AIDS has always been political.

From its beginning, the AIDS epidemic in the US has carried with it marginalization and stigmatization. Disproportionately affecting queer individuals and people of color, HIV/AIDS is inextricably linked to the systems of oppression that render these communities particularly vulnerable. As such, the history of the American political response to the epidemic is a particularly dark one.

Despite the first reports of HIV/AIDS coming to light in 1980–81, the Reagan administration did not publicly acknowledge the existence of the virus until years later. A salient example of the administration’s ignorance — or worse, indifference — can be found Vanity Fair’s 2015 web documentary entitled When AIDS Was Funny. The film features audio of Ronald Reagan’s press secretary, Larry Speakes, when he was first asked about AIDS in 1982. At the time, over 800 HIV/AIDS-related deaths had been reported in the US, yet Speakes simply replied “I haven’t got anything on it” and even inappropriately joked “I don’t have it, do you?”

Much of this public negligence of the AIDS epidemic was due to its particular prevalence in queer communities, specifically among gay and bisexual men. Before the terms HIV and AIDS were coined, the virus was publicly referred to as GRID (Gay-Related Immune Deficiency) and even “gay plague.” Media coverage also featured rather problematic biases — with news outlets explicitly referring to the virus as one inherently associated with sexual promiscuity and drug abuse — or failed to cover HIV/AIDS at all (The New York Times, for example, did not print a cover story on the epidemic until 1983).

By the time Reagan publicly acknowledged the epidemic in 1987, over 20,000 Americans had died from AIDS-related illness, and misinformation and stigma were running rampant. Even then, Reagan’s prevention strategy was primarily rooted in abstinence education, and he even remarked that “morality” was adequately preventative.

There is no way to remotely quantify the trauma inflicted on HIV-positive individuals by such as period of apathy and erasure — just as there is no way to excuse political ignorance and inaction.

Over thirty years later, on World AIDS Day 2018, we can celebrate the progress that has been made in the fight against HIV/AIDS. The advent of antiretroviral therapy (ART) has enabled hundreds of thousands of HIV-positive individuals and their children in the U.S. to live happier, healthier lives. Preventative measures like pre-and-post-exposure prophylaxis (PrEP and PEP) can reduce rates of transmission, as can needle sharing programs for intravenous drug users. To some extent, the American public consciousness has evolved in terms of its perception of the virus and disproportionately affected populations.

But we also must recognize that the AIDS epidemic is far from over, and that we can find some disheartening political parallels today.

The Trump administration has implemented a number of notable HIV/AIDS-related policy changes: diverting funding away from health programs/entities like PEPFAR (President’s Emergency Plan for AIDS Relief) and the CDC, barring HIV-positive individuals from serving in the U.S. military, and proposing cuts to Medicaid (on which 40% of HIV-positive individuals depend for healthcare). Six members of the Presidential Advisory Council of HIV/AIDS (PACHA) appointed during the Obama administration resigned in June 2017 in protest of the Trump administration’s lack of strategy to address the epidemic, and the remaining members had their appointments terminated shortly thereafter. Beyond the federal level, 33 states have HIV-specific laws, including 24 that criminalize lack of disclosure to sexual partners and 25 that criminalize behaviors with low risk for HIV transmission.

Unfortunately, marginalization and stigmatization persist today in our country and contribute to homophobia, racism, and xenophobia. We must also acknowledge the role of the United States within a global context, especially in relation to an epidemic that is particularly concentrated in parts of the world (e.g. sub-Saharan Africa) in which governmental barriers and public stigma are particularly acute.

Political and intersectional consciousness in the fight against HIV/AIDS remain as necessary as ever. On this World AIDS Day, let us reaffirm our commitment to action and visibility over ignorance and erasure.

Written by Claire Fieldman