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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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2026 Midterm Elections

Chris Pappas wins NH Democratic Senate primary

Gay congressman running to succeed retiring U.S. Sen. Jeanne Shaheen

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U.S. Rep. Chris Pappas (D-N.H.) speaks at the LGBTQ+ Victory Fund's 2025 National Champagne Brunch in D.C. (Washington Blade photo by Michael Key)

New Hampshire Congressman Chris Pappas on Tuesday won the Democratic primary in the race to succeed retiring U.S. Sen. Jeanne Shaheen (D-N.H.) in the U.S. Senate.

Pappas defeated Karishma Manzur, who was his primary challenger, by a 61.8-36.1 percent margin.

The gay congressman will face off against former U.S. Sen. John E. Sununu, who defeated former U.S. Sen. Scott Brown in the Republican primary.

“Tonight’s victory sends a clear message that voters are looking for leaders who will fight for their rights, their freedoms, and to be treated with dignity and respect,” said Human Rights Campaign President Kelley Robinson in a statement. 

She campaigned for Pappas in Manchester, New Hampshire’s largest city, on Aug. 30.

“Chris Pappas has delivered results, stood up for equality, and showed up for the people he serves,” said Robinson in her statement. “HRC was proud to mobilize Equality Voters across New Hampshire to help power this win. We don’t have a second to waste between now and November. We look forward to continuing our work with Rep. Pappas as he drives toward victory in November so he can help return a pro-equality majority to the United States Senate.”

poll the University of New Hampshire Survey Center released on Aug. 26 showed Sununu ahead of Pappas by a 45-43 percent margin if they were to face off in the general election. The margin of error is +/-2.1 percent.

Pappas would become the first openly gay man elected to the U.S. Senate if he were to win in November.

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Georgia

Everton Blair makes history as first openly gay congressman from Ga.

Former Gwinnett County Board of Education member to serve remainder of David Scott’s term

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Everton Blair, Jr. (Photo courtesy of Blair's campaign website.)

Georgia made history last week when Everton Blair, Jr., was sworn into the U.S. House of Representatives, becoming the state’s first openly LGBTQ member of Congress and the latest LGBTQ addition to the chamber.

Blair, who represents Georgia’s 13th Congressional District, was sworn in on Sept. 1 after winning a special election to fill the vacancy left by the late-Congressman David Scott. Blair defeated Marcye Scott, the late congressman’s daughter, in the Aug. 25 runoff, winning 53.2 percent of the vote to Scott’s 46.8 percent.

He will serve the remainder of Scott’s term through Jan. 3, 2027. Blair is not running in the November general election for a full term.

Blair brings a progressive platform to Congress.

The 34 year-old supports Medicare for All, a Green New Deal, raising the minimum wage, and universal gun background checks. His campaign platform also included positions on LGBTQ rights, reproductive freedom, workers’ rights, climate, and gun violence.

Since joining the House, Blair has joined the Congressional Black Caucus and Congressional Progressive Caucus. He is also a co-chair of the Congressional Equality Caucus.

Before joining the House, Blair served on the Gwinnett County Board of Education, where he became the first Black member and youngest-ever member elected to the board, as well as its first openly gay member. He was later unanimously selected as chair.

Blair also served as a fellow in President Barack Obama’s White House Initiative on Educational Excellence that focused on improving academic outcomes and expanding opportunities for minority students.

The son of Jamaican immigrants, Blair was born and raised in Georgia’s 13th Congressional District. He earned a bachelor’s degree in applied mathematics from Harvard University, a master’s degree in policy, organization, and leadership from Stanford University, and a Doctor of Education Leadership degree from Harvard.

Blair’s campaign received endorsements from a number of organizations, including the LGBTQ+ Victory Fund and progressive Democratic groups such as Future Democrats.

The Equality PAC, a political action committee dedicated to electing openly LGBTQ candidates to office, celebrated Blair’s victory and provided a statement to the Washington Blade about the historic nature of his election.

“This is a historic election for Georgia, the South, and our entire country,” Equality PAC said in an email. “Everton Blair brings a strong record of public service and a deep commitment to making government work for working families.”

The group said Blair would “fight to lower costs, expand access to quality health care, create economic opportunity, and ensure every community has a voice in Washington.”

“At the same time, Everton understands the importance of standing up for equality and defending the rights and freedoms of LGBTQ Americans and every community facing discrimination,” Equality PAC said. “His historic election as Georgia’s first openly LGBTQ Member of Congress and the first openly LGBTQ man elected from the South is a powerful reminder of how far our country has come — and how much work remains.”

Equality PAC said it was “proud to welcome Everton to the House” and looked forward to working with him.

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U.S. Military/Pentagon

Pentagon expands testosterone screening as trans troops face hormone therapy restrictions

Defense Department says updated guidelines to be issued shortly

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Defense Secretary Pete Hegseth (Washington Blade photo by Michael Key)

The Pentagon has announced that new clinical guidance will be released establishing mandatory testosterone deficiency screening for active-duty and reserve cisgender male service members ages 30 and older, advancing a policy that expands hormone-related care for cisgender troops.

The Defense Department said the existing clinical guidelines, which are not currently available on the Defense Health Agency’s website, are being updated and that the final guidance will be issued shortly.

The announcement comes amid a wave of anti-transgender policies from both the DoD and the Trump-Vance administration, which continue to prohibit trans men from receiving the same treatment.

Under the forthcoming guidance, men ages 30 and older will be forced to undergo testosterone blood tests as part of their medical care. Younger male service members will be tested if they request screening or if clinicians identify warning signs of low testosterone.

The new guidelines formalize a screening program Defense Secretary Pete Hegseth announced in July, when he said the Pentagon would begin testing service members to ensure that “you have the right testosterone levels to operate at your absolute best.”

“Taking care of your long-term health means ensuring you remain strong, resilient, and capable — not just for your next deployment, but for the rest of your life, so you can thrive long after you take off the uniform,” Hegseth said at the time.

The Defense Health Agency’s clinical guidance says the program is intended to address “hormonal and energy-availability issues.” Hegseth said in July that testosterone replacement therapy would remain voluntary for service members if treatment is recommended.

The Food and Drug Administration is also scheduled to hold a meeting later this month with experts to discuss the medical use of testosterone.

The Pentagon’s push to routinely test testosterone levels runs counter to current medical guidance, which generally recommends considering testosterone therapy only for men who have symptoms consistent with low testosterone and have documented low hormone levels on two separate blood tests.

Testosterone is a sex hormone naturally produced by people of all sexes. It plays a role in regulating muscle mass, bone density, and sex drive. Testosterone levels in men naturally decline with age and have been associated with symptoms including erectile dysfunction, low libido, mood changes and weight gain, although experts continue to debate when testosterone therapy is medically appropriate.

The policy has drawn scrutiny from LGBTQ advocates because the Pentagon and Hegseth have simultaneously cited hormone therapy as part of the rationale for removing trans service members from the military.

Under President Donald Trump’s 2025 executive order, “Prioritizing Military Excellence and Readiness,” the military has moved to bar trans people diagnosed with gender dysphoria from serving and has begun formal administrative separation proceedings against trans personnel.

The Pentagon continues to pursue implementation of the trans military ban as litigation over the policy proceeds. As a result, some trans service members have had their gender-affirming hormone therapy halted even as the Pentagon expands testosterone screening and potential treatment for cisgender service members.

SPARTA Pride, a nonpartisan nonprofit organization made up of trans service members, veterans and their allies, criticized the disparity to the Washington Blade when Hegseth first announced the screening program.

“If hormone therapy helps warfighters perform at their best, then it cannot simultaneously be used as evidence that transgender service members are unfit to serve,” said Kara Corcoran, executive director of SPARTA Pride. “The same class of evidence-based medical treatment cannot be characterized as readiness-enhancing for one group and readiness-destroying for another.”

On June 1, the U.S. Court of Appeals for the D.C. Circuit ruled that trans service members already serving in the military could continue to do so while allowing the armed services to continue refusing to enlist new trans recruits.

The Blade reached out to the Pentagon when the testosterone screening program was first announced in July, asking why cisgender service members could receive testosterone therapy while transgender service members could not. The Pentagon did not respond.

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