Backsliding on Progress: The Trump Administration's Assault on LGBTQI+ and HIV Health Equity—A Domestic and Global Reckoning

Abstract The Trump administration wasted no time undermining LGBTQI+ health and the health of people living with HIV both globally and domestically, including through attacks on PEPFAR, the world's largest HIV/AIDS program. Two senior officials from the Biden administration, one who led LGBTQI+ policy at the US Department of Health and Human Services, and the other, who was acting chief of staff for PEPFAR at the State Department, propose a response to the impact of these drastic, chaotic, and unprecedented attacks on global health and the human rights of LGBTQI+ and people living with HIV from both a global and domestic health security lens. The authors plan to highlight the anticipated long-term impact on the health and well-being of LGBTQI+ and HIV+ people and the organizations who care for and support them, and PEPFAR's ability to sustain progress on programs for key populations. Their analysis will explore how these destructive actions will lead to worsened health disparities and new outbreaks of preventable disease.