HIV criminalization on a global level
HIV criminalization on a global level
“In 2025, HIV criminalisation remained a persistent, global human rights and public health failure—visible both in the rise in reported prosecutions and in the continued mismatch between HIV science and legal practice,” writes the HIV Justice Network. The global organization released its annual report on HIV criminalization in January.
According to HIV Criminalisation 2025 – A Year in Review, “In the United States, state-level action remained the primary driver of change. In Maryland, the governor signed legislation repealing the state’s HIV-specific criminal statute, removing a law long criticised for its incompatibility with current scientific evidence. North Dakota also enacted legislation addressing outdated HIV criminalisation provisions, narrowing their scope and reducing the reach of HIV-specific penalties.”
Which country accounted for more than half of the 112 cases around the globe reported by the network? Uzbekistan.
“This is partly because Uzbek courts publish all HIV criminalisation cases online, but mainly due to an exceptionally broad and punitive legal framework combined with extensive mandatory HIV testing,” the report notes. Mandatory testing identifies people with HIV, unlike confidential testing, which keeps their identity private. This also helps them seek the care they need, but privately.
Some themes remained constant around the world, including law enforcement’s focus on marginalized groups such as gay men and trans women and on punishment for “no-risk conduct framed as intentional harm,” such as spitting cases.
The HIV Justice Network’s vision is “of a world where people living with HIV, in all our diversity, can enjoy our human rights and live in dignity, without fear of unjust criminalisation, regulation or control.”
GO TO hivjustice.net/news/2025-in-review-more-reported-cases-uneven-reform
Gender-affirming clinics under attack
Three clinics providing gender-affirming care for transgender youth are now under investigation by the U.S. Department of Health and Human Services (HHS). HHS has basically declared war on such care. The three hospitals under scrutiny are the Seattle Children’s Hospital, Children’s Hospital Colorado and Children’s Minnesota.
A lawsuit filed in December against HHS for its negative stand on gender-affirming care for youth is helping limit further action against the clinics. A comprehensive report from The 19th details the ongoing challenges: 19thnews.org/2026/01/gender-affirming-care-youth-hospitals. The 19th is an independent nonprofit news outlet focusing on “gender, politics, policy and power.”.
Navigating PrEP access
Using PrEP—HIV prevention in the form of pills or long-acting injectables—can help people from acquiring the virus, but it can still be difficult to get the medication. An article from KFF (formerly the Kaiser Family Foundation) follows one man’s frustrations.
“When Matthew Hurley was looking to take PrEP to prevent HIV, the doctor hadn’t heard of the medicine, and when he finally did prescribe PrEP, the bills sent to Hurley were expensive…and wrong. ‘I decided to write in because the process was really super frustrating.’ At one point, Hurley asked, ‘Am I just going to stop this medication to stop having to deal with these coding issues and these scary bills?’”
The January 5 story details Hurley’s journey and provides tips on how to get your PrEP and keep it coming. Titled “To Knock Down Health-System Hurdles Between You and HIV Prevention, Try These 6 Things,” the article includes information on how to overcome billing problems and educate your provider (sadly, it’s still an issue), along with a reminder to get your required lab work done in-network (so that it’s covered by your insurer).
Monitoring HIV decriminalization by state
The Health Not Prisons Collective has launched an online bill tracker to monitor legislation tied to HIV criminalization and sex work decriminalization across the United States. The tool compiles state-level bills in the 2025–2026 legislative session, offering advocates a centralized way to follow policy developments that affect people living with HIV.
The tracker highlights bills that could either advance or undermine public health–centered approaches, says the HNP Collective, including legislation related to HIV exposure laws, sex work and broader criminalization trends. It also reflects an expanded scope: recent updates include monitoring proposals such as mask bans, which advocates warn may increase surveillance and policing of communities already disproportionately impacted by HIV.
Advocates are encouraged to submit additional legislation for inclusion, underscoring the project’s aim to build a more comprehensive, community-informed picture of how state laws shape HIV-related outcomes nationwide. The collective is an initiative led by organizations that include the Positive Women’s Network–USA and The Sero Project.
GO TO healthnotprisons.org/bill-tracker.
—Rick Guasco
HIV testing and college students of color
Results of a survey of 110 students published in the Journal of American College Health show a lag between awareness of HIV and use of prevention resources.
“African American/Black and Hispanic/Latino college students experience disproportionate rates of HIV and other sexually transmitted infections (STIs) compared to their [w]hite peers, yet remain underserved by campus-based sexual health services,” report authors Nmesoma F. Anya, BSN, and Jaquetta M. Reeves, PhD. “National data indicate that individuals aged 18–24 years account for nearly half of all new STIs in the United States, and racial/ethnic disparities persist across all major infections. Structural barriers—such as stigma, limited access to testing and lack of culturally relevant education—further hinder prevention efforts among minority student populations.”
Their study found that, “Despite being sexually active, the majority of participants reported never undergoing testing for HIV (74%, or 81 students) or other STIs (68%, 74 students). Given that people ages 18–24 account for a large share of STI transmission, this finding points to a missed opportunity for early detection and prevention.”
When participants were asked specifically about certain measures of sexual health, the survey found:
- awareness of [HIV] self-sampling kits (23.6%) and PrEP [medication used for HIV prevention] (18.2%) was low
- inconsistent condom use was common
- only 2.7% had used a kit
Still, most of the students said they recognized that young adults are vulnerable to HIV (91.8%) and STIs (97.3%).
“Expanding culturally relevant education, PrEP outreach and self-sampling access is essential to advance sexual health equity,” Anya and Reeves state in their conclusion.
The survey of students at a large public university in North Texas (64.8% were Black and 35.2% Hispanic/Latino) was completed anonymously online in 2023.
To read the report,” published online December 30 and available as open access (free), GO TO tandfonline.com/doi/full/10.1080/07448481.2025.2607140#abstract.
Emergency measure returns ADAP eligibility to thousands in Florida
Florida Gov. Ron DeSantis signed a bill, HB 697, restoring funding through June 30 to the state’s AIDS Drug Assistance Program (ADAP), returning aid eligibility to about 12,000 recipients. The emergency law partially restores healthcare for Floridians with HIV who were thrown into a panic in January when the state’s Department of Health (DOH) dropped the threshold for financial assistance for ADAP and removed Biktarvy from the ADAP formulary, citing a $120 million shortfall caused by federal funding cuts. The new law is considered a stopgap solution until lawmakers pass a new state budget for the 2026–27 fiscal year, which begins July 1.
What the new law does:
- Provides $31 million to fund ADAP through June 30, 2026.
- Restores financial assistance, including co-pays, for ADAP recipients whose annual income is up to 400% of the poverty level (about $62,600), from 130% of the poverty level, or only up to $20,345, proposed in January.
- Directs DOH to assist with co-pays for Floridians on Medicare or employer-based insurance.
What the new law does not do:
- Reverse the restrictions on Biktarvy for ADAP recipients, nor does it relax the restrictions on Descovy.
- Restore premium assistance for the lowest-income Floridians.
- Affect people on private insurance or Medicare/Medicaid.
- Terminate any ADAP recipient’s health insurance plans.
- Determine the long-term structure of ADAP after June 30.
New letters from DOH to ADAP recipients are expected to be sent soon. DOH is providing updates to ADAP at floridahealth.gov/individual-family-health/injury-prevention-wellness/hiv-aids/hiv-aids-management.
The new law also requires DOH to submit monthly reports detailing all federal revenues and expenditures to the Senate Appropriations Committee and House Budget Committee. The reports must itemize manufacturer rebates, enrollment figures by county, prescription utilization by drug class and projected funding deficits. This provision offers transparency, which advocates say has been sorely lacking from DOH.
Michael Rajner, a volunteer HIV activist from Fort Lauderdale who has spent months commuting to Tallahassee to urge legislators to reverse the ADAP, expressed relief at the passage of the stopgap bill but shared some bitterness about DOH.
“The community has risen up and legislators listened,” Rajner told POSITIVELY AWARE. “But the Department of Health has not been—and is still—not transparent.”
Where to find help
Because the law is a temporary solution and only valid for little more than three months, people on ADAP who still fall short on paying their premiums are encouraged to shop for more affordable plans during the special enrollment period, which ends April 30. Covering Florida, the state’s navigator for Affordable Care Act plans, can offer assistance in finding new coverage.
In addition, people in Miami-Dade County may have additional assistance, thanks to a proposed resolution that would provide $1 million to ADAP services. For people who are uninsured, a database can help locate health centers.
Gov. DeSantis signed the measure on March 24. Advocates say their efforts to restore full ADAP services for Floridians will continue, as the fate of premium assistance for the upcoming fiscal year is still in question. Budget negotiations are expected to start in April, just as the 2026 election season heats up.
—Larry Buhl
Ciara joins One2PrEP campaign to promote twice-yearly HIV prevention
One office visit every six months, two times a year for HIV prevention—that’s the message of a recently unveiled national advertising campaign with music based on Grammy Award–winning singer Ciara’s 2004 dance hit 1, 2 Step, with rapper Missy Elliott and producer Jazze Pha.
Launched during the Super Bowl pregame and the Grammy Awards, the peppy commercial featuring men and women, cis and trans, straight and gay helps with one problem plaguing HIV PrEP: lack of awareness.
“There was a nostalgic feeling with this campaign because I remember back in the day the conversation was really big surrounding HIV and AIDS,” Ciara told Time magazine in a video interview. “The awareness level was really high, and I think over time it subsided a little bit and those conversations fell to the wayside. But the reality is that this disease is still rolling strong and there’s so much opportunity for people to protect themselves. … Talk about the PrEP shots alone. It’s groundbreaking. We’re talking about game-changing science. Wherever there is an opportunity where I can impact someone’s life and essentially help save a life, I’m going to be first in line to do it because I feel an obligation to do that with my platform. I just don’t think that I’m given this amazing platform to just sing and dance.”
The campaign promotes Yeztugo, the long-acting HIV prevention medication from Gilead Sciences, which came on the market last year.
“I just thought, ‘This is such an amazing opportunity where you get to see the power of music coming together with the power of medicine, essentially, but ultimately you see impact on someone’s life,’ ” Ciara told Time.
She re-recorded part of her song for the campaign.
“PrEP is not solely for gay people,” said Leo Moore, MD, MSHPM, AAHIVE, at a Gilead-sponsored panel that included Ciara, held at the South by Southwest (SXSW) festival in March, in Austin. As reported by The Grio news site, Dr. Moore explained, “There are many heterosexual men and women who can benefit from PrEP that aren’t considering it because they think it’s solely for the LGBTQ+ community. So, this is ensuring that folks are aware that the [Centers for Disease Control and Prevention] recommends that everyone, adults and adolescents who are HIV-negative, consider PrEP.”
Dr. Moore has served on the Presidential Advisory Council on HIV/AIDS (PACHA).
“I want for my people, and beyond, to understand that there are ways to protect yourselves when you’re out there and you’re curious and you’re dating,” The Grio reported Ciara as saying. “[Once you] take things to new levels physically, you need to know that there are ways to protect yourself on that journey…let’s have conversations. Let’s take away the stigmas or the funkiness of these types of conversations.”
One during your winter glam and one during your summer glow. One during your wintertime and one during your summer shine. To see the Yeztugo One2PrEP commercial, GO TO youtube.com/watch?v=ssBBnGZQfxM. Catch the original dance extravaganza at youtube.com/watch?v=iBHNgV6_znU. To read The Grio’s report, GO TO thegrio.com/2026/03/19/ciara-says-protecting-your-sexual-health-is-a-1-2-prep-process.