Another election has passed, and with it comes the promise of change — or the threat of backsliding. As people who have fought on the front lines of the AIDS epidemic, we know all too well how much power Washington, D.C. wields over the lives of people living with HIV. We've seen what happens when our government turns its back on the vulnerable, and we've seen what we can achieve when we refuse to accept their apathy.
Let us be clear: the stakes for people living with HIV, particularly here in San Francisco, could not be higher. The nominees being floated for key roles in the next administration — those who will decide the future of our health care, prevention strategies, and human rights — are a direct threat to everything we've fought for.
Nowhere is this more apparent than in the nomination of Robert F. Kennedy Jr. to a critical cabinet position overseeing public health policy. This nomination to lead Health and Human Services is not only deeply concerning, it poses a grave threat to the health and well-being of people living with HIV and LGBTQ+ communities. RFK Jr.'s history of spreading misinformation about vaccines and undermining public health initiatives directly contradicts the evidence-based approaches that have saved millions of lives in the fight against HIV and other infectious diseases.
This appointment threatens to erode decades of progress in advancing LGBTQ+ health equity and ensuring access to lifesaving prevention and treatment services. It signals a dangerous shift away from science-driven policy and compassion-centered care — cornerstones of public health that our communities rely upon to thrive. The appointment of RFK Jr. would send a chilling message: that science, evidence, and the well-being of marginalized communities are expendable. This is a punch to the gut to those of us who have spent our lives advocating for policies grounded in truth and compassion.
These aren't abstract dangers. They are wolves in the hen house, people who have spent their careers undermining the very systems that have saved millions of lives. They don't believe in harm reduction. They don't believe in LGBTQ+ equality. And they sure as hell don't believe that health care is a human right.
The implications of this political landscape are staggering. Federal funding for programs like Ryan White HIV/AIDS Program, the Centers for Disease Control and Prevention's Division of HIV Prevention, Housing Opportunities for People With AIDS, the National Institutes of Health's Office of AIDS Research, Minority AIDS Initiative, the ACA/Medicaid expansion, and Substance Abuse and Mental Health Services Administration's harm reduction initiatives — cornerstones of care for people living with HIV and people who use substances — are now at risk. In San Francisco, these funds are not just numbers in a budget; they are the lifeline for thousands of people who rely on access to medications, mental health support, housing, and prevention tools like PrEP. Without this support, the most vulnerable among us will be left to fend for themselves in a system designed to exclude them.
For decades, San Francisco has been the epicenter of resistance. When the government ignored us during the early days of AIDS, we didn't wait for them to care. We created our own systems — our own model of care that put love and dignity at the center of medicine. But make no mistake, we were able to do that because we demanded accountability. We fought tooth and nail for every penny of federal funding, every inch of progress.
Today, that fight is as urgent as ever. The programs we built — Ryan White funding, PrEP subsidies, harm reduction services — are under siege. For people living with HIV in San Francisco, losing these supports could mean losing their lives. The coming battles in Congress and the White House will not just be about budgets and policies — they will be about whether our lives matter.
And to the new administration, we say this: We are watching you. Don't think for a second that your campaign promises or previous time in office have been forgotten. You said you would prioritize ending the HIV epidemic. Prove it. Or prepare to face the wrath of a community that knows how to fight.
Because we will fight. That's what San Franciscans do. From the Castro to City Hall to the steps of the Capitol, we've always made our voices heard. And we're not afraid to be loud, to be angry, to demand what is ours: the right to live with dignity, to thrive, to be seen as full human beings.
For those who think this is just rhetoric, let us remind you of the price we've already paid. We have buried too many of our own. We have held the hands of the dying. We have fought, cried, and screamed for a better future. We won't let you take that future away from us.
But this is not just about fighting back. It's about moving forward. It's about building a world where HIV is not a death sentence, where stigma is a relic of the past, and where everyone — regardless of race, gender, sexuality, or income — has access to the care they need.
San Francisco has always been a beacon of what's possible. We've led before, and we will lead again. But we can't do it alone. We need every one of you — every activist, every ally, every person living with HIV — to join this fight.
The election may be over, but the battle for our lives continues. And if history has taught us anything, it's this: When we stand together, we are unbreakable.
Cleve Jones is a co-founder of San Francisco AIDS Foundation, creator and co-founder of the AIDS Memorial Quilt and author of "When We Rise: My Life in the Movement." He is a human rights activist with a history of activism spanning five decades.
Tyler TerMeer, Ph.D., is CEO of San Francisco AIDS Foundation, a member of the AIDS United Governing Board of Directors and has served for nearly a decade as the elected co-chair of the AIDS United Public Policy Council. He is passionate about improving the health of people living with HIV, ensuring that LGBTQ+ people have access to affirming care, that our nation's overdose response is treated with the dignity and humanity that all people deserve, and in supporting and empowering, Black-led organizations and Black and Brown leaders. TerMeer holds a Ph.D. in public policy and administration from Walden University.
Both authors are living with HIV.
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