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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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Netherlands

Amsterdam Pride Canal Parade draws hundreds of thousands

Gay Dutch Prime Minister Rob Jetten among participants

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A scene from the 2026 Amsterdam Pride Canal Parade. (Washington Blade photo by Michael Key)

Editor’s note: International News Editor Michael K. Lavers and Photo Editor Michael Key are on assignment in the Netherlands through Aug. 10.

AMSTERDAM — Hundreds of thousands of people lined Amsterdam’s canals on Saturday for the city’s annual Amsterdam Pride Canal Parade.

Dutch Prime Minister Rob Jetten, who is openly gay, is among those who participated in the parade that featured more than 80 boats. Participants held signs and posters that, among other things, read “proud to be intersex” and “lesbians love you and a free Palestine.”

The Washington Blade saw at least two attendees holding fans that read “fuck Trump.” One of the boats also compared President Donald Trump and Russian President Vladimir Putin as “the kissing couple.”

(Washington Blade photo by Michael K. Lavers)

(Washington Blade video by Michael K. Lavers)

(Washington Blade video by Michael K. Lavers)

The parade took place a week after a terrorist attack at Berlin’s Christopher Street Day left one person dead and more than two dozen others injured.

It passed the Homomonument, a memorial to gays and lesbians who have suffered persecution. The Homomonument has been transformed into a makeshift memorial to the victims of the July 25 terrorist attack in the German capital.

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The Canal Parade took place during World Pride, which will end in Amsterdam on Aug. 9.

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European Union

Poland’s top court rejects recognition of same-sex marriages from other EU countries

Ruling sets up potential clash with bloc

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(Bigstock photo)

Poland’s top court this week rejected the recognition of same-sex marriages legally performed in other EU countries.

The EU Court of Justice in Luxembourg last November ruled in favor of a same-sex couple who challenged Poland’s refusal to recognize their German marriage. Poland’s Supreme Administrative Court in March reaffirmed the decision.

The couple, who lives in Poland, brought their case to Polish courts in 2019. The Supreme Administrative Court referred it to the EU Court of Justice.

The Polish government in May announced it will recognize same-sex marriages legally performed in other EU countries. Polish President Karol Nawrocki on July 17 vetoed bills that would have extended rights to same-sex couples.

The Constitutional Tribunal ruling, which it issued on July 28, was unanimous and final. It also sets up a potential clash between it and the EU Court of Justice.

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Taiwan

Taiwan’s government has failed to update process to change gender markers on ID documents

Interior Ministry’s 2008 directive remains in place

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(Photo by bRollGO/Bigstock)

More than four years after Taiwan began formally studying legislation to overhaul its legal gender recognition system, and despite repeated recommendations from international human rights experts, the government has yet to introduce a bill that would replace decades-old administrative rules governing how transgender people can change the gender marker on official documents.

On May 15, an independent international review committee examining Taiwan’s implementation of the International Covenant on Civil and Political Rights and the International Covenant on Economic, Social and Cultural Rights urged the government to enact legislation governing legal gender recognition. The committee said Taiwan’s continued reliance on an administrative order, despite a 2023 Supreme Administrative Court ruling that mandatory gender-affirming surgery violates constitutional rights, has created legal uncertainty for transgender people, administrative authorities and judges.

In Taiwan, legal gender recognition has long been governed by a 2008 Interior Ministry administrative directive rather than legislation. 

Under the directive, applicants seeking to change the gender marker on their national identification documents are generally required to provide diagnoses of gender dysphoria from two psychiatrists and proof that they have undergone gender-affirming surgery. For trans men, this typically involves the removal of the breasts, uterus, and ovaries, while trans women generally must undergo the removal of the penis and testicles. Because these requirements are established through an administrative directive rather than a law enacted by the legislature, trans rights activists and human rights organizations have argued they violate human rights.

Although Taiwanese courts have increasingly allowed trans people to change the gender marker on their official documents without undergoing gender-affirming surgery, the Interior Ministry’s 2008 directive requiring surgery remains in force. As a result, Taiwan’s administrative rules and judicial decisions are no longer fully aligned.

In a landmark ruling in May 2024, the Taipei High Administrative Court ordered a household registration office to approve a trans man’s application to change the gender marker on his household registration without requiring gender-affirming surgery. The court held that the Interior Ministry’s 2008 administrative directive, which requires applicants to submit proof of surgery, cannot be treated as an absolute prerequisite for legal gender recognition. Instead, it found that the applicant had provided sufficient medical evidence of a stable and long-standing gender identity and that denying the application solely because he had not undergone surgery was unlawful.

The Executive Yuan began work on legislation in April 2020, when it decided to commission an academic study examining international legal gender recognition systems rather than immediately drafting a law. 

The government subsequently commissioned Shih Hsin University to prepare a report reviewing foreign legal models and developing legislative recommendations, including a bill. Since 2022, the Executive Yuan has held a series of inter-agency meetings involving multiple ministries to consider the study’s recommendations and legislation governing legal gender recognition, though no bill has yet been enacted.

In September 2023, Taiwan’s Supreme Administrative Court set aside a lower court ruling that had upheld the Interior Ministry’s refusal to change a trans person’s legal gender without proof of surgery and ordered the case to be reheard. 

The court held that the ministry’s 2008 administrative directive requiring surgery could not be treated as the controlling legal standard because it lacked a clear statutory basis and implicated constitutional protections, including bodily autonomy and personality rights. Rather than treating surgery as an automatic prerequisite, the court instructed the lower court to determine whether the applicant had established a stable gender identity based on the evidence presented.

“From our perspective, the primary goal should be lowering the barriers to legal gender recognition, particularly by abolishing the mandatory surgery requirement,” the Taiwan Tongzhi (LGBTQ+) Hotline Association, a nonprofit LGBTQ advocacy and support organization founded in 1998, said in an email to the Washington Blade.

The Taiwan Tongzhi (LGBTQ+) Hotline Association said several factors have stalled progress toward comprehensive legislation. 

The organization told the Blade the complexity of the issue and the lack of constructive dialogue are among the primary obstacles. It said legal gender recognition requires extensive discussion, with views differing even within the trans community itself. The Taiwan Tongzhi (LGBTQ+) Hotline Association added that opinions also vary widely within the legislature and across Taiwanese society, while effective channels for dialogue remain lacking.

The Taiwan Tongzhi (LGBTQ+) Hotline Association also attributed the lack of progress to what it described as a lack of political will and an over reliance on “social consensus.” 

According to the organization, the executive branch lacks the political momentum to advance legal gender recognition reforms. The Taiwan Tongzhi (LGBTQ+) Hotline Association said the Interior Ministry and other relevant agencies have often adopted a passive approach in the face of opposition from conservative groups, delaying progress by arguing that there is no social consensus or that further discussion is needed.

The Taiwan Tongzhi (LGBTQ+) Hotline Association also said progress has been hindered by what it described as a backlash following the legalization of same-sex marriage. According to the organization, groups opposed to gender equality and trans rights, including some conservative religious and anti-trans organizations, shifted their focus to trans issues after marriage equality became law. The Taiwan Tongzhi (LGBTQ+) Hotline Association said these groups have promoted fear-based narratives, including concerns about safety in public restrooms, leading many politicians to view trans rights as a politically risky issue and reducing momentum for legislative action.

“The existing system makes changing one’s legal gender marker extremely difficult. Forced surgical removal of reproductive organs imposes a heavy financial burden since it must be paid out-of-pocket, and not every trans person can afford, desires, or is medically advised to undergo organ removal,” the Taiwan Tongzhi (LGBTQ+) Hotline Association said. “Additionally, requiring psychiatric evaluations is problematic because specialized medical resources are scarce and concentrated in major cities. These obstacles severely impact transgender individuals in their daily lives.”

The Taiwan Tongzhi (LGBTQ+) Hotline Association said the continued reliance on an administrative directive rather than legislation has created systemic uncertainty for trans people. The organization said the absence of a statutory framework allows executive agencies to alter requirements without legislative oversight, leaving trans people uncertain whether future policies will become more restrictive or more permissive. The Taiwan Tongzhi (LGBTQ+) Hotline Association added that while several trans people have secured favorable court rulings since 2023, those decisions apply only to the individual cases before the courts and do not guarantee similar outcomes for others. The group also said pursuing litigation requires significant time, financial resources, and emotional investment, making it an inaccessible path for many trans people seeking legal recognition.

The Executive Yuan and the Interior Ministry did not respond to the Blade’s requests for comment.

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