Forty years later, the unequal impact of HIV persists — and we refuse to accept it

Forty years ago, the Centers for Disease Control and Prevention first reported that black and Hispanic people were disproportionately affected by HIV. Today—four decades later—those disparities persist, and for Transgender, Gender Non-Conforming, and Non-Binary (TGNC/NB) communities, they have become even deeper.

That reality should outrage us all. Because what was once a public health emergency has become a test of our collective will — a question of whether we truly believe that the health of each of us deserves equal protection. We must do much harder, especially for TGNC/NB people whose experiences are too often erased in both policy and practice.

In 2025, we know more about HIV than ever before. We have powerful prevention tools such as pre-exposure prophylaxis (PrEP), including long-acting injectables, and post-exposure prophylaxis (PEP). We have effective treatments that allow people living with HIV to live long, healthy lives, and suppress the virus until it is undetectable and untransmittable. And we know how to end the epidemic: by ensuring broad and equitable access to the prevention, treatment and care strategies we already know work.

And yet, in New York and across the country, Black and Hispanic/Latino communities—especially Black and Hispanic/Latino gay and bisexual men, transgender and cisgender women of color, and youth of color—continue to bear the greatest burden of this disease. Although Black and Hispanic/Latino people make up only 12% and 19% of the U.S. population respectively, Black people make up 39% of HIV diagnoses and 40% of people living with HIV, while Hispanic/Latino people make up 31% of HIV diagnoses and 26% of people living with HIV, according to the most recent data from the Centers for Disease Control and Prevention. For TGNC/NB people, particularly transgender women of color, HIV prevalence remains unacceptably high.

These disparities do not exist because of people’s personal decisions. They exist because systems have failed — systems rooted in racism, transphobia, xenophobia, stigma, and structural neglect. Systems that continue to underfund organizations with TGNC/NB leadership and overlook solutions created by the most affected people themselves. The pervasiveness of these injustices in American institutions, policies, and practices is what led Governor Hochul to create an Equity Agenda to “protect the fundamental rights of all New Yorkers and expand the opportunity for people of all backgrounds, beliefs, and identities to pursue the New York Dream,” including achieving optimal health for Black and Hispanic/Latino New Yorkers. That promise must be extended fully to TGNC/NB communities — not piecemeal, not symbolically, but with meaningful investment and action.

At Amida Care, Callen-Lorde Community Health Center, Destination Tomorrow, the Latino Commission on AIDS, and the National Black Leadership Commission on Health, we have seen firsthand how inequities in access to health care, housing, education, income, mental health services, and social supports perpetuate the HIV epidemic. We’ve also seen what happens when we invest in culturally competent, community-led care: people get tested, people get treated, and people thrive.

On this World AIDS Day, we can celebrate advances in medical treatment as effective prevention. We can also recognize the importance of programs like Medicaid and Ryan White, rapid and routine testing, harm reduction efforts, and “Ending the HIV Epidemic” initiatives as smart and successful approaches. At the same time, recent and proposed cuts to these programs threaten to slow or reverse the progress we have made. Now more than ever, it is important to ensure that progress reaches all people.

That is why we call for urgent and coordinated action at all levels of government and the community to confront these disparities head-on. Must:

• Continue to invest in community-based and culturally responsive healthcareincluding gender-affirming care, that recognizes the unique experiences and needs of TGNC/NB people.
• Expand equitable access to prevention and treatmentincluding PrEP, PEP and HIV care, addressing stigma (homophobia, transphobia and xenophobia) and economic barriers.
• Fund housing, food assistance, mental health and harm reduction services with a TGNC/NB equity perspective, because HIV is not just a medical issue — it is a social justice issue.
• Center Black and Brown Leadership including LGBTQ+ people, women, youth and people with lived experience in designing HIV prevention and care strategies.
• Protect financing Medicaid, Ryan White, research, community health centers, community organizations, and organizations that provide vital education and social support services to TGNC/NB communities.

Each HIV statistic represents a person — a son, a daughter, a friend, a neighbor — whose health and dignity matter. Every policy delayed, every clinic underfunded, every community overlooked deepens an injustice that has lasted for generations. Cuts to Medicaid funding will only worsen the impact of HIV on communities of color.

We can commemorate World AIDS Day, but we cannot afford to commemorate another decade of disparities. The science is clear, the tools are here and the need is urgent. The only question that remains is whether we will act. We are getting closer to ending the epidemic for everyone, but we must continue to move towards that goal.

At Amida Care, Callen-Lorde Community Health Center, Destination Tomorrow, the Latino Commission on AIDS, and the National Black Leadership Commission on Health, we are committed to building a future where a person’s race, gender identity, sexuality, immigration or economic status, physical or mental ability, or ZIP code do not determine their health outcomes. Ending HIV means ending inequity — and that starts with all of us.

The time to reflect has passed. The time to act is now.

By Guillermo ChaconPresident, Latino Commission on AIDS; Sean ColemanFounder/CEO, Destination Tomorrow; Joe PressleyVice President of Public Policy and Government Relations, Amida Care; Kimberleigh Joy SmithExecutive Vice President of Public Policy and Communications, Callen-Lorde Community Health Center; y Shirley TorhoPresidenta y CEO, National Black Leadership Commission on Health