TheHuman Rights Campaign is pioneering a new frontier in the fight againstHIVstigma and health disparities. The organization’s GENERATE initiative, part of HRC’s celebrated “My Body, My Health” campaign, is a beacon of hope and empowerment for Black and LatineLGBTQ+ young men living with HIV.
Launched in 2023 with a blend of advocacy, storytelling, and education, GENERATE is more than a program—it’s a lifeline. “This initiative is about transforming lives,” says Torrian Baskerville, the dynamic director of HRC’s HIV and Health Equity program. “We are equipping these young men with the tools to not only survive but thrive.”
The program promises a transformative six-month journey for its eight lucky participants. The most recent application period closed at the end of May. The trans and cisgender men selected will be flown toWashington, D.C., for an immersive weekend of workshops and networking events. Participants will delve into the complexities of mental health, especially as it intersects with HIV, under the guidance of a licensed mental health therapist who shares their lived experiences.
“Access to mental health services has always been a significant barrier,” Baskerville notes. “We’re tackling this head-on by embedding mental health support into every facet of the program.”
After their initial training, participants return to their communities armed with knowledge and a renewed sense of purpose and community. Regular check-ins and ongoing support are in place to ensure they stay on track with their personal goals, whether it’s achieving viral suppression or excelling in their careers. The significance of this continuous support cannot be overstated, as these young men often face isolation and stigma that can hinder their progress. Baskerville says that the GENERATE initiative is committed to their success every step of the way.
The initiative also responds to the pressing need for tailored support within marginalized communities. Baskerville, himself a Black man living with HIV, emphasizes the importance of representation and relatability in this work. “When participants see themselves reflected in their mentors and peers, it creates a powerful sense of belonging and motivation,” he explains. The program provides critical resources and fosters an environment where participants can share their experiences and learn from one another.
The cohort members will be announced later this month, and the program will officially begin in July. The stakes are high, but so is the potential for impact. Baskerville says, “If even one participant walks away with a clearer path to a healthier, more empowered life, we’ve succeeded.”
PrEP access has been maintained for most Americans after an appeals court ruling ended a lawsuit that challenged the medication’s coverage.
In a ruling that upholds crucial components of the Affordable Care Act, the Fifth Circuit Court of Appeals ruled on Friday in Braidwood Management, Inc. v. Becerra, mandating that most insurance providers continue to cover preventive services, including PrEP medication, while deeming parts of the law unconstitutional.
The Advocatewas first to report in 2022 that the plaintiffs, led by Jonathan Mitchell, an ultraconservativeTexas lawyer with a history of challengingLGBTQ+ rights, argued that the ACA’s requirement for insurance plans to cover preventive services violated their religious freedom. They specifically objected to covering PrEP, pre-exposure prophylaxis, a medication that prevents HIV transmission, citing their Christian beliefs against homosexuality.
Judge Reed O’Connor of the U.S. District Court for the Northern District of Texas, who has also been allergic to LGBTQ+ causes, initially sided with the plaintiffs, ruling that the ACA mandate infringed on their religious freedom. The Department of Justicequickly appealed to the Fifth Circuit Court of Appeals, which has jurisdiction over Texas,Louisiana, andMississippi.
In itsruling, the Fifth Circuit upheld the lower court’s decision but limited the scope of the exemption to the plaintiffs in the case. This means that the broader mandate requiring most insurance providers to cover preventive services, including PrEP, remains in effect for the rest of the nation.
The court also addressed constitutional issues regarding the appointments of the United States Preventive Services Task Force members. It determined that these members are principal officers under Article II of the Constitution and must be appointed by the president and confirmed by the Senate. While this raised constitutional concerns, the court reversed the district court’s decision to vacate all agency actions enforcing the preventive care mandates, deeming the remedy overly broad.
Lambda Legal, an advocacy group for LGBTQ+ rights, responded to the decision with cautious relief. “Lambda Legal is relieved after the recent narrow decision by the U.S. Court of Appeals for the Fifth Circuit in the case of Braidwood v. Becerra that ruled most of the nation’s insurance providers must continue to cover PrEP medication and other preventative services,” said Jose Abrigo, Lambda Legal’s HIV project director.
Abrigo pointed out that the ruling’s limitation to the plaintiffs ensures broader protections and national healthcare policies remain intact. However, he expressed concerns about the potential for future legal challenges that could threaten healthcare rights and protections for millions of Americans.
He emphasized the importance of preventative care, noting that PrEP plays a critical role in the fight against HIV and AIDS. Access to such preventive measures is crucial for reducing preventable diseases and promoting public health. “Lambda Legal will closely monitor any further developments related to this case and similar legal challenges,” Abrigo said.
The case will likely go to the Supreme Court when either side appeals the ruling.
Since HIV was first discovered in 1983, medical experts and scientists have grappled with how to best treat the condition. In the 40 years since, there have been significant advancements in treatment that have lengthened lifespans, made identification of the virus easier, and improved the quality of life for those living with HIV and subsequent AIDS diagnoses if patients do not remain in care.
Over the past four decades, a diagnosis of HIV has evolved from essentially a death sentence to what is considered a manageable chronic condition. From the first identification of the virus that causes AIDS, it would take four years to develop and gain FDA approval for the first medication treatment, called AZT.
AZT had been originally developed to treat cancer but was found to be effective in interrupting the HIV-infected cells’ ability to make new viruses and was hailed as a game changer, proving that HIV was treatable. However, it would take many more advancements to loosen the death grip that HIV/AIDS had on the world in the 1980s and through the 1990s.
Challenges and limitations
While initial HIV treatments brought about hope for those who acquired the virus, they also presented a host of challenges and certain limitations. Traditional antiretroviral regimens were complex, necessitating a cocktail of drugs taken simultaneously, and each drug within the cocktail had its own dosing schedule and side effects, ranging from vomiting and diarrhea to insomnia and bone marrow suppression.
The complex nature of early treatments lent itself to human error in dosing and non-adherence to the regimen. Those who were living with HIV and in areas with limited resources, such as rural areas or those facing homelessness, were more likely to lack adherence to the regimen and suffer the consequences of dosing errors — if they were able to access antiretroviral medications at all.
The side effects of early HIV/AIDS treatments significantly diminished the quality of life for patients. Although AZT was hailed as the “light at the end of the tunnel” by the company responsible for its production, it was also fast-tracked through the approval system. Additionally, AZT was still costly and out of reach for many.
Over time, HIV mutated and began to resist AZT. By 1992, AIDS had become the number one cause of death for men ages 25 to 44. It became evident that scientists and experts had to go back to the drawing board to find out how to better combat this stronger strain of the virus.
Advancements in HIV treatment and prevention
As the Centers for Disease Control (CDC) and other experts on HIV and AIDS learned more about how the virus was contracted, spread, and progressed once someone acquired the virus, they began to develop stronger, more effective treatments and prevention methods.
In 1990, the CDC developed a patient-centered counseling model for the prevention of HIV. This model focused on the important aspects of consent, confidentiality, counseling, correct test results, and a connection to prevention, treatment, and care. This approach wildly changed how the medical community faced the virus and those who carried it, focusing on the human aspect of care instead of a virus-centered model.
Clinical trials for HIV treatments continued through the 1990s, with different antiretroviral approaches established to see which were most effective in making the virus undetectable. Meanwhile, methods of preventing HIV and other sexually transmitted diseases, such as condoms, became a hot topic of conversation. Everywhere one looked in the early 1990s, people were talking about safe sex. Tests for HIV improved as well, with the first oral HIV test introduced in 1994. By 1995, the first protease inhibitor was approved by the FDA, opening the door for “highly active antiretroviral therapy” (HAART) and ushering in renewed optimism.
By the end of the 1990s, medical experts were advocating for a “hit early, hit hard” approach to HIV infections, coined by HIV/AIDS researcher Dr. David Ho. This approach advocated for an earlier introduction of highly effective antiretroviral treatment to keep people healthier for longer and is still widely used today to keep HIV undetectable in people for years through early, aggressive intervention.
What advancements mean for those living with HIV
In the past 20 years, there have been other major strides in HIV and AIDS treatment, including the development of pre-exposure prophylaxis (PrEP medication), highly effective antiretroviral therapy (ART), and even the beginning of clinical trials for a possible HIV vaccine. While it may still be too early to tell if we can eliminate HIV for good, these significant steps forward have brought a measure of hope to communities more commonly affected by the spread and stigma of HIV and AIDS.
Clinics such as ours, Hope & Help in Winter Park, Florida, continue to offer free HIV testing, primary care availability for those with HIV, and prevention education. Our efforts harken back to the early days of the AIDS epidemic when groups such as the storied Friends in Deed created support for a population who felt as if they had been abandoned. These community efforts go a long way in supporting those who are living with HIV and AIDS, offering not only medical care but also necessary emotional assistance.
While statistics show that the number of new HIV infections has diminished, the problem has not disappeared. Real change will come with continued scientific study, support, fundraising, and education. As we continue to harness the power of collaboration and technology, bold solutions in HIV treatment will pave the way for a future where HIV/AIDS is not only significantly managed but eventually eradicated.
Lisa Barr is the Executive Director at Hope and Help Center of Central Florida, Inc. d/b/a Hope & Help. She has the privilege of leading an incredible team of talented, compassionate, and dedicated nonprofit healthcare professionals who make a difference every day. For over nine years, she has been overseeing the strategic planning, implementation, risk management, and organizational development of this vital community resource that provides HIV/STD prevention, education, testing, and treatment services. With an MBA from Johns Hopkins University and a background in business development, marketing, and grant writing, Barr brings a combination of analytical skills, strategic thinking, and creative problem-solving to her role. She is passionate about enhancing the quality of life and health outcomes of Hope & Help’s clients, partners, and staff, as well as expanding the organization’s reach and impact in the region. Her mission is to foster a culture of excellence, innovation, and collaboration that enables Hope & Help to fulfill its vision of a world without HIV/AIDS.
Lambda Legal and co-counsel Winston & Strawn LLP, Perkowski Legal, PC, and Scott Schoettes today announced they have reached a settlement with the Department of Defense (DoD) in a lawsuit filed in 2018 on behalf of a former Navy midshipman, Kevin Deese, and a former Air Force cadet, John Doe (a pseudonym), who were denied commissions after graduating from their respective service academies because they are living with HIV. The settlement provides for Deese and Doe to be commissioned as officers in recognition of the status and military careers they qualified for and earned years ago.
“We are gratified that our clients, who were denied officer commissions they had earned because of the U.S. military’s discriminatory policy of withholding career advancement opportunities from HIV-positive service members, will now be able to achieve their goals,” said Kara Ingelhart, Senior Attorney at Lambda Legal. “Service members living with HIV, once affected by an outdated, discriminatory policy, no longer face discharge, bans on commissioning, or bans on deployment simply because they are living with HIV.”
“Joining my brave co-plaintiff in this case was, for me, about demonstrating the very leadership that inspired me to a military career. I follow the mantra of 2004 Naval Academy graduate Travis Manion—“If not me, then who?” said plaintiff Kevin Deese. “Now, ten years after my Naval Academy graduation, future midshipmen and cadets living with HIV will be able to commission with their classmates upon graduation. And I could not be more proud to finally be commissioning.”
“We are grateful for the opportunity to work with Lambda Legal and others to overturn the military’s outdated and unconstitutional policies concerning people living with HIV,” said Bryce Cooper at Winston & Strawn. “Our pro bono efforts, in both the district court and the Fourth Circuit, have brought about a meaningful, and long overdue, change for service members living with HIV.”
This settlement also follows the June 2022 DoD policy changes to some of the military’s former policies that discriminated against service members living with HIV that confirmed service members living with HIV who are asymptomatic with undetectable viral load “will have no restrictions applied to their deployment or to their ability to commission . . . solely on the basis of their HIV-positive status.” That 2022 policy change had the effect of preventing what happened to Deese and Doe from impacting future military academy cadets who seroconvert while in their course of their college education. And those changes followed a groundbreaking federal court ruling in April 2022 that ordered the DoD to stop enforcing those discriminatory policies. The ruling came in two cases—Harrison v. Austin and Roe v. Austin, combined for purposes of discovery and summary judgment—for which Lambda Legal served as co-counsel with Winston & Strawn LLP, Greenberg Traurig LLP, Scott Schoettes, and Peter Perkowski.
As of this release, counsel and clients are currently waiting for a U.S. District Court to rule on the military’s last remaining bar preventing people living with HIV from joining any branch of the U.S. Armed Services in the lawsuit, Wilkins v. Austin.
New statistics have revealed the alarming prevalence of drink spiking in the LGBTQ+ community, with one man telling of the experience that left him cutting himself off from work, family, friends and “anything that looked towards the future I didn’t think I would ever have”.
Released on Thursday (4 April), the Ladbible Group and Stamp Out Spiking study surveyed 2,063 people aged between 16 and 24, in an effort to understand the rise in the number of drinks being spiked.
“Spiking” refers to when someone is given alcohol or drugs without their consent, usually in a drink. A person might spike a victim with the intention of stealing from them, harming them physically or sexually, or even supposedly as a joke.
The findings of the research revealed that of those surveyed, 70 per cent of people aged between 18 and 24 had either experienced or witnessed drink spiking, with more than half of women (51 per cent) and 69 per cent of LGBTQ+ respondents affected.
Stamp Out Spiking ambassador Stephen Hart was spiked then raped in 2006, contracted HIV as a result.
Hart had been in a bar with a friend who had to leave unexpectedly. He decided to stay a bit longer and bought himself two more drinks.
“Within minutes of him leaving I started to feel dizzy, confused, nauseous, hot and cold. I couldn’t lift my head but was aware of a guy asking me if I needed some fresh air. I thought he was going to help so said yes,” Hart told PinkNews.
“The next thing I knew was the sun was waking me up shining through my window. I still felt really unwell and found it hard to walk to the bathroom but thought a shower would help so started to get undressed.
“I kicked off my boots, undid my [trousers] and let them fall to the floor. When I did, I saw blood on my jeans and on the back of my legs, and just collapsed into a heap asking: ‘How could this have happened’ and ‘How can I remember so little?’”
While he knew from crime programmes not to wash away evidence, he felt he was “on fire”, so “crawled into the shower and spent the next 45 minutes in there, scrubbing at my skin until it bled”.
The hospital confirmed he had been raped and had traces of Rohypnol – commonly known as roofies – in his blood.
Roofies is a central nervous system depressant, commonly used as date-rape drug because the effects are felt quickly and persist for upwards of 12 hours, with victims having little memory of what has happened.
Hart was tested for HIV and other sexually transmitted infections and the results came back negative. He was told to return in three months for a second HIV test, which came back positive.
“I had grown up during Section 28 so had no education in school about HIV. All I knew was what was splashed across the newspapers about the deaths of Freddie Mercury, Rock Hudson and Kenny Everett, so I did not think I would survive.
“There was a big part of me that hoped I wouldn’t.
“I spent the next two years cutting myself off from work opportunities, friends, relationships and anything that looked towards the future I didn’t think I would ever have.”
‘There were no men talking about being spiked and raped’
Despite the research showing the prevalence of drink spiking, there is significant under reporting.
87 per cent of victims surveyed chose not to report their experiences to the police. The reasons they gave for that decision were insufficient evidence (48 per cent), believing it was too late to report the crime (38 per cent), and concerns that no action would be taken (27 per cent).
Hart recalled not accepting help for the first two years, but at the same time does not “remember much being on offer”.
He went on to say: “There were no men talking about being spiked and raped so I didn’t talk about it myself for another few years.”
The research comes at a time when the government is looking to bring in a raft of new measures related to spiking.
As it stands, a staggering 86 per cent of those surveyed did not know there was not a specific law to convict against spiking and only 29 per cent of them were aware of the proposed amendments to the Criminal Justice Bill announced by home secretary James Cleverly in December.
Hart said people need to understand that drink spiking can happen to anyone.
“Without government funding to train door, bar and security staff – but also police and first responders – the rates of this crime will continue to rise,” he said.
Commenting on the research, Emily Driscoll, the head of data, intelligence and planning at Ladbible Group, said: “The results highlight the urgent need for greater education, awareness and action to address the concerning prevalence of drink spiking, especially [among] Gen Z.
“As a business, we are committed to using the scale and reach of our platforms – which reaches nearly six in 10 18 to 24 year olds in the UK – to raise awareness and advocate for change to ensure the safety and well-being among young adults.”
Meanwhile, Dawn Dines, the chief executive and founder of Stamp Out Spiking, said: ”We firmly believe key safeguarding education is urgently needed to ensure the safety of partygoers across the UK.
“The numbers speak for themselves, with 60 per cent of young adults supporting our mission, advocating for advanced training for venue staff and greater education regarding spiking awareness.”
Lambda Legal and co-counsels McDermott Will & Emery and Merchant Gould P.C. announced that it has reached a settlement agreement in a lawsuit brought against the Metropolitan Government of Nashville and Davidson County challenging the Metropolitan Nashville Police Department’s (MNPD) discriminatory hiring policies after the MNPD rescinded a hiring offer after learning the applicant was living with HIV.
“I feel vindicated,” said John Doe, a 45-year-old Black man and decorated civil servant who filed the lawsuit anonymously. “All I wanted to do was serve my state and protect its communities, so I’m glad the city is now recognizing that living with HIV is not an obstacle to performing those critical duties. On the contrary, thanks to medical advances, HIV is now treated like other lifelong conditions. We can live healthy lives, be active members of society, and serve as first responders, police officers, parents, and any other job without any problem.”
The settlement includes monetary relief to the plaintiff, as well as an agreement to update and rewrite the city’s Civil Service Medical Examiner’s (CSME) policies to make clear that people living with HIV are no longer categorically ineligible to serve as first responders or police officers.
CSME is the governmental office responsible for assessing new applicants for employment and for conducting periodic or annual medical evaluations for current employees, and the Nashville Metropolitan Government and Police Department sets its policies for hiring.
The updates to their hiring policies include:
New language stipulating that any medical tests must occur after job seekers have been given an offer of employmentand that HIV and other conditions do not automatically disqualify an applicant. This would mean that a person living with HIV or any other medical condition will be given a fair opportunity to serve, unless the condition represents a threat to the health or safety of the applicant or others.
CSME will follow the most updated and latest scientific and medical information available. In the case of HIV, this means understanding that a person living with HIV can live a normal life, especially those who are virally suppressed, which means they have such a low viral load that it is statistically almost impossible to transmit HIV, posing no risk or threat to anyone.
Nashville agreed to implement mandatory training for the medical staff who review and approve job applications delivered through a collaboration with Vanderbilt University’s Medical Center. Vanderbilt University would provide mandatory training on the most up-to-date science on HIV as well as offer optional trainings on a semi-regular basis.
“We are pleased with this settlement agreement that makes clear in Nashville Metropolitan government policies that living with HIV is not reason enough to deny someone a job. Medicine has progressed by leaps and bounds, allowing people living with HIV to live normal lives and there are no reasons why they cannot perform any job as anyone else today. We hope this settlement serves as a testament to the work we need to continue to do to remove stigma and discrimination and update laws to reflect modern science,” said Jose Abrigo, Lambda Legal’s HIV Project Director and attorney in the case.
Background
In 2020, Nashville’s Police Department rejected the plaintiff’s application during the Civil Service Medical Officer’s exam process claiming that an applicant “must meet or exceed the medical standards set forth in the United States Army Induction Standards.” MNPD uses the Pentagon’s medical exam policies for hiring purposes. Lambda Legal is fighting this hiring policy in federal court in Wilkins v. Austin, challenging the U.S. Armed Forces’ policy barring people living with HIV from enlisting.
However, since 2022, the Pentagon is no longer discharging military members due to HIV status or considering HIV status for deployment or commissions, following a landmark ruling in April 2022. In two other related lawsuits, Harrison v. Austin and Roe and Voe v. Austin, a Virginia federal judge ruled that the military could not discharge, refuse to commission, or categorically bar worldwide deployment of servicemembers living with HIV who are asymptomatic and virally suppressed. Moreover, Davidson County voters approved an amendment to their charter removing the problematic requirement tying eligibility to serve to the military’s criteria.
This lawsuit filed in 2023, John Doe v. Metropolitan Government of Nashville and Davidson County, Metropolitan Nashville Police Department argued that MNPD’s policies are unlawful and constitute a violation of federal law including, but not limited to, the Americans with Disabilities Act of 1990.
This settlement is the latest win in Lambda Legal’s long history of fighting HIV discrimination nationwide, starting in 1983 with People v. West 12 Tenants Corp., helping to establish the illegality of discriminating against people living with HIV.
Lambda Legal is a national organization committed to achieving full recognition of the civil rights of lesbians, gay men, bisexuals, transgender people and everyone living with HIV through impact litigation, education and policy work. www.lambdalegal.org
Ohio activists are arming themselves with new data in the battle to repeal antiquated laws across the country that criminalize people with HIV.
Two reports, one released by Equality Ohio with the Ohio Health Modernization Movement, and another from The Williams Institute at UCLA, look at the criminalization of HIV in the Buckeye State. They discovered that over half of prosecutions for so-called “HIV crimes” were for acts statistically unlikely to transmit HIV.
Ohio has six laws on the books that either criminalize certain acts by people living with HIV or substantially increase sentences for them compared to other people in the criminal justice system who do not carry the virus.
Those acts include sex with other adults regardless of the HIV-positive person’s therapy or viral count, and “harassment” by bodily fluids, such as spitting, or throwing urine, feces or blood at someone. Only exposure to blood would result in HIV infection.
Most of Ohio’s HIV laws were written at the height of AIDS panic in the 1980s and early ’90s, before research and experience clarified the limits of HIV infection and effective therapies made living with HIV a reality.
HIV laws remain on the books in 34 states.
The studies also found a disproportionate number of people charged with HIV-related crimes were Black, compared to Ohio’s total population.
“Ohio is unique in that these antiquated laws are actually being utilized and enforced against everyday Ohioans who are living with HIV,” Kate Mozynski, an attorney with Equality Ohio and one of the co-authors of the organization’s report told the Buckeye Flame.
In 2022, about 25,000 people in Ohio were living with HIV, while new diagnoses ticked down from 985 in 2018 to 866. Forty-seven percent of new diagnoses were among Black people, making their infection rate nearly seven times higher than the white population’s.
More than half of new diagnoses were among people aged 20 to 34. Men having sex with men accounted for fifty-six percent of the transmission rate.
Ohio is also one of six states that require anyone convicted of “HIV crimes” to register as a sex offender. Louisiana, South Dakota, Tennessee, Arkansas and Washington State round out that list.
The Williams Institute looked at arrests under Ohio’s six laws over two decades, as well as felony prosecutions from 2009 to 2022 in Cuyahoga County, the state’s most populous county, which is home to Cleveland.
They discovered nearly half of the cases were for HIV-positive individuals who had consensual sex without disclosing their status to their partner, regardless of their viral load and whether or not the other individual contracted the virus that causes AIDS.
As activists fight for repeal at the state level, the Biden administration is deploying the Justice Department to address discriminatory HIV laws.
In December, the DOJ notified Tennessee it was in violation of the Americans with Disabilities Act for enforcing a state law that increases penalties for people convicted of prostitution if they’re also HIV-positive. Federal charges were filed against the state in February.
As part of Black History Month, February 7th marks National Black HIV/AIDS Awareness Day, a day dedicated to addressing the disproportionate impact of the HIV epidemic on Black Americans amidst this month of reflection and acknowledgment of Black heritage and achievements.
In recent years, we’ve witnessed remarkable biomedical advances in HIV treatment and prevention, as well as in innovation in care delivery through telemedicine. However, despite these advancements, Black Americans and other non-white communities still experience higher rates of HIV and have less access to HIV testing and prevention medications compared to their white counterparts.
Job discrimination and structural stressors were correlated with higher risk behavior when it came to HIV.
New technologies, such as injectables for HIV prevention and Generative AI, offer solutions on how to bridge disparities in HIV incidences and increase uptake in preventative measures.
We already have the tools we need to end the spread of HIV
In 2021, the U.S. saw about 32,100 new HIV infections, marking a reduction of more than two-thirds since the peak of the epidemic in the 1980s and showcasing significant progress in combating HIV.
Preventive medications are 99% effective when taken as prescribed – options include a daily pill and long-acting injectables. HIV treatments can suppress the virus to undetectable levels, preventing HIV from sexual transmission when patients consistently follow their treatment plan.
The cost of HIV prevention medication and treatment has become more affordable due to the preventive care mandates in the Affordable Care Act, the safety net provided by the Ryan White Program for individuals living with HIV, and the availability of generic HIV prevention medication options.
Many telehealth providers (Nurx, FOLX, and Q Care Plus) have made HIV treatment and prevention care more accessible by addressing common barriers such as transportation and time constraints. The largest telehealth provider for PrEP, MISTR, even collaborates with local non-profits to ensure patients incur no out-of-pocket expenses for services like lab tests.
Under the leadership of Harold Phillips, the former Director of the White House Office of National AIDS Policy, the federal government released its “Ending the HIV Epidemic in the U.S. by 2030″ initiative, which represents a concerted effort with funding to drastically reduce new HIV infections, with the goal of cutting new HIV cases by 75% by 2025 and 90% by 2030.
The disproportionate impact of HIV on Black communities
HIV Incidence: While Black Americans constitute 13% of the U.S. population, they account for 43% of new HIV diagnoses, 42% of people living with HIV, and 44% of HIV-related deaths. A Black MSM (man who has sex with men) has a 1 in 2 chance of acquiring HIV in their lifetime.
Black Women: The disparity is particularly pronounced among Black women, who represent 72% of women living with HIV today. One-fifth of new HIV infections in 2021 occurred in women, with over half of those new infections in Black women.
Black and Trans: The situation among Black transgender populations is alarming. A CDC report from 2021 revealed that 40% of transgender women in major U.S. cities have HIV. The prevalence is even higher among African American/Black transgender women, with nearly two-thirds being HIV positive.
Black Youth and HIV: In 2020, individuals aged 13 to 34 accounted for more than half of new HIV diagnoses. African American youth are particularly affected. Of the nearly 21,000 infections estimated to occur each year among African Americans, one-third are among young people aged 13 to 24. The rate of new infections among young Black males aged 13 to 24 is 11 times as high as that of young white males and four times as high as that of young Hispanic males.
Access to HIV Prevention Care: The issue of HIV prevention also reflects significant racial disparities. While 94% of White individuals who could benefit from PrEP have been prescribed it, the figures are strikingly low for Black and Hispanic/Latino populations, at just 13% and 24%, respectively.
These statistics highlight the critical need for comprehensive, targeted strategies that address both HIV prevention and treatment specifically tailored to meet the needs and challenges of Black communities, including Black women, Black youth, and Black transgender individuals.
Promising new technologies: generative AI
AI-driven chatbots can increase access to HIV-related information and support, particularly for those who may face barriers in traditional healthcare settings.
AI has the potential to enhance the efficiency and equity of HIV care but also to play a pivotal role in providing personalized care, educating populations, reducing stigma, mitigating medical mistrust, and ensuring that comprehensive health information and linkage to care are readily accessible to all, irrespective of their background or circumstances.
A new biannual shot to improve HIV prevention
Gilead Sciences is developing a groundbreaking 6-month injectable form of PrEP that is poised to revolutionize HIV prevention. This long-acting shot, administered only twice a year, could enhance adherence and convenience, significantly reducing barriers to consistent PrEP use. Adherence to daily PrEP medication for HIV prevention presents challenges, notably for individuals without an illness, to manage daily pill intake. Studies reveal that almost half of those prescribed PrEP discontinue it within a year. There’s optimism surrounding Gilead’s upcoming PrEP injection, expected in late 2025, which could significantly improve adherence by requiring attention only twice a year versus the current daily PrEP pills.
In honoring Black History Month, let’s reaffirm our commitment to addressing the HIV/AIDS epidemic in Black communities, leveraging technological innovations, and working towards a future where HIV does not disproportionately impact any community.
For inspiration on where to start and how to get involved, these Black-led organizations focus on HIV in Black communities: SisterLove (the first women’s HIV, sexual, and reproductive justice organization in the Southeast, founded by longtime HIV advocate Dázon Dixon Diallo), the Black AIDS Institute (founded by Phill Wilson in 1999, a prominent Black HIV/AIDS activist), and the Southern AIDS Coalition.
In addition, HIV.gov’s HIV Services Locator can help you find HIV services like testing, HIV care, PrEP, and much more.
Gabriella Palmeri, Healthvana Head of Partnerships
Healthvana is the leading technology company working to end the HIV epidemic in the U.S. Since 2015, they’ve helped over 500,000 patients receive HIV/STI treatment/HIV prevention-related care. Healthvana’s customers include the largest national HIV care provider and the nation’s largest public health department.
New research published this week by the Centers for Disease Control and Prevention (CDC) suggests that social and economic marginalization, including employment and housing discrimination, increases transgender women’s risk of contracting HIV.
The report, published Thursday in the CDC’s Morbidity and Mortality Weekly Report, analyzed data from a survey of more than 1,600 transgender women in seven U.S. cities from 2019 to 2020. The goal of the survey was to assess for the first time the factors that have led transgender women—and especially trans women of color—in the U.S. to have disproportionately high rates of HIV infection.
Survey participants were also provided with HIV testing, with 42 percent of participants testing positive for HIV. Among Black participants, 62 percent were HIV positive compared to 35 percent of Hispanic and Latina participants and 17 percent of white participants.
Overall, nearly 70 percent of participants reported experiencing at least one type of anti-trans discrimination in the past 12 months. Over 32 percent said they’d had trouble finding a job, while nearly 10 percent said they had been fired. Nearly 14 percent said they were denied housing or evicted because they were transgender.
The analysis showed that employment discrimination is particularly impactful on health outcomes for trans women, as employment and health insurance coverage are “intertwined in the United States.”
“When economically marginalized transgender women are refused employment,” researchers wrote, “this refusal cyclically contributes to economic hardships and might lead them to engage in survival sex work and potentially incarceration,” factors that are also related to increased risk of contracting HIV.
Similarly, nearly a third of participants reported experiencing periods of homelessness and housing instability, which are also associated with an increased risk of HIV infection.
Researchers also found that the more psychological and structural stressorstransgender women face, the more likely they are to engage in sexual behaviors that put them at risk of HIV infection.
CDC researchers urged policymakers to use the results of their analysis to guide civil rights legislation efforts and to tailor HIV prevention and housing services for transgender women.
“It is no secret that trans people, trans women, and especially trans women of color face immense barriers in HIV prevention,” New York University professor and queer health advocate Joseph Osmundson, who was not involved in the CDC research, told STAT News. “This new research not only formalizes this knowledge but addresses some of the underlying reasons, including increased rates of homelessness and transactional sex.”
“Policies that reduce poverty, increase access to healthcare, and address homelessness for all can have an outsized effect for trans women, and including trans people as leaders of these efforts will be necessary to their success,” Osmundson said.
Tennessee’s decades-old aggravated prostitution statute violates the Americans with Disabilities Act, the U.S. Department of Justice announced Friday after an investigation, warning that the state could face a lawsuit if officials don’t immediately cease enforcement.
Tennessee is the only state in the United States that imposes a lifetime registration as a “violent sex offender” if convicted of engaging in sex work while living with HIV, regardless of whether the person knew they could transmit the disease.
LGBTQ and civil rights advocates have long criticized the measure as discriminatory, making it almost impossible to find housing and employment due to the restrictions for violent sex offenders. Earlier this year, the American Civil Liberties Union and the Transgender Law Center filed a lawsuit seeking to overturn the law in federal court.
The department’s findings on Friday are separate from the ongoing lawsuit.
The department is calling on the state to not only stop enforcing the law, but also remove those convicted under the statute from the sex offender registry and expunge their convictions. The agency also says Gov. Bill Lee should introduce legislation to repeal the law.
The ADA is the landmark 1990 federal law prevents discrimination against disabled people on everything from employment to parking to voting. HIV and AIDS are considered disabilities under the ADA because they substantially hinder life activities.
“Tennessee’s aggravated prostitution law is outdated, has no basis in science, discourages testing and further marginalizes people living with HIV,” said Assistant Attorney General Kristen Clarke, with the Justice Department’s Civil Rights Division, in a statement. “People living with HIV should not be treated as violent sex offenders for the rest of their lives solely because of their HIV status.”
The department’s letter was addressed specifically to Attorney General Jonathan Skrmetti, Tennessee Bureau of Investigation Director David Rausch and Shelby County District Attorney Steven Mulroy.
Shelby County, which encompasses Memphis, was named because DOJ said it’s where the law has been “enforced most frequently.”
Through a spokesperson, Mulroy noted that the allegations stem from cases handled before he took office in September 2022. Mulroy said he agrees with the Justice Department’s findings and his office is fully cooperating.
A spokesperson for the Tennessee investigation bureau said officials were reviewing the letter but had no other response to DOJ’s investigation.
A spokesperson for Skrmetti did not immediately respond to an email requesting comment.
Prostitution has long been criminalized as a misdemeanor in Tennessee. However, in 1991 — as the AIDS epidemic provoked panic and prevalent misinformation over prevention — Tennessee lawmakers enacted an aggravated prostitution statute, which was a felony and applied only to sex workers living with HIV. The law was later reclassified in 2010 as a “violent sexual offense,” requiring those convicted to face lifetime sex offender registration.
Court documents state that more than 80 people are registered for aggravated prostitution in Tennessee.
The DOJ letter details several of the struggles of those with aggravated prostitution convictions. A lifetime sex offender registration can stop people from visiting with their grandchildren, revoke job offers, and severely limit housing options. One person shared that they were barred from taking a course to get a general education diploma because children might be present in the building.
Plaintiffs who had filed a lawsuit seeking to block the aggravated prostitution law in October said the DOJ’s letter only further supports their efforts.
The lawsuit was brought by four unidentified people and OUTMemphis, a nonprofit that serves LGBTQ people.
“OUTMemphis welcomes the DOJ’s findings that, through its outdated and punitive aggravated prostitution law, Tennessee is discriminating against people living with HIV,” said Molly Quinn, executive director, OUTMemphis, in a statement. “We agree, and that’s why we are suing to get the law struck down. Whether this issue is resolved informally or in court, it is long past time to end HIV criminalization.”
