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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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State Department

State Department implements anti-trans bathroom policy

Memo notes directive corresponds with White House executive order

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(Photo courtesy of the Library of Congress)

The State Department on April 20 announced employees cannot use bathrooms that correspond with their gender identity.

The Daily Signal, a conservative news website, reported the State Department announced the new policy in a memo titled “Updates Regarding Biological Sex and Intimate Spaces, Including Restrooms.”

The State Department has not responded to the Washington Blade’s request for comment on the directive.

“The administration affirms that there are two sexes — male and female — and that federal facilities should operate on this objective and longstanding basis to ensure consistency, privacy, and safety in shared spaces,” State Department spokesperson Tommy Piggot told the Daily Signal. “In line with President Trump’s executive order this provides clear, uniform guidance to the department by grounding policy in biological sex as determined at birth.”

President Donald Trump shortly after he took office in January 2025 issued an executive order that directed the federal government to only recognize two genders: male and female. The sweeping directive also ordered federal government agencies to “effectuate this policy by taking appropriate action to ensure that intimate spaces designated for women, girls, or females (or for men, boys, or males) are designated by sex and not identity.”

The Daily Signal notes the new State Department policy “does not prohibit single-occupancy restrooms.”

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I’m telling the scared little girl I once was it’s okay to feel free

This week is Lesbian Visibility Week

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(Design by Soph Holland)

Uncloseted Media published this article on April 23.

By SOPHIE HOLLAND | At 13 years old, I remember looking in the mirror in my Toronto bathroom and thinking, “Yeah, I’m a lesbian.” At the time, I thought it was a dirty word. Thinking back, it could be because the first time I heard it was when a family member said, “I don’t know what a lesbian is, they are like aliens.”

And although I walked around in camouflage Crocs with a rainbow My Little Pony charm, plaid knee-length shorts and a shark tooth necklace (yes, these are all, in my opinion, stereotypically lesbian apparel!), I didn’t feel like I fit the mold. The longer I thought about it, the worse I felt, so I buried my feelings deep inside.

Now I am 25, and I have been out since I was 22. Three years ago, I never could have imagined that I’d be working for a queer news publication and celebrating Lesbian Visibility Week, an annual event meant to honor and uplift lesbian perspectives and highlight the hardships our community faces. To me, LVW is so important because, frankly, it has been an absolute shit show getting here, to a place where I feel love and joy most days.

I think back to the frustration of constantly being asked, “Do you have a boyfriend?” Of watching princess movies and seeing a broken girl only find herself when her prince charming arrives. I remember listening to music that was always about heterosexual relationships. I remember feeling left out in high school when, one by one, my friends got boyfriends.

I tried the boyfriend, and I tried really hard for it to work at a large detriment to my wellbeing. I brainwashed myself into thinking I was probably bisexual, which I told my closest friends around 16 and unsuccessfully told my parents at the same age. I was probably subconsciously using this as a litmus test of their acceptance and to soothe the anxiety I felt around my sexuality.

Learning to love who I am did not only come from me unraveling my internalized lesbophobia and dissecting the oppressive societal messages of heteronormativity. It came from meeting an awesome community of lesbians and queers. I found people who understood my worldview and who showed me the ropes. I no longer had to stutter over concepts like lesbian loneliness or my frustration with misogynistic straight men.

They all just got it.

Without this community, I am not sure if I could be as warm and confident in myself as I am today.

And while I still experience homophobia, like being spat on while walking with an ex in downtown Toronto or having a stranger yell in my face “Are you fucking lesbians?” in Kensington Market, the joy and love still outweighs the nasty.

So, as the sentimental dyke that I have become, I decided to ask a set of lesbians in my orbit — including my friends as well as Uncloseted staffers, board members and followers — if they would share a little bit about what makes them love being a lesbian. And now, I can share it with all of you. Here they are. Happy LVW!

Timi Sotire

Falling in love with her was a reset. I felt like a kid again, hopeful about the future. We’ve had to overcome many obstacles to be together, but I’d choose her in every lifetime. I was sick with a long-term health condition when we met, and hanging out with Sophia really helped me with my recovery after my surgery.

Bella Sayegh

Being a lesbian is one of the most beautiful things in the world. To be authentically yourself in resistance and joy is so special within the lesbian community.

Parker Wales

When I met Liv, I finally understood why almost every song is about love.

Gillian Kilgour

There is no connection quite as perfect as between lesbians, no one sees me like my lesbians do.

Chyna Price

There’s many things I love about being a lesbian. But here are my top three:

  1. There’s just a deeper understanding when it comes to being loved by another woman.
  2. The next one would be the sense of community, especially being a POC masculine-presenting lesbian. I don’t feel like I’m cosplaying as someone else like I felt like I was doing before I came out.
  3. There’s so much history going back to the 1800s on how we found and fought for our love. That fight makes me proud because it shows me … that we’ve [found] ways to express our love even when it was misunderstood, illegal and deemed as madness.

Hope Pisoni

Before I knew I was a lesbian, romantic relationships seemed suffocating — it felt like everyone would expect me to act my part in the meticulous performance that is heterosexuality. But meeting my spouse and discovering our identities together showed me just how freeing it could be to love without a script to follow.

Leital Molad

It was the joy of watching the New York Sirens defeat the Toronto Sceptres at our first professional women’s hockey game — surrounded by hundreds (maybe thousands?) of cheering lesbians.

Angela Earl

I spent years building a life that looked right. But I never felt settled, and eventually I started asking what would actually make me happy. Coming out was about more than who I love, it was letting go of everything I was told to be. The last few years have felt like coming home to a life that had been waiting for me.

Tali Bray

What I love about being a lesbian is what I love about being in love … the wonder and joy of “oh, this is what it’s supposed to feel like.” I love moving through the world with women.

Izzy Stokes

I didn’t fall in love until I realized that queerness was an option. My queer friends have helped me see so much more than I grew up seeing. I’m so proud of us, and I’m so grateful for my lesbian community.

Nandika Chatterjee

When I met my fiancée is when I started to feel most like myself. That meant loving myself for who I am and embracing my identity as a lesbian. I felt free in a way I have never before. That’s the long and short of it.

Liz Lucking

The love and joy of being a lesbian is getting to live the life I dreamed of but never thought I would get to have!

Reflections

As I read these beautiful entries, it’s not lost on me that we’re still living in a world where lesbians are more likely to struggle with maternity problemsfetishization, and compulsory heterosexuality — not to mention the intersectional pressures of racism from both inside and outside the queer community. That’s part of why, according to a 2024 survey, 22 percent of LGBTQ women have attempted suicide, and 66 percent have sought treatment for trauma.

So if you are a lesbian who isn’t out or doesn’t feel safe, I hope you read this and can glean some hope from these messages. So when you look in the mirror, you know that it’s okay to release the weight — which can feel so heavy — of a heteronormative world.

We still have a long fight until all lesbians can feel safe to be themselves, but this is a community that does not back away from the tough, from the joy, from being loud and from all the other things that it takes to start a small revolution.

Hell yeah, lesbians! Here’s to you.

*I am signing off with my cat on my lap and a pride flag over my head <3.

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Cuba

Trans parent charged with kidnapping, allegedly fled to Cuba with child

Cuban authorities helped locate Rose Inessa-Ethington

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A transgender Pride flag flies over Mi Cayito, a beach east of Havana. Cuban authorities helped locate a transgender woman who U.S. authorities fled to the island with her 10-year-old child who she allegedly kidnapped. (Washington Blade photo by Michael K. Lavers)

Federal authorities have charged a transgender woman with kidnapping after she allegedly fled to Cuba with her 10-year-old child.

An affidavit that Federal Bureau of Investigation Special Agent Jennifer Waterfield filed in U.S. District Court for the District of Utah on April 16 notes the child is a “biological male who identifies as a female” and “splits time living with divorced parents who share custody” in Cache County, Utah.

Waterfield notes the child on March 28 “was supposed to be traveling by car to” Calgary, Alberta, “for a planned camping trip with his transgender mother, Rose Inessa-Ethington, Rose’s partner, Blue Inessa-Ethington, and Blue’s 3-year-old child.”

The affidavit notes the group instead flew from Vancouver, British Columbia, to Mexico City on March 29. Waterfield writes the Inessa-Ethingtons and the two children then flew from Mérida, Mexico, to Havana on April 1.

The 10-year-old child called her biological mother on March 28 after they arrived in Canada. The custody agreement, according to the affidavit, required Rose Inessa-Ethington to return the child to her former spouse on April 3.

“Interviews of MV [Minor Victim] 1’s family members provided significant concerns for MV 1’s well-being, as MV 1 was born a male, however, identifies as a female child, which is largely believed to be due to manipulation by Rose Inessa-Ethington,” reads the affidavit. “Concerns exist that MV 1 was transported to Cuba for gender reassignment surgery prior to puberty.”

The affidavit indicates authorities found a note in the Inessa-Ethingtons’ home with “instruction from a mental health therapist located in Washington, D.C., including instruction to send the therapist the $10,000.00 and instructions on gender-affirming medical care for children.”

The affidavit does not identify the specific “mental health therapist” in D.C.

A Utah judge on April 13 ordered Rose Inessa-Ethington to “immediately” return the child to her former spouse. The former spouse also received sole custody.

“Your affiant believes that due to the extensive planning and preparation exhibited by both Rose Inessa-Ethington and Blue Inessa-Ethington to isolate MV 1 and take MV 1 to Havana, Cuba, without notifying or requesting permission from MV 1’s mother indicates they are likely not planning to return to the United States,” wrote Waterfield.

The affidavit notes Cuban authorities found the Inessa-Ethingtons and the child.

A press release the U.S. Attorney’s Office for the District of Utah issued notes the Inessa-Ethingtons “were deported from Cuba” on Monday “with the assistance of the FBI.”

The couple has been charged with International Parental Kidnapping. The Inessa-Ethingtons were arraigned in Richmond, Va., on Monday. The press release notes a federal court in Salt Lake City will soon handle the case.

The New York Times reported the child is now back with their biological mother.

“We are grateful to law enforcement for working swiftly to return the child to the biological mother,” said First Assistant U.S. Attorney Melissa Holyoak of the District of Utah in the press release.

The case is unfolding against the backdrop of increased tensions between Washington and Havana after U.S. forces on Jan. 3 seized now former Venezuelan President Nicolás Maduro and his wife, Cilia Flores.

President Donald Trump shortly after he took office in January 2025 issued an executive order that directed the federal government to only recognize two genders: male and female. A second White House directive banned federally-funded gender-affirming care for anyone under 19.

The U.S. Supreme Court last year in the Skrmetti decision upheld a Tennessee law that bans gender-affirming care for minors.

Cuba’s national health care system has offered free sex-reassignment surgeries since 2008.

Activists who are critical of Mariela Castro, the daughter of former President Raúl Castro who spearheads LGBTQ issues as director of Cuba’s National Center for Sexual Education, have previously told the Washington Blade that access to these procedures is limited. The Blade on Wednesday asked a contact in Havana to clarify whether Cuban law currently allows minors to undergo sex-reassignment surgery.

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