Vance administration’s removal of the Pride flag from the Stonewall National Monument in New York earlier this month.
The suit, filed in the U.S. District Court for the Southern District of New York, asks the court to rule the removal of the Pride flag at the Stonewall National Monument is unconstitutional under the Administrative Procedures Act — and demands it be restored.
The National Park Service issued a memorandum on Jan. 21 restricting the flags that are allowed to fly at National Parks. The directive was signed by Trump-appointed National Park Service Acting Director Jessica Bowron.
“Current Department of the Interior policy provides that the National Park Service may only fly the U.S. flag, Department of the Interior flags, and the Prisoner of War/Missing in Action flag on flagpoles and public display points,” the letter from the National Park Service reads. “The policy allows limited exceptions, permitting non-agency flags when they serve an official purpose.”
That “official purpose” is the grounds on which Lambda Legal and the Washington Litigation Group are hoping a judge will agree with them — that the Pride flag at the Stonewall National Monument, the birthplace of LGBTQ rights movement in the U.S., is justified to fly there.
The plaintiffs include the Gilbert Baker Foundation, Charles Beal, Village Preservation, and Equality New York.
The defendants include Interior Secretary Doug Burgum; Bowron; and Amy Sebring, the Superintendent of Manhattan Sites for the National Park Service.
“The government’s decision is deeply disturbing and is just the latest example of the Trump administration targeting the LGBTQ+ community. The Park Service’s policies permit flying flags that provide historical context at monuments,” said Alexander Kristofcak, a lawyer with the Washington Litigation Group, which is lead counsel for plaintiffs. “That is precisely what the Pride flag does. It provides important context for a monument that honors a watershed moment in LGBTQ+ history. At best, the government misread its regulations. At worst, the government singled out the LGBTQ+ community. Either way, its actions are unlawful.”
“Stonewall is the birthplace of the modern LGBTQ+ rights movement,” said Beal, the president of the Gilbert Baker Foundation. The foundation’s mission is to protect and extend the legacy of Gilbert Baker, the creator of the Pride flag.
“The Pride flag is recognized globally as a symbol of hope and liberation for the LGBTQ+ community, whose efforts and resistance define this monument. Removing it would, in fact, erase its history and the voices Stonewall honors,” Beal added.
The APA was first enacted in 1946 following President Franklin D. Roosevelt’s creation of multiple new government agencies under the New Deal. As these agencies began to find their footing, Congress grew increasingly worried that the expanding powers these autonomous federal agencies possessed might grow too large without regulation.
The 79th Congress passed legislation to minimize the scope of these new agencies — and to give them guardrails for their work. In the APA, there are four outlined goals: 1) to require agencies to keep the public informed of their organization, procedures, and rules; 2) to provide for public participation in the rule-making process, for instance through public commenting; 3) to establish uniform standards for the conduct of formal rule-making and adjudication; and 4) to define the scope of judicial review.
In layman’s terms, the APA was designed “to avoid dictatorship and central planning,” as George Shepherd wrote in the Northwestern Law Review in 1996, explaining its function.
Lambda Legal and the Washington Litigation Group are arguing that not only is the flag justified to fly at the Stonewall National Monument, making the directive obsolete, but also that the National Park Service violated the APA by bypassing the second element outlined in the law.
“The Pride flag at the Stonewall National Monument honors the history of the fight for LGBTQ+ liberation. It is an integral part of the story this site was created to tell,” said Lambda Legal Chief Legal Advocacy Officer Douglas F. Curtis in a statement. “Its removal continues the Trump administration’s disregard for what the law actually requires in their endless campaign to target our community for erasure and we will not let it stand.”
The Washington Blade reached out to the NPS for comment, and received no response.
