Editorial: AIDS progress is slipping

There may be a giant red ribbon displayed at the White House on Monday, December 1, signifying World AIDS Day. President Donald Trump had continued the tradition during his first term as president. Though in 2025, this first year of his second term, the symbolism will fall flat. Trump and his administration, notably Health and Human Services Secretary Robert F. Kennedy Jr., have done more to dismantle programs that help people living with HIV/AIDS than any other administration, with the exception of former President Ronald Reagan, who didn’t do – or say – anything in those early years as the disease unleashed its horror on gay men, trans people, women, injection drug users, and others. As Mary Fisher, a straight white woman living with AIDS, said during her groundbreaking speech at the Republican National Convention in 1992, AIDS doesn’t discriminate.

“It does not care whether you are a Democrat or Republican,” said Fisher. “It does not ask whether you are Black or white, male or female, gay or straight, young or old.”

Thankfully, Fisher and thousands of others have survived. Tragically, millions more have not. A vaccine appears unlikely, as various trials have failed. New HIV prevention drugs have proved extremely successful, but they cost a lot of money and, as a result, there are disparities, especially in communities of color in the U.S. and poorer countries abroad.

The state of AIDS in 2025 is marked by a funding crisis that threatens decades of progress. Elon Musk rode into Washington, D.C. as the head of the Department of Government Efficiency in January and promptly slashed global funding for HIV/AIDS and other programs. USAID was decimated. Today, after all of the cuts and false information about government programs, DOGE has been disbanded, even though there are eight months left on its charter. “That doesn’t exist,” Office of Personnel Management Scott Kupor told Reuters when asked of DOGE’s status. But don’t look for the government to restore any of those contracts or personnel. Trump got what he wanted, a drastic reduction in the federal workforce. And Musk got what he wanted, more federal contracts for his SpaceX company. All of it was at the great expense of human lives, livelihoods, and global respect. It was a high price to pay.

In San Francisco, new HIV transmissions ticked up slightly in 2024, rising from an all-time low of 140 cases in 2023 to 146 cases in 2024, according to the latest HIV epidemiology annual report from the SF Department of Public Health, released in September. The report showed an increase in diagnoses among Black people and women; in 2022, cases rose among Latinos. And at a time when San Francisco faces budget deficits, nonprofits that have served HIV/AIDS communities are struggling.

Several of them, including the San Francisco AIDS Foundation and the San Francisco Community Health Center, continue to wage legal action against the Trump administration. As we reported earlier this year, nine LGBTQ nonprofits filed a lawsuit in federal court, seeking the restoration of grant funding. After a judge issued a temporary injunction, the nonprofits saw $6.2 million in funds restored, as the legal case proceeds. This is an early victory, and an indictment of Trump’s executive orders trying to erase transgender people as well as diversity, equity, and inclusion efforts. But it is not enough. The AIDS foundation announced staff layoffs this summer and ended its AIDS/Lifecycle bicycle fundraising program it co-produced with the Los Angeles LGBT Center, in part due to declining revenue. (The foundation will offer a new, different endurance bike ride benefit, Cycle to Zero, next year.)

As we look ahead to 2026, some things are clear to us. First, Congress needs to step up and take back its power of the purse regarding federal funding. It can no longer capitulate to Trump. Funding for HIV/AIDS programs must be restored throughout the country.

Second, the Department of Health and Human Services needs to stop meddling in the Centers for Disease Control and Prevention, which, as we’ve noted, has been hit hard by Kennedy’s anti-vaccine stance. (Kennedy has cast doubt on whether HIV causes AIDS.) HHS oversees the CDC, which has seen its new director fired and other staffers resign. This has left a vacuum at the agency that’s charged with dealing with pandemics and public health matters, such as HIV/AIDS and sexually transmitted infections.

Finally, the president himself needs to spend more time addressing top domestic priorities such as affordability and less on efforts denigrating trans people, women, and others. We don’t hold out hope for that; Trump has been parroting the same nonsense for the last decade. But maybe his MAGA followers are beginning to see the light. Congressmember Marjorie Taylor Greene (R-Georgia) sure is. She announced last week that she’s resigning her seat in early January because she’s tired of being bullied by Trump. More Republicans need to speak out like that. Greene is certainly no friend of the LGBTQ community, but even she has realized that Trump is no good.

As for progress fighting HIV/AIDS, that takes money. We’d like to see more companies and foundations step up with grant funding since cuts by federal and local governments are likely to continue. It’s all interconnected: when federal grants, many of which are funneled through state and local governments, dry up, then there’s no way to make up the difference. That means the private sector and generous donors are going to be called up to help out. Now is the time for these benefactors to contribute to the many nonprofit agencies that are working to provide HIV/AIDS services. HIV transmissions can be reduced, and people living with AIDS can achieve undetectable viral loads – but many rely on programs and agencies that are struggling themselves.