I’ve been meaning to post this since the early hours of December 1, officially World AIDS Day, but I’ve been traveling for work, am very jet lagged, and couldn’t make it happen. But it’s OK, because HIV and AIDS affect people around the world every day, not just the one day a year when many people don red ribbons and take the time to share remembrances of people we’ve lost, or recommit to the fight against HIV.
Unless you’re part of the Trump administration, of course.
It’s ironic, because it was February 5, 2019, when President Donald Trump surprised a lot of people by announcing his administration’s new initiative, called Ending the HIV Epidemic: A Plan for America, during his State of the Union address. In his speech, he said, “My budget will ask Democrats and Republicans to make the needed commitment to eliminate the HIV epidemic in the United States within 10 years.” And indeed, a huge amount of federal dollars flowed for this purpose, and great strides have been made in HIV prevention and care in the last 5 years as a result. It was one of his best legacies.
Unfortunately, halfway through his own 10-year plan, President Donald Trump v2.0 seems to have forgotten his own pronouncement. Just shy of 6 years from the date he announced his plan to end the HIV epidemic within a decade, Trump (with Elon Musk on his shoulder of course) announced a pause on U.S. foreign aid, including HIV work made possible through USAID and PEPFAR.
The AIDS Vaccine Alliance estimates that as of October 15 of this year, 2.5 million people who used HIV pre-exposure prophylaxis (PrEP) in 2024 to prevent HIV transmission in 2024 lost access to their medicines in 2025 due to this change. In a report released last week, UNAIDS projected that as a result of these cuts there will be an additional 3.9 million people who newly acquire HIV between 2025 and 2030. This is the opposite of ending the HIV epidemic by 2030. It’s making it much worse.
(And just in case you hear anyone around you saying “Well, Trump said he’d end the HIV epidemic in the United States; it’s not our responsibility to end it around the world,” let’s be clear that we live in a global society. You simply cannot end HIV in one country—especially one as big and internationally connected as the United States—without ending it everywhere. Period.)
This year’s World AIDS Day theme, selected as usual by the World AIDS Campaign’s Global Steering Committee, was “Overcoming disruption, transforming the AIDS response.” Huh. I wonder how they came up with that theme?
On the Tuesday before Thanksgiving, someone at CDC posted a screenshot of their computer screen to the AltCDC account on BlueSky, sharing with the world the guidance they had just received from the administration:
It’s hard to believe that after 11 months of this crap I can still be surprised by anything this administration does, but this one got me. Like many people who’ve devoted the last 20, 30, or 40 years of their careers to HIV prevention and care, this felt like not just a slap in the face, but a bizarre 180° position for the Trump administration to take.
You can’t just wish AIDS away. Pretending it doesn’t exist makes it worse, not better. And for an administration that claims to care so much about government waste, you’d think they’d realize that you can’t decide on November 25 to withdraw from activities planned for December 1 without a huge amount of waste. Money has already been spent. Muzzling civil servants from talking about it doesn’t help anybody.
So here it is. This World AIDS Day, we should have been celebrating some incredible advances in HIV prevention. This year, especially, there was a huge game-changer: clinical trials were completed for a new drug, lenacapavir, which is incredibly effective at preventing HIV transmission with a single injection every 6 months. This is the closest we’ve ever been to an HIV vaccine, by a lot. Twice a year, people need to go to a clinic and get an injection, and they’re very likely to stay HIV free. This could be the thing that finally turns the tide. Recognizing this, in July the WHO recommended widespread use of lenacapavir as soon as possible.
Except, the Trump administration’s overnight withdrawal of foreign aid funds to support HIV work worldwide has broken much of the very infrastructure that could make this happen. In most cases, lenacapavir sits as unfilled potential. Even if countries can access the drug (which isn’t a sure thing), in so many cases the staff who would have helped administer it have been laid off amidst massive funding cuts.
So instead of celebrating a turning point in the HIV epidemic—which has killed almost ¾ of a million people in the United States and more than 44 million people worldwide since 1980—the U.S. government asked federal workers to spend nothing, and say nothing during World AIDS Day this year. It’s despicable. You know who else acted like that as president? Ronald Reagan. He might be revered by a lot of Republicans for his economic policies, but it’s hard for anyone to paint a rosy picture of his handling of the HIV epidemic. It’s widely acknowledged that his failure to act in the 1980s is one of the key reasons the epidemic was able to take hold, killing so many around the world.
It’s fitting then that ACT UP (the famous activist group AIDS Coalition to Unleash Power) launched a new media campaign on World AIDS Day this year. If you were around in the 80s, you might remember that ACT UP created a green poster with Ronald Reagan’s face, hot pink eyes, and the matching hot pink caption “AIDSGate,” to raise awareness of how Reagan’s mishandling of HIV and AIDS was leading to thousands (now millions) of unnecessary deaths. That poster was everywhere, and it did have an impact.
Well I’ve talked a lot about Trump in this post, but of course RFK Jr. is the man at the helm of the Department of Health and Human Services. Yes, the guy who infamously has said that HIV does not cause AIDS—like, he said that in 2023, not 1987—and has recently blamed the early days of HIV transmission on the “gay lifestyle” and drug use (addiction to poppers, to be specific), which was debunked as a scientific theory more than 30 years ago.
“AIDSGate” is an outdated term, plus it’s already been used. More importantly, RFK Jr. isn’t just terrible on HIV and AIDS like Reagan was, he’s terrible on all sorts of health issues that will lead to unnecessary death. ACT UP is paying attention, and you should be, too:
Dismantling Healthcare = Death. Spread the word. ACT UP, FIGHT AIDS!