Health
CMS moves to expand HIV-positive organ transplants
HIV/AIDS activists welcome potential development
The Centers for Medicare and Medicaid Services is pushing forward a proposed rule that would make it not only easier for people with HIV in need to get organ transplants from HIV-positive donors, but also make it a priority where there was often a barrier.
The Washington Blade sat down with people familiar with this topic — from former heads of the Centers for Disease Control and Prevention, to HIV activists and to the first HIV-positive person to donate an organ — about what this proposed change could mean.
HIV is a virus that attacks the body’s immune system, particularly targeting the body’s T-cells, which makes it harder to fight off infection and disease. If left untreated, HIV can become AIDS. Without treatment, AIDS can lead to death within a few months or years. The virus is spread through direct contact with bodily fluids — often through sex, unclean needles, or from mother to baby during pregnancy.
According to HIV.gov, a website managed by the U.S. Department of Health and Human Services, approximately 1.2 million people in the U.S. were living with HIV in 2022. Of those 1.2 million, 13 percent don’t know they have it.
The virus disproportionately impacts men who have sex with men and people of color.
The CDC’s statistics show men are most affected, making up almost 80 percent of diagnoses, with gay and bisexual men accounting for the majority. Racial disparities also are present — Black people make up 38 percent of diagnoses. The World Health Organization estimates that around 44.1 million people have died from AIDS-related illnesses globally as of 2024.
Since the virus was first detected 45 years ago, scientists have been working on ways to treat and prevent its spread. In 1987, the first breakthrough in fighting HIV came as the U.S. approved the first HIV medication, AZT — marking the beginning of antiretroviral therapy. This medicine — and later descendants of it, like today’s widely prescribed Biktarvy — stop the HIV virus from reproducing and allow the body to keep its T-cells.
Then in 2012, another big step toward minimizing the scope of the potentially fatal disease came as the CDC approved the first HIV prevention medication, Truvada, more commonly known as PrEP. As of 2024, nearly 600,000 people in the U.S. are using PrEP, according to AIDSVu, which uses data from Gilead Sciences (manufacturers of Truvada and Biktarvy) and is compiled by researchers at the Rollins School of Public Health at Emory University.
The following year, in 2013, the HIV Organ Policy Equity (HOPE) Act was signed into law, enabling the use of organs from HIV-positive donors for transplants into HIV-positive recipients, overturning a 1988 ban.
There are an estimated 123,000 people waiting for organ transplants in the U.S. The number of HIV-positive people on that list is estimated to be smaller, harder to precisely quantify, but they are still in dire need.
A study from the New England Journal of Medicine, published in 2024, analyzed the outcomes of 198 kidney transplantations to people with HIV at 26 medical centers across the U.S. from 2018 to 2021.
Results from the study showed that for kidney transplants performed using organs from 99 donors with HIV and 99 without HIV, one-year survival rates for HIV-positive recipients were nearly identical (94 percent and 95 percent, respectively). Three-year survival rates were also similar (85 percent and 87 percent). Organ rejection rates were also numerically on par after three years (21 percent and 24 percent). Other measures for surgical outcomes, including the number of side effects that occurred, were also roughly the same for both groups.
This shows that, overall, HIV-positive-to-HIV-positive transplants are nearly identical in outcome to transplants between HIV-negative donors and recipients.
Where we are now
Now in 2026, CMS is pushing past the clinical trial testing phase it has been in, making HIV-positive-to-HIV-positive organ transplants more widespread and more accessible.
Adrian Shanker, the former deputy assistant secretary for health policy and senior advisor on LGBTQ health equity at HHS, explained to the Blade that the HOPE Act was a step in the right direction, but this policy change from CMS will expand the ability to help HIV-positive patients in need.
“The original HOPE Act asked for scientific research,” Shanker explained. “There were 10 years of clinical trials. The Biden administration promulgated a rule that removed clinical trial requirements for kidney and liver transplants between people living with HIV. This proposed rule is further implementation on the CMS side with the organ procurement organizations to ensure they’re carrying out the stated intent of the HOPE Act law. It’s building on consensus that has existed through multiple administrations.”
The proposed change would go into effect on July 1, and, according to Shanker, would help everyone in need of an organ — not just HIV-positive people.
“People living with HIV, their ability to receive organs from other people living with HIV in a more streamlined way means that the overall organ waitlist is sped up as well,” he added. “So it benefits everyone on the waitlist.”
Shanker, who was also a member of the Presidential Advisory Council on HIV/AIDS, spoke about how this is a rare moment of bipartisanship.
“There’s no secret that the Trump administration has been quite adversarial to LGBTQI plus health, and to the health of people living with HIV/HIV prevention resources as well … From destabilizing PEPFAR to shutting down one of the primary implementation partners, which is USAID, to firing almost the entire staff of the Office of Infectious Disease and HIV Policy at HHS … But what this is is a glimmer of hope that we can have bipartisan solutions that improve quality of life for people living with HIV.”
Harold Phillips, the CEO of NMAC, a national HIV/AIDS organization that pushes policy education and public engagement to end the HIV epidemic, and an HIV-positive American, sees this as a huge gain for the HIV-positive community.
“For a number of years, we were excluded from that pool of potential donors,” Phillips said. “Many people living with HIV were excluded from being able to get organ transplants. So this opens up that door. This is a positive step forward that will help save lives.”
That “open door,” Phillips said, does more than just provide life-saving organs to people in the most need. It provides a sense of being able to support their community.
“I remember when I was no longer able to check that box on my driver’s license,” Phillips recalled during his interview with the Blade. “I remember what that meant — that my organs might not be able to save a life. The potential that now they could is really exciting for me.”
“To think about people living with HIV donating their organs to other people living with HIV and helping extend their health and well-being — that’s an exciting moment in our history. It reinforces that HIV is not a death sentence anymore.”
Human Rights Campaign Senior Public Policy Advocate Matt Rose also sat down with the Blade to explain the realities of HIV-positive people in the U.S. right now who are looking for a transplant.
“If you’re HIV positive and on the waitlist for an organ right now, your chance of getting one is slim to nil,” Rose said. “This at least gives you a real shot.”
He went on to explain that while the HOPE Act started to move in the right direction, it hasn’t done enough for HIV-positive people in dire need.
“This bill [HOPE] was supposed to fix that — and it never really has. But every administration, we keep chipping away at the next hurdle,” he said. “This latest move will drastically expand the ability for someone who is HIV positive to donate an organ.”
That slow chipping away, in addition to the non-stop trials being done to prove the efficacy and ability for HIV-positive people’s bodies to accept organ donation, is part of the broader push to normalize this practice and remove outdated restrictions.
Shanker elaborated, explaining all that time was necessary to figure out the efficacy of HIV-positive-to-HIV-positive organ transplants but now that the data has been collected — its time to expand the availability.
“There were over a decade of clinical trials between the original HOPE Act law being signed by President Obama and our rule being promulgated at the end of the Biden administration. It was to allow those clinical trials to run their course,” Shanker said.
Nina Martinez is the first HIV-positive person to donate an organ to another person with HIV.
She explained that the stigma and lack of understanding from the general public is another hurdle that those working to improve the quality of life for people living with HIV have to deal with.
“People don’t generally understand that treatment works,” Martinez said, who became the first person to undergo HIV-positive organ donation in 2019. “When you have access to antiretroviral therapy, it lowers the virus in your bloodstream to levels so low that lab tests can’t detect it. Clinically, that correlates to good health and an inability to transmit HIV sexually. I was healthy enough to pass the same evaluation as any other living donor without HIV.”
She continued explaining:
“Just by having a diagnosis of HIV, they’re labeling donors as medically complex, and that’s not accurate. Every donor with HIV has to pass the same evaluation as donors without HIV,” she said. “If someone passes that evaluation and still isn’t allowed to donate, that’s discrimination. If a patient is willing to accept that organ and you block it because of preconceived notions, you’re denying someone care based on disability. That runs counter to basic fairness.”
When asked about her decision to become a donor and what message she hopes it sends, Martinez emphasized that the choice should remain personal.
“I didn’t undertake this endeavor to say that people with HIV should donate. This is a community that’s been through a lot and has contributed to science — we have served. But for people who wanted a way to leave a legacy, and that is what I wanted, they should be supported in that. There shouldn’t be arcane scientific perceptions and myths getting in the way of that.”
National Donor Day, which raises awareness of organ donation, is on Feb. 14. To become an organ donor, visit registerme.org.
Health
United States Conference on HIV/AIDS grapples with federal budget cuts
Annual gathering is largest of its kind in the country
Advocates, public health experts, and healthcare providers gathered for the United States Conference on HIV/AIDS on Sept. 17 in Anaheim, Calif.
The conference is the largest of its kind in the nation and came amid a wave of new challenges for HIV research and treatment. Since the beginning of the second Trump-Vance administration, federal spending cuts have targeted HIV/AIDS programs, including the gutting of the U.S. Agency for International Development and proposed cuts to PEPFAR, which supports HIV testing and treatment globally, in 2025.
Last year, Congress maintained funding for HIV programs after proposed cuts faced opposition from advocacy groups and bipartisan criticism. Yet, this year Congress has proposed similar cuts to many of the same programs, which would cut nearly one billion dollars in HIV funding. The majority of the cuts would impact HIV prevention and outreach, which includes ending nearly all Centers for Disease Control and Prevention HIV prevention activities.
“If we continue down this path,” said Jeremiah Johnson, the executive director of PrEP4ALL, an advocacy group that supports expanding access to HIV prevention. “We’re going to see more people falling off treatment. We’re going to see more wait lists. That’s going to lead to more people dying from AIDS-related complications.”
Cuts and challenges
The funding cuts loomed over the conference and inspired protest from activists.
On the first day of USCHA, activists with Save HIV Funding organized a mock funeral outside the convention center. Advocates living with HIV wrote eulogies for themselves, meant to show the consequences of diminished access to treatment. Then activists marched through the conference carrying fake coffins.
Johnson, who helped organize the protest, said that “the Trump administration has eviscerated global aid … and the fears that many of us are just talking about hypothetically for ourselves at the moment are already happening [internationally]. And so we wanted to place that front and center at this conference.”
The attacks on funding for HIV research and outreach come at a complicated time for the movement to end the AIDS epidemic. While options for prevention and treatment have never been more accessible, such as PrEP and antiretroviral therapy, there have been some concerning upticks in infections, particularly among communities of color.
Southern states account for the majority of new HIV infections in the country, despite making up only 38 percent of the population. And these infections impact disproportionately Black and Latino communities. According to the CDC, even as overall HIV infections decreased from 2018 to 2022, diagnoses of HIV among Latinos grew by 17 percent, with a majority of this increase happening in the South.
Stigma is still the biggest barrier for people seeking out HIV treatment, said Guillermo Chacón, president of the Latino Commission on AIDS.
“The progress that we [made] in the past two years has been demolished,” he said.
Chacón blames the federal government for stigmatizing HIV treatment by using harmful rhetoric about queer people.
“The level of homophobia and transphobia right now is even higher because it has been used as a political message to create fear and division in our country,” he said.
Chacón believes that research and outreach must be done to reverse the rising HIV infections among Latinos. However, this is exactly the type of research that the Trump-Vance administration is targeting most intensely. Research into “health disparities” — why some health problems impact certain communities more than others — has been heavily criticized by the White House, along with other research that it considers “woke” and claims is not supported by science.
Impact felt at conference
The opening plenary for the conference addressed some of the funding challenges the movement was facing but tried to shift the focus to the victories the movement has seen over the years. Speakers highlighted historic successful activist campaigns like ACT UP, and recent improvements in medical care and access to treatment.
Randevyn Pierre, head of U.S. external affairs at ViiV Healthcare, the sponsor of the plenary, took the stage to celebrate the success of the U = U campaign (undetectable viral load =
untransmittable HIV virus), and ViiV’s investment of $33 million in HIV community organizations across the U.S. This comes as the Trump-Vance administration has made moves to end direct funding of community-based organizations, opting to give the funding to state healthcare agencies.
The speakers at the conference discussed reducing stigma for those living with HIV and the joy of living authentically. They also emphasized the diverse groups of people that are impacted by HIV and how they can come together to fight for a cure. Longtime AIDS activist Rae Lewis Thorton exclaimed, “When they tell me there’s a cure to HIV, I’m gonna take off my 4-inch heels and put on gold slippers,” to applause from the audience.
The opening plenary also featured song and dance from a variety of artists, many of whom spoke about how HIV has impacted their own lives and how advocacy has uplifted their spirits. However, the joyous atmosphere at the conference would not last.
On the final day of USCHA, Geri Donenberg, the associate director of AIDS research at the National Institutes of Health, took the stage to address the conference.
As she spoke, phones began to buzz around the room with breaking news: the Trump-Vance administration was drafting an executive order to create an external board to oversee NIH grants and screen them for political content. NMAC CEO Harold Philips took the stage after Donenberg to address the crowd. “It’s up to us,” Philips said, “to hold NIH accountable.” He added that HIV advocates “have supporters inside NIH who are struggling and working to do the right thing. We have to have their back.”
Chants of “stand up, fight back, fight AIDS” erupted from the crowd as Philips spoke. “We do have to fight back. We do have to continue to fight,” Philips replied.
Caleb Kaufman is a California Local News Fellow placed with the Los Angeles Blade. The California Local News Fellowship is a state-funded initiative to support and strengthen local news reporting. Learn more about it at fellowships.journalism.berkeley.edu/cafellows.
Health
AIDS Healthcare Foundation announces 3 million people globally in its care
Los Angeles-based group lauded ‘historic milestone’
The AIDS Healthcare Foundation, a Los Angeles-based nonprofit group founded in 1987 that has become the world’s largest HIV/AIDS organization, has announced it has three million people in care around the world.
In a statement released on May 26, the organization, known worldwide as AHF, said the latest accomplishment reflects its global commitment to HIV prevention, care, and treatment. It says the accomplishment comes at a time when AHF marks the 25th anniversary of its first global programs launched in South Africa and Uganda in early 2001.
The statement says the three million people in care milestone also comes while the group approaches the 40th anniversary of its founding in 1987.
“Today, AHF provides lifesaving services in 50 countries across Africa, the Americas, Asia, and Europe, supporting millions of people living with HIV through a network of 1,056 global clinics, 79 healthcare centers in the U.S., 67 pharmacies, 96 wellness centers, 26 Out of the Closet thrift stores, outreach programs, and community partnerships,” the statement says.
“This accomplishment is far more than a number — it represents 3 million individuals whose lives have been touched by compassion, commitment, and the belief that healthcare is a human right,” Condessa M. Curley, the AHF board chair, said in a statement. “We extend our deepest gratitude to every member of the AHF team whose dedication made this milestone possible,” Curley said.
The AHF website notes the organization was founded in 1987 in Los Angeles as a network of hospices committed to “fighting for the living and caring for the dying” at a time when there was no effective treatment for HIV/AIDS. A statement on the website says since that time AHF has greatly expanded, converting its hospices into healthcare centers “and building a new paradigm for HIV care both in the United States and around the world.”
The statement adds, “Under the leadership of president and co-founder Michael Weinstein, AHF has grown from a group of friends dedicated to creating dignified hospice care to the largest AIDS organization in the world.” It says Weinstein “has been at the forefront of creating cutting-edge healthcare and advocacy programs and continues to drive the organization forward with the aim of saving more lives around the world.”
The statement announcing the milestone has also come at a time when more than 40 million people worldwide are living with HIV, “while hundreds of thousands continue to die annually from AIDS-related illnesses despite the availability of effective treatment.”
It says AHF’s response has included an expansion of its prevention and public health programs worldwide. In 2025 alone, according to the statement, AHF and its affiliated programs provided nearly five million free HIV tests globally and distributed more than 54 million free condoms, “underscoring the organization’s continued emphasis on both prevention and treatment.”
In D.C. AHF operates health care centers at 1701 K St., N.W., Ste. 400 [202-293-8680], 650 Pennsylvania Ave., S.E., Ste. 310 [202-350-5000], and 1647 Benning Road, N.E., Ste. 300 [202-350-5000].
Cannabis Culture
LGBTQ people, weed, and mental health: what you need to know
Community uses marijuana at much higher rates than general population
Uncloseted Media published this story on May 7.
By SPENCER MACNAUGHTON | In 2025, the global cannabis market size was valued at nearly $103 billion. By 2034, that number is expected to explode by roughly 1,400 percent to more than $1.43 trillion.
In short, as an increasing number of countries legalize marijuana use, everyone is starting to consume a lot more weed. And LGBTQ people tend to use cannabis at much higher rates than the general population. One study found that 55 percent of lesbian and 45 percent of gay young adults use marijuana, compared to about 33 percent and 37 percent, respectively, of their straight counterparts.
As LGBTQ people face a mental health crisis, the mainstream stereotypes that depict weed as an antidote for anxiety, panic and depression aren’t painting the full picture. And that could be exacerbating the mental health struggles so many queer people, and especially youth, face.
Here’s what the research demonstrates about marijuana and its effects on mental health:
- Multiple studies suggest a link between marijuana use and an increased risk of mental health disorders, including schizophrenia, depression and anxiety in individuals who are genetically predisposed.
- One study found that daily marijuana use, especially among younger people, makes some individuals seven times more likely to develop psychosis.
The increase in higher-potency strains of marijuana could pose unknown risks. In 1995, the average content of Tetrahydrocannabinol (THC) in confiscated marijuana was less than 4 percent. In 2022, it was more than 16 percent. Researchers don’t know the full extent of the impact that these higher concentrations can have on mental health and especially on younger people whose brains are still developing.
- A systematic review of studies published between 2013 and 2025 found damning results for the mental health of young cannabis users:
They were 51 percent more likely to experience depression, 58 percent more likely to experience anxiety, between 50 and 65 percent more likely to experience suicidal ideation and 80 to 87 percent more likely to have attempted suicide.
- While the above stats paint a grim picture, there is also some research that suggests benefits of cannabis use:
- A 2025 systematic review found that “medicinal” weed showed some efficacy in relieving withdrawal symptoms of opioid use disorder. THC use has been associated with improvement of post-traumatic stress disorder symptoms, bipolar symptoms and sleep quality.
- Other studies found that THC administered in a controlled setting was associated with a decrease of symptoms and adverse effects for a range of mental health disorders, including schizophrenia, psychotic symptoms, and anorexia nervosa.
Beyond what we pulled from academia, there is an astounding lack of information about the interplay between weed and mental health. As we dive deeper into Mental Health Awareness Month, I hope advocacy organizations, influencers and news outlets ramp up their coverage of this important topic that affects the countless LGBTQ weed smokers, many of whom are already struggling.
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