A Call to Action on World AIDS Day
This year’s World AIDS Day theme, “Collective Action: Sustain and Accelerate HIV Progress,” is a call to action to step up our efforts to end the HIV epidemic. Yet this year, World AIDS Day, which falls annually on December 1st, carries a profound sense of urgency as we face the possibility of policies that could reverse our hard-fought gains.
President-elect Donald Trump has officially nominated Robert F. Kennedy Jr. to lead the Department of Health and Human Services (HHS). Known for his controversial and unscientific stances on vaccines and public health, Kennedy’s nomination raises serious concerns. Among them is his history of promoting discredited theories about HIV, including questioning whether HIV is the sole cause of AIDS—a position long debunked by the scientific community. In his 2021 book, The Real Anthony Fauci, Kennedy also suggested that recreational drug use, such as “poppers,” played a significant role in the HIV epidemic, a claim widely dismissed by experts. These views not only undermine decades of progress but also risk fueling HIV-related stigma, misinformation, and disinformation at a time when leadership rooted in science and equity is more critical than ever.
Progress to end the U.S. HIV epidemic has been driven by persistent grassroots activism, a vibrant force since the epidemic’s earliest days, and pioneering scientific advancements in HIV treatment and prevention coupled with government investments, most recently, the federal Ending the HIV Epidemic initiative, launched in 2019 during the last Trump administration. However, these hard-won gains remain fragile. Black and Latinx people, particularly cisgender and transgender women and men who have sex with men, continue to be disproportionately impacted by HIV and face systemic barriers to care due to structural racism and discrimination. The recent rise in new HIV diagnoses among Latinos highlights the epidemic’s disproportionate impact on racially minoritized communities.
We cannot take our foot off the gas as we work towards the ambitious yet attainable goal of ending the HIV epidemic.
Recommitting to Science and Health Education
Kennedy’s potential leadership of HHS is deeply concerning. His history of spreading vaccine disinformation and promoting pseudoscientific theories about HIV undermines public trust in science and could erode decades of progress in HIV and public health more broadly. Investing in community-based organizations and community leaders who can be trusted messengers to deliver accurate, science-based health education is critical to counteract this. National professional organizations in science, health care, and public health must unify in their advocacy for equity-centered, evidence-based policies. We are already seeing new advocacy coalitions in this space, such as Defending Public Health, emerge to meet this call to action. At the same time, media platforms must do their due diligence to amplify credible voices to combat misinformation and disinformation actively.
Applying a “Health Equity in All Policies” Approach
The end of the HIV epidemic cannot be achieved by focusing solely on healthcare systems; it requires addressing the structural and social determinants of health that drive HIV-related inequities. This approach, often referred to as “health in all policies,” must be expanded into “health equity in all policies,” ensuring that equity is prioritized in all areas of policymaking. For communities most affected by HIV—Black and Latinx people, LGBTQ+ individuals, and those living in poverty—policies governing housing, education, employment, and the criminal legal system play a critical role in shaping health outcomes. For example, stable and affordable housing is a proven intervention for improving outcomes for people living with HIV. Yet, many states lack sufficient affordable housing, leaving people with and affected by HIV vulnerable to housing insecurity. Grassroots organizations, particularly those led by and serving Black, Latinx, and LGBTQ+ individuals, are critical in advocating for these changes. Their insights and lived experiences ensure that policies are not only inclusive but also responsive to the unique needs of marginalized communities. By adopting health equity in all policies and amplifying the voices of those most affected, we can dismantle the structural barriers that have continued to fuel the HIV epidemic and its disproportionate impact.
Ensuring Access to HIV Pre-Exposure Prophylaxis
Expanding access to HIV pre-exposure prophylaxis (PrEP) remains a cornerstone of efforts to end the HIV epidemic. Yet, access remains inequitable, with many Black and Latinx communities unable to access this highly effective HIV prevention strategy. PrEP4ALL’s proposal for a National PrEP Program offers a path forward, calling for federal funding for free or low-cost PrEP and support for local efforts to reach communities most in need. Recently, lenacapavir, a twice-yearly HIV prevention injection, demonstrated extremely high effectiveness in preventing HIV infection in clinical trials. This injectable could revolutionize HIV prevention for those who face barriers to daily pill regimens, offering improving long-term protection. However, once approved, policymakers and pharmaceutical companies must help ensure access to this potentially game-changing PrEP strategy.
Combatting Discriminatory Legislative Policies
Ending the HIV epidemic efforts intersects with broader struggles for racial and LGBTQ+ justice. Recent legislative trends, including efforts to ban gender-affirming care, criminalize HIV, and dismantle diversity, equity, and inclusion initiatives, threaten the health and well-being of marginalized communities. For example, Texas state legislators recently introduced 32 anti-trans bills for 2025, and Ohio advanced a bathroom bill targeting transgender students. These measures amplify stigma and create barriers to care, adversely impacting health outcomes. However, there are small wins that offer hope. Georgia’s 2022 reforms introduced an intent requirement for HIV-related prosecutions and reduced penalties, while Tennessee’s 2024 settlement allowed individuals previously convicted under HIV-related laws to apply for removal from the sex offender registry. These examples demonstrate that progress is possible through sustained advocacy and coalition-building.
Ending the HIV epidemic is not just a scientific imperative but a moral and political one. The progress we’ve made since the beginning of the HIV epidemic is tremendous. It can be sustained and advanced further if we remain committed to investing in trusted community organizations to deliver evidence-based health education and amplifying credible voices to counter misinformation, addressing structural inequities through a “health equity in all policies” approach, ensuring equitable access to effective, potent HIV prevention tools, and advocating against discriminatory policies that amplify HIV stigma and place already vulnerable communities at risk. Together, we can resist efforts to reverse decades of progress to make the end of the HIV epidemic a reality.