Last week President Trump gave his State of the Union address to Congress. While the news cycle mostly focused on his hypocritical cry for political unity and bipartisanship (and Speaker of the House Nancy Pelosi's brilliant “clap back” that went viral), it's important to discuss the lack of LGBTQ inclusion as well as Trump's questionable promise to end HIV.
First, let's begin with Trump's erasure of the LGBTQ community. He celebrated the country's military and veterans but didn't mention the trans people that his ban would forbid from serving. On the Democrat side, Speaker Pelosi invited six trans military members to be in the audience as her guests.
While Trump acknowledged the record number of women elected to Congress this term, he did not mention the record 10 openly LGBTQ people currently serving in Congress, including Sen. Krysten Sinema of Arizona, Rep. Mark Takano of California and Rep. Sharice Davids from Kansas; the latter is also the first Native American Congresswoman. In fact, Trump didn't mention “LGBTQ,” “lesbian,” “gay,” “bisexual” or “transgender” at all.
By contrast, Stacey Abrams, the Democratic candidate for governor in Georgia last year, did mention the LGBTQ community in the official Dem response to the State of the Union, saying, “We affirmed marriage equality, and yet the LGBTQ community remains under attack.”
The only relevant LGBTQ issue that Trump did speak of was a promise to end HIV by the year 2030, saying, “In recent years we have made remarkable progress in the fight against HIV and AIDS. Scientific breakthroughs have brought a once-distant dream within reach. My budget will ask Democrats and Republicans to make the needed commitment to eliminate the HIV epidemic in the United States within 10 years. Together, we will defeat AIDS in America.”
But the Trump administration's contentious history with HIV/AIDS makes this new promise a complete 360 in policy. First, his 2018 budget plan proposed to cut $35 million in funding for domestic HIV/AIDS research and prevention being done by the U.S. Centers for Disease Control and Prevention (CDC). The budget also proposed to cut funding for the Housing Opportunities for Persons With AIDS (HOPWA) program, which is run through the Department of Housing and Urban Development. Finally, the budget proposed to cut U.S. global HIV/AIDS programs by $1 billion and change many programs' funding from mandatory to discretionary, making it easier for more budget cuts to these programs in the future.
That's not all. In June 2017, six members of the Presidential Advisory Council on HIV/AIDS resigned, saying Trump didn't care about fighting HIV (he later fired the remaining 16 members and replaced them). There have also been military discharges under Trump for soldiers with HIV when there was no medical reason for them to be discharged. And we can't forget that last summer, the Trump administration moved $5.7 million that was being used for the Ryan White HIV/AIDS Program, which supports those living with the illness, to help cover the increasing costs of detaining illegal immigrant children. (It's also worth noting that in addition to moving money supporting those with HIV/AIDS, $13 million was taken from the National Cancer Institute.)
“The Ryan White HIV/AIDS Program is one of our nation's premier public health efforts, and it is unthinkable that the Trump-Pence administration would divert funds away from HIV treatment to fund its cruel attacks on kids and families at the border,” the Human Rights Campaign wrote on Twitter at the time.
Even if you don't take this hypocrisy into consideration, Trump's plan to eradicate HIV/AIDS, which was revealed in more detail following the State of the Union, is still questionable. On HIV.gov, which is operated by the Department of Health and Human Services, Health Secretary Alex Azar is quoted as saying, “Thanks to the HIV medicine antiretroviral therapy, individuals with HIV that take their medicine as prescribed and maintain an undetectable viral load can live long, healthy lives and have effectively no risk of sexually transmitting HIV to a partner.” The website also declares how HIV disproportionately affects groups like gay and bisexual men and people of color, although there's no mention of transgender women — a quarter of whom are HIV-positive in America.
HHS then sets some goals on the site: 75 percent reduction in new infections in five years, and a 90 percent reduction in 10 years. To do this, HHS plans an expansion in testing, pre-exposure prophylaxis (PrEP), antiretrovirals and local teams to assist in all these programs and medications. They will focus their efforts on 48 “highest burden counties” as well as Washington, D.C., and San Juan, Puerto Rico (where half of all new infections occur). Additionally, seven states with a high rural HIV “burden” will be given assistance. This may sound easier than it actually is — five of these seven states, which are in the Deep South, have blocked or delayed Medicaid expansion in the past.
Another statement addresses the importance of taking PrEP in fighting infections. While PrEP has thankfully become more common among gay and bi men, many outside the LGBTQ community who are at risk are not taking PrEP. Additionally, there's no mention on how the government will cover the costs. Right now, PrEP can cost up to $2,000 a month out of pocket (although in most cases it's closer to $1,300). Most health insurance covers PrEP, but many in these “high burden counties” may not have insurance or may just have Obamacare, which the Trump administration has been working hard to destroy. And would HIV/AIDS be considered a pre-existing condition? After all, this administration has been trying to restore the ability to deny coverage for pre-existing conditions.
All of these open questions, combined with Trump's past coldness to HIV/AIDS prevention, make his promise questionable. As Speaker Pelosi said in a statement to The Advocate, “While the president's call for ending HIV transmission in America is interesting, there is certainly skepticism given this administration's assault on pre-existing conditions and the [Affordable Care Act], policies against the dignity of the LGBTQ community, and history of proposing drastic budget cuts to crucial programs like Ryan White, PEPFAR [the President's Emergency Plan for AIDS Relief] and the Global Fund.”
Pelosi mentioned that the Democrats will be working toward eradicating the disease as well, and her history suggests that she will try. It shouldn't be lost on anyone that the Republicans wouldn't even say the word “AIDS” in the '80s when they controlled the White House. Trump's promise to end the disease in 11 years is a commendable goal and, if true, would be one of the few positive legacies he leaves behind. But his lies and broken promises don't bode well for this to become a reality.