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Despite assurances, LGBT advocates want more for bi-national couples

DHS says same-sex marriage a factor in evaluating deportation cases

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The US Department of Homeland Security

The issue of keeping married bi-national gay couples together in the United States is receiving fresh attention as LGBT advocates call for more action beyond a recent statement from the Department of Homeland Security saying being in a same-sex marriage is a factor in determining whether a potential deportee should be able to stay in the country.

On Thursday, Peter Boogaard, a DHS spokesperson, affirmed that the Obama administration would examine whether an individual is in a same-sex marriage when deciding to exercise prosecutorial discretion in a deportation for an undocumented immigrant.

“Pursuant to the Attorney General’s guidance, the Defense of Marriage Act remains in effect and the Department of Homeland Security will continue to enforce it unless and until Congress repeals it, or there is a final judicial determination that it is unconstitutional,” Boogaard said. “However, when exercising prosecutorial discretion in enforcement matters, DHS looks at the totality of the circumstances presented in individual cases, including whether an individual has close family ties to the United States as demonstrated by his or her same-sex marriage or other longstanding relationship to a United States citizen.”

Boogaard’s statement marks the first time the Obama administration has said on the record it will factor in whether someone is in a same-sex marriage when determining whether to exercise prosecutorial discretion in a deportation case. The administration previously communicated in August 2011 that it would “consider LGBT families” under a policy in which officials would examine on a case-by-case basis the potential deportations of about 300,000 undocumented immigrants, but that was only said without attribution. The new statement also changes “LGBT families” to “same-sex marriage.”

Additionally, the words mark one of the few times that the Obama administration has said it would recognize married same-sex couples even though DOMA, which prohibits federal recognition of same-sex marriage, remains on the books. Last year, the Justice Department announced it would allow married same-sex couples to file jointly for bankruptcy; the Office of Personnel Management gave U.S. Ninth Circuit Court of Appeals employee Karen Golinski health benefits for her same-sex spouse, but both of those decisions were more limited in scope and the result of court orders.

The DHS statement comes in response to a letter that 84 House Democrats signed calling for DHS to issue guidance for providing prosecutorial discretion for married bi-national same-sex couples in situations where the foreign national in the relationship is undocumented and possibly in danger of deportation. Straight Americans can sponsor their spouses for residency in the United States through a marriage-based green card application, but that option isn’t available to gay Americans because of DOMA.

In a letter dated Aug. 3, the signers — who include House Minority Leader Nancy Pelosi (D-Calif.), Rep. Jerrold Nadler (D-N.Y.), and Rep. Mike Honda (D-Calif.) — ask for “written field guidance or a memorandum” indicating DHS will “consider LGBT family ties as a positive factor for the exercise of prosecutorial discretion.” It’s not the first time such a letter has been sent. Last year, 69 House Democrats sent a letter to DHS calling for similar action.

Despite the new statement from DHS, those behind the letter say they want more and a response from a DHS spokesperson doesn’t take the place of written guidance. Some behind the letter say the statement from DHS reflects a policy that is already understood to be in place.

Nadler, sponsor of the Uniting American Families Act, which would enable gay Americans to sponsor their foreign partners for residency in the United States, was among those saying more is necessary.

“I appreciate the response from DHS’s spokesperson on the issue of prosecutorial discretion, but the policy mentioned is the one I already understood to be in place,” Nadler said. “What my colleagues and I are asking, and have been requesting since 2011, is that those guidelines now be put clearly onto paper for DHS agents in the field so that there is no longer any confusion as to their mission vis-à-vis the deportation of gays and lesbians with demonstrated family and community ties in the U.S.”

Drew Hammill, a spokesperson for Nancy Pelosi, called the statement a “welcome development,” but echoed the sentiment that more was sought in the letter.

“It’s a welcome development that a DHS spokesperson is explicitly and publicly acknowledging that DHS’s consideration of family ties includes same-sex couples and spouses,” Hammill said. “We look forward to the written guidance that we expect would be a logical next step.”

Rep. Mike Honda (D-Calif.) (Blade file photo by Michael Key)

Honda, sponsor of the Reuniting Families Act, which has UAFA-inclusive language, said he “greatly appreciate[s]” the statement from DHS,  but also wants the policy clearly written in guidance for U.S. Customs & Immigration Enforcement officials.

“I greatly appreciate the Department of Homeland Security’s explicit verbal statement recognizing the value of same-sex relationships in immigration proceedings,” Honda said. “However, for the sake of those LGBT families, who — today or tomorrow — may face a tragic and senseless separation, their attorneys, and ICE field officials, an indubitable and unequivocal written policy and implementation guideline remain the best assurance for protection. I look forward to working with DHS to ensure that this becomes a reality.”

That sentiment was echoed by an LGBT advocacy group that focuses on immigration issues. Steve Ralls, a spokesperson for Immigration Equality, noted there’s nothing new in the statement provided by DHS.

“We’ve heard verbally before that they intend for their guidelines to be inclusive, but then, on the flipside of that, we’ve heard from field officers that they’ve never received that instruction in writing,” Ralls said. “Leader Pelosi and the other signers of the letter were very clear that they want to see that policy articulated in writing and distributed to the field, and that doesn’t seem to be the commitment that we’re getting in the statement today from DHS.”

Asked whether he thinks it’s significant that DHS is for the first time articulating this policy on the record, Ralls said, “Again, I think the real issue is who they say it to and not who says it. It needs to be a written policy directed squarely to the field. … That’s what we need. That’s what Nadler, Honda and Pelosi wanted. That’s not what DHS delivered today.”

The exception to the nonplussed reactions was Lavi Soloway, an immigration attorney and co-founder of Stop the Deportations, who called the news “a giant step forward in the fight against DOMA” and the first formal recognition from the Obama administration of married same-sex couples.

“This move is significant beyond the immigration context, as it constitutes the first time any agency of the federal government has created a policy explicitly recognizing same-sex marriages,” Soloway added. “By giving legal effect to the lawful marriages of gay and lesbian couples, the Obama administration has demonstrated what we have argued all along to be true: that executive branch agencies can create policy to mitigate the discriminatory impact of DOMA on gay and lesbian binational couples, even while DOMA continues to prevent approval of those couples’ green card petitions.”

Still, Soloway said he wants to see the policy articulated in guidance, saying, “To ensure that our families are protected with consistent application of this newly inclusive prosecutorial discretion policy, it is crucial that detailed written guidance encompassing this official announcement be issued without delay.

Despite these calls for having instructions explicitly written in guidance, DHS maintains agents and attorneys have been trained to know that LGBT families and same-sex couples are covered under the new policy. Since the DHS announcement last year, ICE has already announced that several bi-national couples have been taken out of the deportation pipeline, such as Anthony Makk and Bradford Wells of San Francisco.

DHS didn’t respond to a request to comment on reactions from lawmakers and advocates to the statement provided last week.

Letter renews call to hold marriage-based green cards

The House Democrats’ letter isn’t the only one that the Obama administration has received recently on married bi-national same-sex couples. Immigration Equality delivered a letter to the White House and the Justice Department on Friday asking for the marriage-based green card applications to be held in abeyance now that a time for when the Supreme Court will review DOMA has become more clear.

The letter, signed by Immigration Equality Executive Director Rachel Tiven and Legal Director Victoria Neilson, is dated July 26 and renews an earlier request from the organization that was denied by the Obama administration, saying the administration should reconsider because “it is now clear that a final judicial determination on the constitutionality of DOMA is imminent.”

“[I]t is now clear that the Supreme Court will render a decision on the constitutionality of Section 3 of DOMA within a year. In the meanwhile, if USCIS continues to deny the applications of lawfully married couples, lesbian and gay immigrant families will continue to suffer irreparable harm through forced separations, forced exile, or the accrual of unlawful presence in the United States,” the letter states. “Holding green card petitions and applications without adjudicating them will preserve agency resources and prevent real harm to real families until the Supreme Court resolves this issue next year.”

Among the reasons cited in the letter for a likely imminent decision from the Supreme Court on DOMA are rulings against the anti-gay law from the First Circuit and district courts as well as multiple pending petitions asking the high court to take up the law.

The letter is dated the day after U.S. Chief Judge Carol Bagley Amon of the Eastern District of New York placed a stay on Immigration Equality’s lawsuit against DOMA, Blesch v. Holder, pending resolution of another DOMA lawsuit, Windsor v. United States, before the Second Circuit Court of Appeals.

The Justice Department didn’t respond to a request for comment. A White House spokesperson deferred to DHS, which provided the same statement in response to the letter signed by House Democrats. As of Monday, Immigration Equality has said it hasn’t yet received a response from the Obama administration.

Soloway also said putting marriage-based green card applications in abeyance for same-sex couples is the best way for the Obama administration to ensure these families can remain together in the United States without fear of separation.

“To address this immediate, irreparable harm, the administration should stop denying green card petitions filed by gay and lesbian binational couples and instead put those cases on hold pending a ruling by the Supreme Court on the constitutionality of DOMA expected next year,” Soloway said.

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The White House

As house Democrats release Epstein photos, Garcia continues to demand DOJ transparency

Blade this week sat down with gay House Oversight Committee ranking member

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A photo released by the House Oversight Committee showing Donald Trump 's close relationship with Jeffrey Epstein . (Photo courtesy of the U.S. House Oversight Committee)

Democrats on the House Oversight Committee have released new photos from Jeffrey Epstein’s email and computer records, including images highlighting the relationship between President Donald Trump and the convicted sex offender.

Epstein, a wealthy financier, was found guilty of procuring a child for prostitution and sex trafficking, serving a 13-month prison sentence in 2008. At the time of his death in prison under mysterious circumstances, he was facing charges of sex trafficking and conspiracy to traffic minors.

Among those pictured in Epstein’s digital files are Trump, former President Bill Clinton, former Trump adviser Steve Bannon, actor and director Woody Allen, economist Larry Summers, lawyer Alan Dershowitz, entrepreneurs Richard Branson and Bill Gates, and Andrew Mountbatten-Windsor.

One photo shows Trump alongside Epstein and a woman at a Victoria’s Secret party in New York in 1997. American media outlets have published the image, while Getty Images identified the woman as model Ingrid Seynhaeve.

Oversight Committee Democrats are reviewing the full set of photos and plan to release additional images to the public in the coming days and weeks, emphasizing their commitment to protecting survivors’ identities.

With just a week left for the Justice Department to publish all files related to Epstein following the passage of the Epstein Files Transparency Act, which requires the Justice Department to release most records connected to Epstein investigations, the Washington Blade sat down with U.S. Rep. Robert Garcia (D-Calif.), the ranking member on the Oversight Committee to discuss the current push the release of more documents.

Garcia highlighted the committee’s commitment to transparency and accountability.

U.S. Rep. Robert Garcia (D-Calif.) during a sit down with the Washington Blade. (Washington Blade photo by Michael Key)

“We’ve said anything that we get we’re going to put out. We don’t care who is in the files … if you’ve harmed women and girls, then we’ve got to hold you accountable.”

He noted ongoing questions surrounding Trump’s relationship with Epstein, given their long history and the apparent break in friendship once Trump assumed public office.

“There’s been a lot of questions about … Donald Trump and Jeffrey Epstein. They were best friends for 10 years … met women there and girls.”

Prior to Trump’s presidency, it was widely reported that the two were friends who visited each other’s properties regularly. Additional reporting shows they socialized frequently throughout the 1990s and early 2000s, attending parties at Trump’s Mar-a-Lago resort in Florida and Epstein’s residences. Flight logs from an associate’s trial indicate Trump flew on Epstein’s private jet multiple times, and Epstein claimed Trump first had sex with his future wife, Melania Knauss, aboard the jet.

“We’ve provided evidence … [that leads to] questions about what the relationship was like between Donald Trump and Jeffrey Epstein.”

Garcia stressed the need for answers regarding the White House’s role in withholding information, questioning the sudden change in attitude toward releasing the files given Trump’s campaign promises.

“Why is the White House trying to cover this up? So if he’s not covering for himself … he’s covering up for his rich friends,” Garcia said. “Why the cover up? Who are you hiding for? I think that’s the question.”

He confirmed that Trump is definitively in the Epstein files, though the extent remains unknown, but will be uncovered soon.

“We know that Trump’s in them. Yeah, he’s been told. We know that Trump’s in them in some way. As far as the extent of it … we don’t know.”

Garcia emphasized accountability for all powerful figures implicated, regardless of financial status, political party, or personal connections.

“All these powerful men that are walking around right now … after abusing, in some cases, 14‑ and 15‑year‑old girls, they have to be held accountable,” he said. “There has to be justice for those survivors and the American public deserves the truth about who was involved in that.”

He added that while he is the ranking member, he will ensure the oversight committee will use all available political tools, including subpoenas — potentially even for the president. 

“We want to subpoena anyone that we can … everyone’s kind of on the table.”

He also emphasized accountability for all powerful figures implicated, regardless of financial status, political party, or relationship with the president.

“For me, they’re about justice and doing the right thing,” Garcia said. “This is about women who … were girls and children when they were being abused, trafficked, in some cases, raped. And these women deserve justice.”

“The survivors are strong.”

Deputy White House Press Secretary Abigail Jackson issued a statement regarding the release the photos, echoing previous comments from Republicans on the timing and framing of the photos by the Oversight Committee.

“Once again, House Democrats are selectively releasing cherry-picked photos with random redactions to try and create a false narrative,” Jackson said.

“The Democrat hoax against President Trump has been repeatedly debunked and the Trump administration has done more for Epstein’s victims than Democrats ever have by repeatedly calling for transparency, releasing thousands of pages of documents, and calling for further investigations into Epstein’s Democrat friends,”

In a press release on Friday, Garcia called for immediate DOJ action:

“It is time to end this White House cover-up and bring justice to the survivors of Jeffrey Epstein and his powerful friends. These disturbing photos raise even more questions about Epstein and his relationships with some of the most powerful men in the world. We will not rest until the American people get the truth. The Department of Justice must release all the files, NOW.”

Steve Bannon and Jeffrey Epstein in Epstein Files photo. (Photo courtesy of the U.S. House Oversight Committee)
Trump in another photo from Epstein’s digital files. (Photo courtesy of the U.S. House Oversight Committee)
(Photo courtesy of the U.S. House Oversight Committee)
Bill Gates and Andrew Montbatton-Windsor in Epstein Files photo. (Photo courtesy of the U.S. House Oversight Committee)
Bill Clinton and Ghislaine Maxwell and Jeffrey Epstein in Epstein Files photo.
(Photo courtesy of the U.S. House Oversight Committee)

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White House deadnames highest-ranking transgender official

Rachel Levine’s portrait altered at HHS

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Adm. Rachel Levine speaks at the International LGBTQ Leaders Conference on Dec. 2, 2021. (Washington Blade photo by Michael Key)

Admiral Rachel Levine — the first transgender person ever confirmed by the U.S. Senate and the highest-ranking trans official in American history — had her official portrait in the Humphrey Building altered, with staff replacing her correct name with her deadname, the name she has not used since 2011.

NPR first reported the change, and an HHS spokesperson confirmed to the outlet that Levine’s portrait had recently been altered. A digital photograph obtained by NPR shows Levine’s former (male) name typed on a placard beneath the portrait, placed under the glass of the frame.

Levine served as a four-star admiral in the U.S. Public Health Service Commissioned Corps under the Biden-Harris administration and was appointed the 17th assistant secretary for health.

During her tenure, Levine oversaw the Commissioned Corps and helped lead national public-health initiatives, including the federal COVID-19 response and vaccination strategy; efforts to address rising syphilis infection rates; HIV/AIDS prevention and treatment programs; and strategies to combat the opioid epidemic, particularly through expanded harm-reduction approaches for the communities most affected.

The Trump-Vance administration’s decision to publicly deadname Levine is widely viewed within the trans community as demeaning and disrespectful. The move comes amid a series of federal policy reversals targeting LGBTQ Americans, particularly trans youth seeking gender-affirming care.

Those actions include: weakening workplace protections for LGBTQ employees; limiting restroom access; downgrading gender-identity discrimination cases; pressuring hospitals to end gender-affirming care; cutting HIV research and prevention funding; removing LGBTQ crisis resources; restricting access to trans-inclusive medical policies for veterans and young people; supporting trans sports bans and threatening funding for teams that include trans athletes; and forcing schools and universities to eliminate DEI and LGBTQ offices, inclusive curricula, gender-neutral bathrooms, and books or training materials addressing LGBTQ issues.

The Trump–Vance administration has also expanded federal censorship by removing LGBTQ language from surveys, agency websites, Smithsonian materials, and human-rights reports; blocking Pride recognitions; creating federal communications that misgender trans women; imposing passport and travel barriers for trans Americans; lifting protections for trans service members; limiting benefits and care for LGBTQ veterans; and pressuring states, universities, and hospitals to end trans-inclusive policies under threat of losing federal research, education, or Medicaid funds. The administration has additionally deported LGBTQ asylum seekers to unsafe conditions, removed LGBTQ issues from global human-rights reporting, and escalated anti-trans rhetoric at public events.

These actions stand in stark contrast to Levine’s public-health record. As assistant secretary for health, she worked to expand LGBTQ+ health data collection, promote equitable vaccine distribution, strengthen national health-equity initiatives, and reduce care disparities experienced by historically underserved communities, including LGBTQ populations. Within HHS, she led councils and task forces dedicated to reducing structural barriers to care and improving community outcomes.

Before joining the federal government, Levine oversaw health and safety for nearly 13 million residents as Pennsylvania’s physician general from 2015–2017 and as Pennsylvania secretary of health from 2018–2021.

Rachel Levine‘s official portrait, which now bears her deadname. (Photo public domain)

Asked by NPR about the alteration of her official portrait, Levine responded that it had been an honor to serve as assistant secretary for health, adding: “I’m not going to comment on this type of petty action.”

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The harsh truth about HIV phobia in gay dating

HIV and stigma remain baked into queer dating culture

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(Photo by Val Chaparro for Uncloseted Media)

Uncloseted Media published this article on Dec. 9.

This story was produced with the support of MISTR, a telehealth platform offering free online access to PrEP, DoxyPEP, STI testing, Hepatitis C testing and treatment and long-term HIV care across the U.S. MISTR did not have any editorial input into the content of this story.

By SAM DONNDELINGER | In his room, 19-year-old Cody Nester toggles between Grindr profiles on his phone.

As he senses chemistry with a match, he knows he has to flag something that could be a deal breaker.

“Did you see on my profile that I’m HIV positive?” he writes.

The reply arrives instantly.

“You’re disgusting. I don’t know why you’re on here.” Seconds later, the profile disappears, suggesting Nester is blocked.

“He went out of his way to say that. People could at least be more aware, ask questions, and understand the reality [of living with HIV] instead of attacking us,” Nester told Uncloseted Media.

“I would say 95 percent of people respond that way,” says Nester, who lives in Hollywood, Fla., and works at a Mexican restaurant. “The entire conversation is going fine. They’re down to meet up and then right when I mention [HIV], it’s always, ‘Oh no, never mind.’”

Some other messages he’s received include:

“You’ll never get anything in your life.”
“Why don’t you die?”
“Why are you on here?”

More often, it’s silence, a cold “No” or a sudden block.

“It’s like you’re a white fish in a school of black fish,” he says. “You’re immediately the odd one out.”

Even though Nester’s undetectable status makes it impossible for him to transmit HIV to partners during sex, he experiences stigma around HIV, something which nearly 90 percent of Americans agree still exists, according to a 2022 GLAAD report. And a survey shared in 2019 found that 64 percent of respondents would feel uncomfortable having sex with someone living with HIV, even on effective treatment. The emotional cost of this stigma is a significant barrier to intimacy and can result in a loss of self-esteem, fear of disclosure and suicidal thoughts.

What the science says — and why it doesn’t seem to matter

“The fear comes from antiquated ideas around HIV,” says Xavier A. Erguera, senior clinical research coordinator at University of California, San Francisco,’s Division of HIV, Infectious Diseases & Global Medicine. “A lot of people who are newly diagnosed still fear it’s a death sentence. Even though we have medications now to treat it effectively, and it’s basically a chronic condition, people haven’t caught up.”

Since 1996, antiretroviral therapies have developed to where they can suppress the virus to levels so low that it is undetectable in the blood, and thus not able to be transmitted to sexual partners. This is known as Undetectable = Untransmittable, or U=U. According to a Centers for Disease Control and Prevention report from 2024, 65 percent of HIV-positive cases are virally suppressed.

Another line of defense is pre-exposure prophylaxis (PrEP), which reduces the risk of acquiring HIV from sexual intercourse by roughly 99 percent when taken as prescribed. Approved by the Food and Drug Administration in 2012, the medication launched as a once-a-day pill and was hailed as a breakthrough as it transformed the sex lives of gay men, which had been shaped by decades of fear about HIV complications and about where AIDS came from.

“Internal logic doesn’t reflect what we know scientifically,” says Kim Koester, associate professor in the Department of Medicine at UCSF. “I was very optimistic when PrEP came out. The drug works, so why wouldn’t everyone use it?”

Even with PrEP use on the rise, less than 600,000 Americans used it in 2024, and Koester says skepticism and judgments about taking the drug persist.

“The phobia is pervasive,” Koester told Uncloseted Media. “People believe that others get the disease because of their lifestyle. … PrEP was supposed to be the antidote to the threat of HIV, reduce the anxiety, and make you more open to who you are and the sex you want. It’s supposed to be liberating. It is part of the answer. But it’s not enough. We don’t have enough people using PrEP for it to make the dent in the stigma we need.”

According to a 2023 study of seven informants living with HIV, public stigma stems from problematic views from society that those living with HIV are “a dangerous transmission source,” “disgraceful” and “violators of social and religious norms who have committed deviant behavior.”

Laramie Smith, assistant professor of Global Public Health at the University of California, San Diego, says this stigma is unwarranted and fueled by misunderstanding:

“With today’s treatments, it shouldn’t be a life-altering identity shift. It should be no different than, ‘I have diabetes.’ If you’re virally suppressed, it shouldn’t matter whether you’re friends with someone, whether you’re sleeping with someone — the science shows us that.”

How HIV phobia shows up online

Nester, who contracted HIV last year from a Grindr hook-up who insisted he was negative, says he is just starting to accept his diagnosis. “I didn’t go back on the apps for a long time after that. It messed with my mental health … realizing I’d have to take medication for the rest of my life.”

Since he started dating again this year, returning to apps like Grindr and Sniffies, he has faced a new normal. He tries to do everything “right” and disclose his status early. Even on his Grindr profile, he identifies as “poz,” slang for HIV-positive.

Still, he says most people ghost him once they find out. “The second I bring it up, it’s ‘No,’” says Nester. “The amount of discrimination you get … it’s always the same pattern. … People don’t know, and they don’t want to know. It messes with you.”

This discrimination may be fueled by a deprioritization of HIV awareness programs across the country. Earlier this month, the U.S. State Department did not commemorate World AIDS Day for the first time in 37 years. HIV prevention programs have been slashed, especially in conservative districts, and only 25 states and D.C. require both HIV and sex education. In many states, health curricula often lag behind current science and omit teaching about PrEP, gay sex and concepts like U=U. Research shows that Gen Z is currently the least educated generation about HIV.

“I could go all day explaining HIV, but people don’t want to listen,” says Nester, who is part of Gen Z. “People don’t want to learn about it; they just want to avoid it.”

HIV anxiety and public stigma shaped by history

Even in more progressive areas, stigma still exists. Damian Jack, a 45-year-old from Brooklyn, remembers sitting in an exam room in 2009 as a doctor explained how low his T-cell count was, which is a hallmark of HIV infection.

“I started hysterically crying,” he told Uncloseted Media. “HIV meant death. That’s what I thought.”

In 1981, when Jack was 1 year old, the first reports of a mysterious and deadly immune deficiency syndrome, which would later be named AIDS, appeared in the U.S. Growing up, Jack saw countless terrifying images of men on their deathbeds with Kaposi sarcoma, the purple lesions the media once called “gay cancer.” Public misinformation and fearmongering spread ideas that AIDS was a disease that “only gay men and drug users get.” And politicians often equated it with homosexuality and moral failure, calling it a “gay plague.” It wasn’t until September 1985, four years after the crisis began and thousands had died, that President Ronald Reagan first publicly mentioned AIDS.

Decades later, the emotional residue of that era and the shame associated with the virus lingers.

Hours after learning of his diagnosis, Jack faced his first encounter with rejection. He already had a date planned that night, and his doctor and friends encouraged him to go.

They had a great time until the date asked him: “Are you negative or positive?”

He told the truth.

“It was just understood there wouldn’t be a second date,” says Jack. “I remember thinking, ‘This is how dating is going to be now.’ I felt so anxious telling guys. It followed me everywhere. I don’t think that anxiety ever truly goes away.”

The emotional impact of HIV stigma

For those who are HIV-negative, experts say that “stigma’s whole design is to ‘other.’”

“The ‘us versus them’ creates that false sense of safety when it comes to HIV,” says Smith. “If I can believe that someone did something to deserve their diagnosis, and I’m not that [kind of person], then I’m safe.”

This othering is painful and can lead to shame, fear and isolation, and it is linked to a higher risk of depression and anxiety.

“If I’m undesirable, and that’s what those messages are communicating, that threatens your sense of safety, your sense of belonging and the fundamental desire we all have to be loved,” Smith says. “And that starts to reinforce the thinking that ‘I am not worthy. This virus that I have means that I’m not lovable. I am not safe showing up among other men.’”

“I pretend it doesn’t hurt, but some things do sting a little bit,” Nester says. “You start thinking, ‘Am I really that disgusting? Am I really that singled out?’”

When public stigma turns inward

“Internalized stigma is what occurs when applying the stereotypes about who gets HIV, the prejudice, the negative feelings, onto yourself,” says Smith.

In 2024, 38 percent of people living with HIV reported internalized stigma. And studies show that it can predict hopelessness and lower quality of life, even when people are engaged in care or virally suppressed.

Internalized stigma can also affect how people practice safe sex and communicate about the virus. A 2019 survey of men who have sex with men found that individuals who perceived greater community-level stigma were less likely to be aware of — and use — safer-sex functions available on dating apps, such as HIV-status disclosure fields, as well as sexual health information and resources.

“[HIV phobia] is probably the most intense, subvert bigotry I think you could experience,” Joseph Monroe Jr., a 48-year-old living in the Bronx, told Uncloseted Media.

On dating apps, men have messaged him things like, “You look like you’ve got that thing” and “Go ahead and infect someone else.”

Monroe has also dealt with misinformed people who rudely opine about how he contracted the virus: “Who fucked you? That’s how you got it, right?” people will say to him.

“You end up internalizing all these stereotypes about who gets HIV — that you were promiscuous, that you didn’t care about yourself, that you did something wrong,” says Smith. “You carry that in, and then you have to relearn: ‘No, I didn’t. This is just a health condition.’”

What HIV acceptance looks like and raising awareness

For those living with HIV, acceptance feels far away.

“You’re living under this threat of HIV and the threat that others find you threatening. It inhabits you socially and sexually,” Koester says. “People are hunkering down. Not putting themselves out there and having a mediocre quality of life. To have a sense of empowerment, you have to be legitimate and seen in the world and it’s hard to do that with the stigma that exists.”

Researchers say the path forward lies as much in conversation as in medicine.

Koester says she talks about HIV and PrEP anywhere she can, including in salons, cafes and restaurants. “Whenever I get into a cab with someone, I’m going to bring up HIV so the driver gets accustomed to hearing about it. … We have a long way to go in terms of exposure and awareness and every little bit helps.”

Part of this lies in increasing awareness through targeted marketing campaigns. PrEP is still profoundly misunderstood outside major urban centers, with uneven uptake among minority groups and usage gaps in the Bible Belt. And a 2022 U.S. survey found that 54.5 percent of people living with HIV didn’t know what U=U meant, and less than half of Americans agree that people living with HIV who are on proper medications cannot transmit the virus.

While eradicating stigma is slow, there is hope for acceptance.

Years after Jack’s diagnosis, in 2021, he told a man he was on a third date with that he was HIV-positive but undetectable. His date’s reply was almost casual:

“Oh — is that it? I thought you were going to say you had a boyfriend or something. I’m on PrEP. You’re fine.”

“It felt so good to hear him say that and accept me,” says Jack. “I was like, ‘This is my person. You’re my person.’” One year later, they got married.

Back in Florida, 19-year-old Cody Nester isn’t feeling this acceptance. He still scrolls past profiles that read “Only negative guys” and tries to ignore the hateful messages.

“It still hurts, but I know it’s coming from fear,” he says. “I wasn’t too informed about HIV before I got it. … When I got it, I really jumped into the rabbit hole and began to learn. I really do think [HIV and stigma] is because people are not knowledgeable. … When people don’t know details, they tend to get scared.”

Additional reporting by Nandika Chatterjee.

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