For days preceding Tuesday night’s State of the Union address, word was that President Trump intended to roll out plans to end forever the HIV/AIDS epidemic in America. What he said in his address was terse. He observed the “remarkable progress” that had been made in recent years in the fight against the disease. He promised, “My budget will ask Democrats and Republicans to make the needed commitment to eliminate the HIV epidemic in the United States within 10 years.” And he ended with a flourish, “Together we will defeat AIDS in America.” Not much in the way of plans, but as Samuel Johnson said of a dog walking on its hind legs: “It is not done well; but you are surprised to find it done at all.”

HIV/AIDS has disproportionately affected gay men and trans women. Trump’s policies — his ban on transgender military service, his support of businesses’ and employers’ right to exercise “sincerely held religious beliefs” to discriminate against gay people — seem to demonstrate his contempt for gay men and trans women. So how are we to understand his pledge, however vague, to defeat the disease that was called, when it was first identified, “Gay Related Immune Deficiency” (GRID)?

From the start of the epidemic, HIV/AIDS has been a political football. At the epidemic’s height, in the 1980s and early 1990s, conservative politicians and commentators used AIDS as a surefire way to appeal to the right’s fear and loathing of homosexuals. Patrick Buchanan wrote in his syndicated column in 1983 that AIDS is “Nature exacting an awful retribution” on unnatural homosexual sex. Blaming the victims of the disease, Buchanan complained that homosexuals were not only a “moral menace,” as he’d always believed, but now their disease also rendered them “a public health menace.” He pointedly made AIDS a political issue. The Democrats had included a gay rights plank in their 1980 platform. Buchanan asked with mocking incredulity, “Does the Democratic Party still maintain its solemn commitment to federally protected civil rights for active homosexuals — equal access to jobs, housing, and public accommodations?”

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Republican Ronald Reagan had won that 1980 election. His press secretary, Larry Speakes, was asked in 1982 about the president’s reaction to a report from the Centers for Disease Control and Prevention stating that 600 cases of AIDS had been identified and more than a third of those with the disease had already died. It was known as the “gay plague,” the reporter told Speakes, whose response was only to laugh and then quip, “I don’t have it. Do you?” By 1984, when Reagan was running for reelection, huge numbers of Americans had already been diagnosed as HIV positive. But Reagan had still not publicly discussed the epidemic — other than to tell an organization that kept a “presidential biblical scoreboard” that his administration pledged to “resist the efforts of some to obtain government endorsement of homosexuality.” Not even the AIDS death in 1985 of Rock Hudson, Reagan’s Hollywood buddy, could turn his eyes from the “presidential biblical scoreboard.” Reagan’s proposed federal budget for 1986 included a cut of 11 percent over the previous year for AIDS spending.

But Reagan was far from the only politician who heeded the homophobia of their constituency to punish people with AIDS. In 1987, the Senate was considering a $300 million appropriations bill for AIDS education, when Jesse Helms, Republican senator from North Carolina, turned the venom he had once expressed for integration on homosexuals, admonishing his fellow senators, “We’ve got to call a spade a spade and a perverted human being a perverted human being.” He proposed an amendment that mandated that education about AIDS prevention would be limited to “sexual abstinence only.” It passed 94 to 2 — Democrats as well as Republicans demonstrating their disapproval of homosexual behavior.

More recently, Trump’s bedfellows have also made clear their indifference or hostility to those suffering from AIDS. His nominee for attorney general, William P. Barr, has, for example, decried the notion that government should help fight AIDS. Speaking to the Knights of Columbus at a time when the epidemic was still at a height and no effective cure was in sight, Barr proclaimed his disagreement with policies that made the state responsible for the “costs of misconduct,” such as “handing out condoms” to prevent AIDS instead of forcing people to take “sexual responsibility” themselves.

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Vice President Pence also has a history of reluctance to involve the state in AIDS prevention. As governor of Indiana, he long opposed a government-sponsored needle-exchange program to stop HIV infection among intravenous drug users: Pence argued that it would encourage drug abuse. Even in the midst of a large outbreak of HIV infections in southeastern Indiana, and pleas from public health officials and doctors from the CDC who told him how important needle exchange was in cutting down on the spread of HIV, Pence was recalcitrant. He finally agreed to the needle-exchange program (after “praying on it,” as he said). However, no state funding was approved for the syringes or the administrators.

To this day, AIDS remains a political football. Trump has made getting rid of the Affordable Care Act a top priority, but the ACA has been crucial to people with HIV/AIDS because it prohibits insurance companies from refusing coverage to those with preexisting conditions. The Trump administration has supported cuts in Medicaid coverage, but 40 percent of people with HIV/AIDS are dependent on Medicaid. Trump’s first two budgets proposed cuts in funding for the National Institutes of Health, but NIH has been central to AIDS research.

These are unpromising indications. Despite them, it would be lovely to believe that Trump will “make the needed commitment to eliminate the HIV epidemic in the United States within 10 years,” that his promise is not simply empty rhetorical distraction from his failure to get Congress to fund his border wall, that it is more than just another pass of the political football.

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