News
Biden’s update to HIV strategy hailed for recognizing racism as health issue
New blueprint outlines plan 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.”
U.S. Military/Pentagon
Federal appeals court rules White House illegally banned trans troops
Defense Secretary Pete Hegseth says Pentagon will appeal to SCOTUS
A panel of federal appeals court judges ruled that President Donald Trump’s policy banning transgender troops likely violates their constitutional rights.
The three-judge panel from the U.S. Court of Appeals for the District of Columbia Circuit ruled 2-1 that Trump’s Executive Order 14183, also known as “Prioritizing Military Excellence and Readiness,” was created with the intent to exclude people from the military based on their gender identity.
The policy argues that trans people are inherently incapable of meeting the military’s “high standards of readiness, lethality, cohesion, honesty, humility, uniformity, and integrity,” citing a history of or signs of gender dysphoria as the cause. According to the Defense Department, this creates “medical, surgical, and mental health constraints on [an] individual.”
The policy states that, regardless of the physical or intellectual capabilities of each applicant, it views trans military applicants as a monolith, considering them less qualified than their cisgender peers.
Despite the panel’s majority opinion issued on Monday, the first day of Pride Month, the ban remains in effect. The U.S. Supreme Court allowed the Pentagon to enforce the policy last year and will continue to allow it to remain in place as litigation proceeds.
The panel’s new ruling will prevent the military from discharging current service members named in the lawsuit, but it does not allow new transrecruits to join.
The policy “appears to be driven by the bare desire to harm a politically unpopular group: persons who identify as transgender,” Judge Robert Wilkins, a Democratic appointee of President Barack Obama wrote for the majority.
Judge Justin Walker, the author of the dissenting opinion and a Republican Trump appointee, argued that the authority to determine military policy does not rest with the courts. Instead, he wrote, the Constitution grants that power to Congress through legislation and to the president as commander in chief of the armed forces.
“We have neither the expertise nor the authority to decide whether the military can exclude the plaintiffs from its ranks. The Constitution assigns that authority to Congress and the commander-in-chief,” Walker wrote.
Defense Secretary Pete Hegseth indicated that an appeal is in the works, posting, “See you at SCOTUS” on X on Monday in response to the ruling.
Jennifer Levi, senior director of transgender and queer rights at GLAD Law, which has led the litigation since last November, applauded the decision.
“Today’s decision is a powerful vindication of the plaintiffs’ extraordinary courage and unwavering commitment to their country,” Levi said.
The Washington Blade spoke with Second Lt. Nicolas (Nic) Talbott of the U.S. Army, the lead plaintiff in the case, and Levi from GLAD Law back in November.
While discussing the case and his experiences as a trans service member, Talbott said his identity is an asset rather than a hindrance, particularly when it comes to identifying problems and finding solutions, regardless of what others may think or say.
“Being transgender is not some sad thing that people go through,” Talbott told the Blade. “This is something that has taken years and years and years of dedication and discipline and research and ups and downs to get to the point where I am today … my ability to transition was essential to getting me to that point where I am today.”
He also discussed the impact of removing qualified and dedicated service members from the military, arguing that the consequences will be felt long after Trump leaves office.
“When we’re losing thousands of those qualified, experienced individuals … those are seats that are not just going to be able to be filled by anybody,” he said. “[That’s] military training that’s not going to be able to be replaced for years and years to come.”
“Every person who puts on the uniform is expected to make a tremendous amount of sacrifice,” Talbott said. “Who I am under this uniform should have no bearing on that … We shouldn’t be picking and choosing which veterans are worthy of our thanks on that day.”
Levi characterized the policy as overtly cruel and legally indefensible to the Blade.
“This policy and its rollout is even more cruel than the first in a number of ways,” Levi explained. “For one, the policy itself says that transgender people are dishonest, untrustworthy and undisciplined, which is deeply offensive and degrading and demeaning.”
She also argued that the administration’s cost justification is flawed, saying that removing and replacing trans service members is more expensive than retaining them.
“There’s no legitimate justification relating to cost … it is far more expensive to both purge the military of people who are serving and also to replace people … than to provide the minuscule amount of costs for medications other service members routinely get.”
National
Results from key Tuesday primary races
State officials in California had not called the governor’s race as of Wednesday morning but Republican Steve Hilton and Democrat Xavier Becerra appear likely to advance to the general election.
The race for governor has been scrambled several times after Kamala Harris opted not to run, Rep. Eric Swalwell dropped out after sexual misconduct allegations surfaced, and Rep. Katie Porter’s campaign fizzled. Becerra would be the state’s first Latino governor since 1875 if elected. Hilton was endorsed by President Trump.
In the Los Angeles mayor’s race, the AP declared that incumbent Mayor Karen Bass will advance to the Nov. 3 runoff while former reality TV star Spencer Pratt and LA Council member Nithya Raman were competing for second place. California is notoriously slow in counting ballots and only about half of the results were available by Wednesday morning.
In San Francisco, Democratic State Sen. Scott Wiener advanced to the general election in November, besting Supervisor Connie Chan, who was endorsed by House Speaker Emerita Nancy Pelosi. Pelosi is retiring from Congress after nearly 40 years in the House.
In Iowa, Democratic state Rep. Josh Turek won the primary for an open U.S. Senate seat, defeating state Sen. Zach Wahls. Turek will face Rep. Ashley Hinson, who won the GOP primary with President Donald Trump’s endorsement, in the general election.
The Iowa seat is open because Sen. Joni Ernst (R) decided not to seek re-election. The primary was closely watched by LGBTQ advocates because Wahls rose to national prominence after a speech he made defending marriage equality went viral in 2011. Wahls was raised by a lesbian couple.
Congress
10 HIV/AIDS activists arrested on Capitol Hill
Protesters interrupted Secretary of State Marco Rubio during hearing
U.S. Capitol Police on Tuesday arrested 10 HIV/AIDS activists who protested Secretary of State Marco Rubio during a Senate Foreign Relations Committee hearing.
The activists from Housing Works, Health GAP, the Treatment Action Group, and ACT UP held signs and chanted “Rubio’s Cuts Kill People with AIDS, PEPFAR Saves Lives!” before officers removed them from Dirksen Senate Office Building room where the hearing took place.
A media advisory the Washington Blade received before the protest noted “mounting evidence of Rubio’s attempts to sabotage PEPFAR (the President’s Emergency Plan for AIDS Relief, U.S. bilateral AIDS program) and vital global health programs.” The press release specifically highlighted three specific points:
• Eliminating Centers for Disease Control’s (CDC) lifesaving PEPFAR programs, which currently support approximately 12 million people on HIV treatment across 51 countries. Instead, Rubio intends to dismantle CDC’s current PEPFAR role and stamp out their global footprint in disease outbreak and surveillance for pandemics beyond HIV. Experts including eight former CDC Directors under Republican and Democratic administrations have spoken out against this effort to dismantle PEPFAR. Recent PEPFAR data showed sharp decreases in the numbers of people newly tested, diagnosed, and treated for HIV, but these data would have been even worse if not for CDC’s PEPFAR programs.
• Withholding $2 billion in Congressionally appropriated FY25 funding, including $330 million to combat HIV, $250 million to fight malaria, $320 million for maternal and child health programs, and nearly $650 million in global health security programs.
• Negotiating secret bilateral deals blackmailing African governments by demanding access to critical mineral wealth as a condition of access to HIV treatment and prevention funding.
The groups have staged several protests against the Trump-Vance administration’s HIV/AIDS policies since it took office.
Rubio on Jan. 28, 2025, issued a waiver that allowed PEPFAR and other “life-saving humanitarian assistance” programs to continue to operate during a freeze on nearly all U.S. foreign aid spending. HIV/AIDS service providers around the world with whom the Blade has spoken say PEPFAR cuts and the loss of funding from the U.S. Agency for International Development, which officially closed on July 1, 2025, has severely impacted their work.
The State Department last September announced PEPFAR will distribute lenacapavir in countries with high prevalence rates.
The New York Times last summer reported Vought “apportioned” only $2.9 billion of $6 billion that Congress set aside for PEPFAR for fiscal year 2025. (PEPFAR in the coming fiscal year will use funds allocated in fiscal year 2024.)
Bipartisan opposition in the U.S. Senate prompted the Trump-Vance administration last July withdraw a proposal to cut $400 million from PEPFAR’s budget. Vought a few weeks later said he would use a “pocket rescission” to cancel $4.9 billion for HIV/AIDS prevention and global health programs and other foreign aid assistance initiatives that Congress had already approved.
The White House in January expanded the global gag rule to ban U.S. foreign aid for groups that promote “gender ideology.” President Ronald Reagan in 1985 implemented the original regulation, also known as the “Mexico City” policy, which bans U.S. foreign aid for groups that support abortion and/or offer abortion-related services. Advocacy groups insist the expanded rule will adversely impact HIV prevention efforts around the world.
“Congress must stop Secretary Rubio before he dismantles PEPFAR,” said Treatment Action Group’s Kendall Martinez-Wright. “Rubio continues to defy the will of Congress and the American people who want this program restored and repaired. Under his leadership he is diverting funding and trying to eliminate the essential role of technical experts in global HIV and global health, while program performance is flailing.”
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