Sexuality in Color: On HIV/AIDS

December 1st of every year is World AIDS Day.

Traditionally, on that day, the president of the United States issues a proclamation acknowledging the historical impact HIV and AIDS have had on millions of people, as well as addressing the progress and vision of the National HIV/AIDS Strategy, a comprehensive government plan to address HIV-related health outcomes in the U.S. and abroad. The most recent strategy was released in 2010, when it was updated to reflect goals all the way out to 2020.

Below is the statement that President Trump released — read through it and see if you can spot some of the glaring omissions.

The first documented cases of the human immunodeficiency virus infection (HIV) and acquired immune deficiency syndrome (AIDS) 36 years ago became the leading edge of an epidemic that swept across the United States and around the globe, devastating millions of individuals, families, and communities. As a Nation, we felt fear and uncertainty as we struggled to understand this new disease. In the decades since — through public and private American leadership, innovation, investment, and compassion — we have ushered in a new, hopeful era of prevention and treatment. Today, on World AIDS Day, we honor those who have lost their lives to AIDS, we celebrate the remarkable progress we have made in combatting this disease, and we reaffirm our ongoing commitment to end AIDS as a public health threat.

Since the beginning of the HIV/AIDS epidemic, more than 76 million people around the world have become infected with HIV and 35 million have died from AIDS. As of 2014, 1.1 million people in the United States are living with HIV. On this day, we pray for all those living with HIV, and those who have lost loved ones to AIDS.

As we remember those who have died and those who are suffering, we commend the immense effort people have made to control and end the HIV/AIDS epidemic. In the United States, sustained public and private investments in HIV prevention anything d treatment have yielded major successes. The number of annual HIV infections fell 18 percent between 2008 and 2014, saving an estimated $14.9 billion in lifetime medical costs. We have also experienced successes around the globe. Through the President's Emergency Plan for AIDS Relief (PEPFAR) and its data-driven investments in partnership with more than 50 countries, we are supporting more than 13.3 million people with lifesaving antiretroviral treatment. We remain deeply committed to supporting adolescent girls and young women through this program, who are up to 14 times more likely to contract HIV than young men in some sub-Saharan African countries. Our efforts also include the DREAMS (Determined, Resilient, Empowered, AIDS‑free, Mentored, and Safe) public-private partnership, which has resulted in a 25–40 percent decline in new HIV infections among young women in districts in 10 highly affected African countries during the last 2 years.

While we have made considerable progress in recent decades, tens of thousands of Americans are infected with HIV every year. My Administration will continue to invest in testing initiatives to help people who are unaware they are living with HIV learn their status. Internationally, we will rapidly implement the recent PEPFAR Strategy for Accelerating HIV/AIDS Epidemic Control (2017-2020), which uses data to guide investments and efforts in more than 50 countries to reach epidemic control.

Due to America's leadership and private sector philanthropy and innovation, we have saved and improved millions of lives and shifted the HIV/AIDS epidemic from crisis toward control. We are proud to continue our work with many partners, including governments, private-sector companies, philanthropic organizations, multilateral institutions, civil society and faith-based organizations, people living with HIV, and many others.

NOW, THEREFORE, I, DONALD J. TRUMP, President of the United States of America, by virtue of the authority vested in me by the Constitution and laws of the United States, do hereby proclaim December 1, 2017, as World AIDS Day. I urge the Governors of the States and the Commonwealth of Puerto Rico, officials of the other territories subject to the jurisdiction of the United States, and the American people to join me in appropriate activities to remember those who have lost their lives to AIDS and to provide support and compassion to those living with HIV.

IN WITNESS WHEREOF, I have hereunto set my hand this thirtieth day of November, in the year of our Lord two thousand seventeen, and of the Independence of the United States of America the two hundred and forty-second.

In reading through this year's proclamation, I found myself getting incredibly frustrated, and I really struggled to finish it, even though the text is not all that long or complicated.

It wasn't until I went back and reread Barack Obama's 2016 World AIDS Day proclamation did it finally click — President Trump never even mentioned queer and trans people or people of color.

While it's true that the practice of issuing a World AIDS Day proclamation is largely ceremonial — it's not as if the statement enacts new policies or legislation — it can and does set the tone for HIV prevention and treatment work to follow. In contrast to last year, this year's proclamation made no mention of the disproportionate incidence of HIV within communities of color, especially among queer and trans folks, sex workers, and those who inject drugs intravenously. While it's true that HIV is not what it used to be (a rapidly-spreading, close-to-fatal disease with no known treatment or effective strategy for prevention), that does not mean that it is not still a problem.

As an HIV Testing Counselor, I hear folks talk this way all the time — they say to me, "But things aren't the way that they were in the 80's, right?"

I usually try to gently push back against that idea by talking about all the different folks for whom HIV can be life-threatening and practically untreatable (folks who are houseless or homeless, queer and trans youth, incarcerated populations, those with other disabilities or chronic illnesses, folks who are undocumented or can't afford healthcare, etc.).

A friend of mine who works in HIV prevention for the Public Health Department takes a more cynical-sounding stance: he likes to say that it's no longer an epidemic for the people who matter. I have to agree with him — not that communities who are disproportionately affected by HIV don't matter, but rather, over time, as the threat of HIV has reduced among people who are white, powerful, and affluent, the "crisis" has shifted out of the public narrative, and the subsequently those populations have been left to combat these issues on their own, without major institutional support. By excluding these specific populations, Donald Trump has once again made an already marginalized group of people feel even less visible and supported by the institution that is supposed to serve and protect them.

The folks at Southern Poverty Law Center brought up another important observation about the President's proclamation:

In his statement, Pres. Trump urged other leaders “to provide support and compassion to those living with HIV.” But his administration's efforts to repeal or weaken the #ACA would worsen quality of life for those suffering from the disease. #WorldAIDSDay

— SPLC (@splcenter) December 1, 2017

While urging the public to provide support and compassion, President Trump is also simultaneously responsible for pushing to weaken/repeal the Affordable Care Act, effectively denying subsidized and no-cost treatment for millions of Americans. One of the key elements of the ACA that benefitted folks living with HIV is that no one could be turned away or charged more for health insurance due to a pre-existing condition, and President Trump is attempting to get rid of that clause. Those populations dealing with higher rates of HIV and more complicating factors (low income, lack of insurance or coverage, homelessness, substance use issues) are left without the aid of government-funded healthcare programs, and are essentially hung out to dry. For these folks, social services like the ACA, Medicaid, and needle exchange programs (which may be endangered thanks to our current vice president) aren't a convenience or a luxury; they mark the difference between life and death. This "poor people are not my problem" approach to public health is one that I frequently see reflected in this administration, and is one that is incredibly damaging to the welfare of marginalized communities.

For World AIDS Day this year, I encourage you to think about the role that HIV plays in your community (or doesn't), and to ask yourself what you can do to reduce stigma and improve access to HIV testing, treatment, and care in marginalized communities around you: Get tested for HIV. Educate yourself about how it can and cannot be spread. Learn about the negative impacts of HIV criminalization. Read about how PEP and PrEP medications reduce HIV transmission dramatically. Learn about how consistent barrier use and low risk activities can reduce the spread of HIV and other STIs. Find and volunteer at a local HIV services organization. And above all, keep resisting.

Know of a blog, organization, or resource that belongs here? Send it to our curator, Al (that's me!), at al AT scarleteen DOT com. Interested in contributing as a guest writer for our Sexuality in Color series, or any other part of Scarleteen? Check out our information for writers and then take it from there! Experienced queer and trans writers of color of varied abilities and backgrounds are always strongly encouraged to apply.