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Biden’s update to HIV strategy hailed for recognizing racism as health issue

New blueprint outlines plan from 2022 to 2025

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Biden's update to the National HIV Strategy outlines plan for HIV from 2022 to 2025.

A recent update to the National HIV Strategy by the Biden administration is getting good reviews from advocates in the fight against HIV/AIDS, who are praising the new blueprint for recognizing challenges in the epidemic and racism as a public health issue.

Carl Schmid, executive director of the HIV & Hepatitis Policy Institute and member of the President’s Advisory Council on HIV/AIDS, assessed the update as “very, very positive,” saying it built on components of a previous iteration of the strategy issued during the Trump administration and made new ones.

“I think the community is extremely pleased,” Schmid said. “There’s a new component…racism is a public health issue. So, all these positive — the disparities, which is just so big. Anytime you’re addressing HIV, you’re always addressing disparities.”

Schmid also said the updated blueprint — which articulates a plan from 2022 through 2025 and was issued last week to coincide with the first World AIDS Day during the Biden administration — makes outreach to the private sector.

“I think that’s good because it’s the people who influence society like technology companies, people who have high gay and bisexual employees, like [the] travel industry, get them all involved,” Schmid said. “So, and that, I think should help with the stigma.”

Schmid also hailed the strategy for its promotion of the Affordable Care Act as a tool to fight HIV/AIDS, which he said was absent in the iteration of the report under former President Trump.

President Biden, in remarks on World AIDS Day last week before advocates in the fight against HIV/AIDS in the East Room the White House, said the uptrend strategy is “a roadmap for how we’re going to put our foot on the gas and accelerate our efforts to end the HIV epidemic in the United States by the year 2030.”

“That’s the goal,” Biden added. “And it centers on the kind of innovative, community solutions — community-driven solutions that we know will work.”

Consistent with his administration’s stated commitment to racial equity and recognizing disparities among diverse groups, including LGBTQ people, Biden said the plan ensures “the latest advances in HIV prevention, diagnosis and treatment are available to everyone, regardless of their age, race, gender identity, sexual orientation, disability, or other factors.”

“Critically, this strategy takes on racial and gender disparities in our health system that for much too long have affected HIV outcomes in our country — to ensure that our national response is a truly equitable response,” Biden said.

The updated blueprint is the fourth iteration of the National HIV Strategy, which was first issued during the Obama administration, then updated during the Obama years and again during the Trump administration before the Biden administration unveiled the version last week.

The 93-page strategy makes recognition of racism as a public health issue a key component of the plan to fight HIV/AIDS, calling it a “serious public health threat that directly affects the well-being of millions of Americans.”

“Racism is not only the discrimination against one group based on the color of their skin or their race or ethnicity, but also the structural barriers that impact racial and ethnic groups differently to influence where a person lives, where they work, where they play, and where they gather as a community,” the strategy says. “Over generations, these structural inequities have resulted in racial and ethnic health disparities that are severe, far-reaching, and unacceptable.”

Data shows racial disparities remain a significant obstacle in thwarting the HIV/AIDS epidemic. According to the Centers for Disease Control & Prevention, new HIV infections in the United States declined by 8 percent between 2015 and 2019, with much of the progress due to larger declines among young gay and bisexual men in recent years.

But although HIV infections among young gay and bisexual men have dropped 33 percent overall, with declines in young men among all races, the CDC finds “African Americans and Hispanics/Latinos continue to be severely and disproportionately affected.”

A senior Biden administration official, speaking last week on background in a conference call with reporters to promote the HIV strategy, said in response to a question from the Washington Blade the recognition of racism “as a serious public health threat” was a key difference from previous iterations of the blueprint.

“There are several updates in this,” the official said. “And some of those new features or new areas of focus have come about from both community input as well as sitting down with our federal partners and thinking about also the priorities of this administration, where there is a focus on equity, there is a focus on addressing stigma and discrimination and ensuring that also marginalized populations have access to healthcare, and that we are also working to ensure that the voices of those with lived experience are part of our response.”

Jennifer Kates, director of global health & HIV policy for the Kaiser Family Foundation, said the recognition of social and racial disparities is a key component of the updated strategy.

“One area in which the updated strategy stakes out new and stronger ground is in its explicit focus on the social/structural determinants of health,” Kates said. “The strategy doesn’t just mention them but seeks to address them through a variety of objectives. This is a departure and an important one.”

Kates, however,.cautioned: “Of course, the devil will be in the details and there will always be a tension between what the federal government itself can do and the power that state and local jurisdictions actually have.”

One aspect of note during Biden’s remarks on World AIDS Day was his articulation of 2030 as the target date to beat HIV, with the goal of reducing new infection rates by 90 percent in that year. That 2030 goal was established by health officials during the Trump administration, but Biden had campaigned on 2025 — much to the skepticism of some observers.

The Department of Health & Human Services, in response an inquiry from the Blade on whether a decision was made to forgo 2025 and stick with 2030 as the target date, deferred comment to the White House, which didn’t immediately respond.

Schmid, who was among those during the election who expressed skepticism of the 2025 target date, said he spoke to the White House after an initial Blade report on the changed target date and was told the administration determined 2025 was “not feasible.”

“That was a campaign statement,” Schmid said. “I said then that it was not realistic, and I think others agreed with me particularly because of COVID, and we were during the campaign, but he said it and sometimes people say things during the campaign that they might not always live up to because it was unrealistic.”

Schmid, however, downplayed the importance of Biden articulating a different target date to beat HIV/AIDS compared to the one he promised during the presidential campaign, saying the initial date had demonstrated his “strong commitment” on the issue.

Now that the Biden administration has issued the new strategy, the work turns toward implementation, which would mean acting on the blueprint in conjunction with the Ending the HIV Epidemic initiative already underway.

Schmid said the next step in the process is making sure funding is robust, HIV testing continues despite the coronavirus pandemic — and working to make PrEP more accessible.

Key to the effort, Schmid said, would be new legislation introduced before Congress to set up a national PrEP program, one introduced by Rep. Bonnie Watson Coleman (D-N.J.), another by Rep. Adam Schiff (D-Calif.) and another by Sen. Tina Smith (D-Minn.). Those bills, Schmid said, would ensure the uninsured have access to PrEP and health plans cover them without cost.

“I’ve been focusing a lot on that,” Schmid said. “It would be great to get the administration’s support for these as well, and money in the budget to implement these national PrEP programs.”

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National

Advocacy groups issue US travel advisory ahead of World Cup

Renee Good’s death in Minneapolis among incidents cited

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(Photo by fifg/Bigstock)

More than 100 organizations have issued a travel advisory for the U.S. ahead of the 2026 World Cup.

The World Cup will take place in the U.S., Canada, and Mexico from June 11-July 19.

“In light of the deteriorating human rights situation in the United States and in the absence of meaningful action and concrete guarantees from FIFA, host cities, or the U.S. government, the undersigned organizations are issuing this travel advisory for fans, players, journalists, and other visitors traveling to and within the United States for the June 2026 FIFA Men’s World Cup. World Cup games will be played in 11 different cities across the United States, which, like many localities, have already been the target of the Trump administration’s violent and abusive immigration crackdown,” reads the advisory that the Council for Global Equality and other groups that include the American Civil Liberties Union issued on April 23.  “The impacts of these policies vary by locality.”

“While the Trump administration’s rising authoritarianism and increasing violence pose serious risks to all, those from immigrant communities, racial and ethnic minority groups, and LGBTQ+ individuals have been and continue to be disproportionately targeted and affected by the administration’s policies and, as such, are most vulnerable to serious harm when traveling to and/or within the United States,” it adds. “This travel advisory calls on fans, players, journalists, and other visitors to exercise caution.”

The advisory specifically mentions Renee Good.

A U.S. Immigration and Customs Enforcement agent on Jan. 7 shot and killed her in Minneapolis. Good, 37, left behind her wife and three children.

The full advisory can be read here.

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Rehoboth Beach

Rehoboth’s Blue Moon sold; new owners to preserve LGBTQ legacy

‘They don’t want to change a thing’

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The Blue Moon in Rehoboth Beach was sold. (Washington Blade photo by Michael Key)

The iconic Blue Moon restaurant and bar in Rehoboth Beach, Del., has been sold to new owners who have pledged to keep it an LGBTQ-affirming space, according to longtime owner Tim Ragan.

Ragan and his partner Randy Haney sold the Blue Moon to Dale Lomas and Mike Subrick, owners of Atlantic Liquors on Route 1. 

“They don’t want to change a thing,” Ragan said. “They’re local people, they live here. Dale worked his first job at Dolle’s.”

Ragan and Haney did not sell the business, only the real estate. The deal includes a 10-year lease with renewal options under which Ragan and Haney will continue to operate the Moon. He noted that the couple could opt to sell the business at any time.

“It’s going really well so I’m not in any hurry,” Ragan told the Blade. “It’s hard to run a business and manage a property that’s 120 years old — now someone else has to fix the air conditioning. Our responsibility will be to run the business.”

Ragan offered reassurances that the Moon will continue to be a gay-friendly destination.

“Dale’s comment was that Rehoboth has been good to us and we just want to give back. The Moon is part of Rehoboth’s history and we want to preserve that.”

He said there are no immediate changes planned for the structure, apart from a new roof in the atrium that was damaged in a hail storm. Ragan noted that the property comes with several apartment rental licenses that they have never exercised and the new owners may decide to rent those out.

The Blue Moon business, at 35 Baltimore Ave., dates to 1981 and is an integral part of Rehoboth’s LGBTQ community, hosting countless entertainment events, drag shows, and more over 45 years. Local residents have celebrated birthdays, anniversaries, weddings, and other special occasions in the acclaimed restaurant. 

The two buildings associated with the sale were listed by Carrie Lingo at 35 Baltimore Ave., and include an apartment, the front restaurant (6,600 square feet with three floors and a basement), and a secondary building (roughly 1,800 square feet on two floors). They were listed for $4.5 million. The bar and restaurant business were being sold separately. 

But then, earlier this year, the Blue Moon real estate listing turned up on the Sussex County Sheriff’s Office auction site. The auction was slated for Tuesday, April 21 but hours before the sale, the listing changed to “active under contract” indicating that a buyer had been found but the sale was not yet final.

Ragan said the issue was the parties couldn’t resolve how much was owed due to a disagreement with the bank. “We didn’t owe $3 million,” he said. “We said we’re not paying any more until we sell.” 

The sale contract was written five months ago. It took three attorneys to get a payoff amount agreed to by the bank, he added.

“No one wanted to buy both things. We now have a longterm lease. We couldn’t be happier.”

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Philippines

Filipino HIV/AIDS group questions US, Philippines health agreement

Country’s epidemic disproportionately impacts MSM, trans people

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(Photo by argus456/Bigstock)

A new health agreement between the U.S. and the Philippines has raised questions among HIV/AIDS service providers.

A joint declaration signed by the U.S. and the Philippines on April 7 sets out a plan for closer health cooperation, aimed at transitioning the Philippines toward greater autonomy and “self-reliance” in its health systems, according to a State Department statement released.

In practice, “self-reliance” in health systems refers to a country’s ability to fund, manage, and deliver care without heavy dependence on external donors. In the Philippines, programs serving LGBTQ people — particularly those focused on HIV prevention, testing and treatment — have relied in part on international funding and technical support, including from the U.S., according to UNAIDS. 

The Philippine Department of Health has led the national response to the pandemic.

The joint declaration of intent was signed under the Trump-Vance administration’s “America First Global Health Strategy.” The State Department said the agreement would involve co-funding of mutually agreed global health objectives under bilateral health cooperation between the U.S. and the Philippines in the near future.

The declaration also outlines areas of cooperation beyond financing: workforce development, health information systems, and emergency preparedness. The State Department said the framework is intended to strengthen coordination between U.S. and Philippine institutions while supporting the Philippines’ capacity to manage public health challenges independently over time. The statement does not specifically address LGBTQ health.

Similar agreements in other regions have drawn scrutiny from LGBTQ advocacy groups. 

In Africa, community organizations have warned that a shift from donor-funded, community-led health programs to government-to-government frameworks could affect access for marginalized populations, including LGBTQ people. The Washington Blade found that such changes may reduce reliance on specialized clinics that have historically provided stigma-free care, raising concerns about discrimination, privacy, and continuity of services.

Desi Andrew Ching, president of HIV & AIDS Support House in the Philippines, said the partnership presents a significant opportunity, but added that, like any large-scale international agreement, its success for the LGBTQ community will depend on how it is implemented on the ground.

“On one hand, it’s a positive move. Increased cooperation on health systems can lead to better technical support and potentially more resources for HIV/AIDS prevention and mental health — areas that deeply impact our community,” Ching told the Blade. “If the government and civil society work closely together, we could see some real progress.”

Ching said community concerns often center on where those resources ultimately go. Ching added there is a risk funds could remain within “usual” government-aligned channels or traditional implementers that may not have the trust or reach of grassroots LGBTQ organizations.

The Philippines is facing one of the fastest-growing HIV epidemics in the Asia-Pacific region, with UNAIDS statistics indicating new infections increased by about 543 percent between 2010 and 2023.

The epidemic is concentrated among key populations, particularly men who have sex with men and transgender women who account for a vast majority of new infections. A 2023 analysis found that key populations represented about 92 percent of new HIV cases in the country, underscoring the disproportionate impact on LGBTQ communities. At the same time, stigma, limited access to testing and gaps in healthcare delivery continue to shape outcomes for these groups.

Ching said that for the partnership to be effective, support would need to be closely targeted to reach those most at risk, including individuals who often avoid government facilities because of stigma and fear of judgment. 

“If the partnership prioritizes ‘community-led’ monitoring and direct support to local organizations, it will be a game-changer. If it stays at the top tier of administration, we might just see the same results as before,” Ching said.

Community-led organizations have been central to the Philippines’ HIV response, particularly in reaching LGBTQ populations often underserved by formal healthcare systems. UNAIDS notes groups such as LoveYourself have expanded testing and treatment access through community-based clinics and online outreach, including during the COVID-19 pandemic, when movement restrictions limited access to government facilities.

“To be honest, in these high-level agreements, ‘guarantees’ are hard to come by on paper. The real safeguards lie in the mechanics of implementation,” said Ching. “From the community’s perspective, we believe the best way to prevent services from being diluted is through direct involvement in the planning phase. We would like to see the funding groups and government stakeholders sitting at the same table as the community to game out the specific work plans. It should not be a top-down approach; it needs to be co-designed.”

Ching said oversight would be a critical layer of protection, adding that a dedicated point of contact, such as a U.S Agency for International Development technical lead or a similar monitor, would be needed to track how funds are used.

USAID officially shut down on July 1, 2025, after the Trump-Vance administration dismantled it.

Ching added community-led monitoring would also be necessary in addition to government oversight. He said safety and trust cannot be guaranteed by policy alone but must be built through experience, noting that community-led organizations have consistently reached the most marginalized populations. 

“Safety and trust aren’t things you can just write into a policy; they have to be built through experience,” Ching said, adding that community-based sites are often seen as more accessible and safer because they are “for us, by us.” 

He said the partnership should direct substantial support to grassroots organizations that have demonstrated an ability to overcome stigma, while strengthening coordination with government clinics. The most effective approach, he added, would combine government infrastructure with community-led delivery, allowing trusted local groups to serve as the primary point of access.

’We want a seat at the table’

According to a report by the World Health Organization on the Philippines, prevention efforts account for only about 6 percent of total HIV spending, despite a sharp rise in cases. The report said the gap has been compounded by a recent pause in U.S. funding, which has delayed the development and implementation of prevention programs and community-led responses.

Asked whether community-led LGBTQ organizations would be funded and included in implementation or sidelined under a government-led approach, Ching said that remained the central question for the community, adding that no detailed plan has yet been made public.

“But we have to be realistic about the politics — both within the government and even within civil society — that can sometimes slow things down,” said Ching. “A good baseline to look at is the UNAIDS 30-80-60 targets. These milestones are specifically designed to put community-led responses at the center of the HIV fight. If we’re being honest, as a country, we are still finding our footing in meeting those specific targets. There is a very real risk of being sidelined if the execution defaults to a standard ‘government-only’ approach.”

The UNAIDS set global targets to guide the HIV response, most notably the “95-95-95” goals for 2025. 

The framework calls for 95 percent of people living with HIV to know their status, 95 percent of those diagnosed to receive sustained treatment and 95 percent of those on treatment to achieve viral suppression. The targets were designed to reduce transmission and improve health outcomes, while also highlighting gaps in access to testing, treatment, and prevention services.

“We view this new partnership with the U.S. as a chance to course-correct. If the intention is to end AIDS as a public health threat, the data shows it simply cannot be done without the community in the driver’s seat for service delivery,” said Ching. “Our hope is that the implementation isn’t just government-led, but government-enabled. We want a seat at the table not just for the sake of being there, but to ensure the resources are actually hitting the ground where they matter most. We’re looking for a partnership that honors those 2025 milestones by making community-led organizations formal, funded partners in this roadmap.”

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