What Does a Trump Presidency Mean for the AIDS Epidemic in Black America?

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It’s no secret that the reality of President-elect Donald Trump scares the hell out of many of us. Granted, our situation was suspect under eight years of President Barack Obama, but it cannot be denied that there’s much more at stake for African Americans after Inauguration Day.

This includes the threat of millions of Americans losing their health care either through the Affordable Care Act, the Children’s Health Insurance Program or Medicaid; the evisceration of LGBTQ protections; the loss of access to abortion and reproductive-health clinics; and an inevitable increase of state and police violence in our already over-policed communities. And that’s just the short list.

But for African Americans living with HIV/AIDS and those at risk for the disease—the most vulnerable of the vulnerable—what does a Trump presidency mean for them? Especially given that the White House will be led by an administration of white supremacists and evangelicals that view the AIDS epidemic as a moral conundrum instead of a public health crisis?

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To get a better understanding of what the next four years could look like for the AIDS epidemic in black America, The Root spoke to African Americans living with HIV/AIDS and advocates across the country. Here are their predictions:

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Shane Johnson, Washington, D.C., Diagnosed in 1998

“We are facing a return to the days where private insurance companies can deny a person coverage based on HIV being defined as a pre-existing condition. Denial of coverage for pre-exposure prophylaxis even though scientific evidence overwhelmingly demonstrates that PrEP and AIDS meds play a crucial role in eliminating new HIV infections.

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“If the GOP is successful in its quest to gut the Affordable Care Act, this will have a ripple effect on Ryan White programs—namely Housing Opportunities for Persons With AIDS and AIDS Drug Assistance Program programs. In short, we will see state ADAP waiting lists grow again and people die like they did not too long ago. In addition, Ryan White programs have always remained flatly funded under both Democratic and Republican presidential administrations, but with the GOP in firm control of the executive and legislative branches, things will only get worse.”

Marsha Jones, Dallas, Executive Director of the Afiya Center

“Our community is going to be devastated by this new president, especially in the South, where the epidemic is already at a devastating place. We are already seeing our legislators cut our programs because it’s clear that they don’t care about HIV—and this was happening even under a White House that somewhat affirmed our work and the communities at risk.

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“And so what is going to happen now? I predict HIV rates soaring, lifesaving programs cut and funds for HIV/AIDS reallocated. We will also see a growing ADAP list for people waiting for AIDS medication who could die waiting for that treatment. And those who are most at risk for contracting HIV will further fall in the public health cracks. And to make matters worse, we are going to see a Trump administration, which refuses to believe in science, slash money for necessary research.

“Now, none of this will happen the day after Trump’s inauguration, but we will definitely see all of this happen during the next four years and beyond if he gets re-elected into office.”

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Timothy DuWhite, Brooklyn, N.Y., Diagnosed in 2012

“When I think about HIV/AIDS in the age of Trump, I am compelled to also think about HIV/AIDS in the age of Obama, which then leads me all the way back to the age of Reagan. This jettison of thought does not stem from an observance of contrast but, rather, a bewilderment of how same it all feels.

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“In New York, Gov. [Andrew] Cuomo has declared HIV/AIDS Services Administration for all, stating that you do not have to have AIDS or be highly symptomatic anymore to garner government assistance for living with HIV. When I reckon with the idea of victory, or forward progression, or even when I should or should not deem a moment appropriate to celebrate, I am left deflated with the fact that this is our government which facilitates the perpetuation of this disease in the first place. Using that framework of thought, is government ‘assistance’ for all regarding this disease even a radical change?

“So if the question here is centralized on Trump's foreseeable actions, I think we have already lost. The question should be and remain, why are some folks (especially black folks) far more structurally vulnerable to transmitting this disease than others? I wish to hold a discussion that is not reactionary but, rather, one that caters to the daily lives of those disproportionately affected. They have been at risk long before Trump, and nothing changes, long after him.”

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 Khafre Kujichagulia Abif, Atlanta, Diagnosed in 1999

“For our community, the election of Donald Trump will be another storm that we will continue to stand in and endure like we have with everything else. We have deep roots, and our collective community resilience will push past our initial fear.

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“We all understand the effects of how intersections of structural racism, poverty, lack of access, mass incarceration and other social determinants affect our lives, our work and our ability to fight HIV, provide health care for the infected and the prevention of new HIV infections. But our communal fear will be transformed into action, speaking truth to power and making a way out of no way.”

Evany Turk, Grand Prairie, Texas, Diagnosed in 2001

“I’m afraid that the pre-existing conditions clause will be removed. I’m also terrified that my insurance plan will rise and that the price of my lifesaving medications will be even higher than it already is now.

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“Essentially, a Trump presidency means bad health care, and bad health care equals depression, hopelessness, not being able to take care for my children and possibly not being able to see my children grow up and have children of their own. Bad Health Care = Death.

“And I still have a lot of living to do!”

Kimberly Parker, Dallas, Associate Professor, HIV Activist

“Right now I’m thinking about how reproductive justice, women’s health clinics and HIV/AIDS services are intertwined. Look what happened in Indiana under [now-Vice President-elect Mike] Pence when Planned Parenthood was basically shut down, and how they experienced an HIV outbreak. That, and these really restrictive abortion laws in Texas that cut access to rural women who now have to travel hours to seek an abortion or other services that would include HIV prevention and contraception methods.

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“These barriers for care will get only worse for those who are the most at risk, the most isolated and the most marginalized. This system isn’t going to try to understand the health needs of persons of color, women and especially women of color.

“We are going to see more stigma, a deeper sense of hopelessness, and what happened in Indiana will occur all over this nation.”