Black Women, HIV, and the Lie of the "Down Low": What the Data Actually Says

Education Is Elevation is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.I asked Dr. Dontá Morrison a question I knew was going to be uncomfortable. I told him it was uncomfortable on purpose. When somebody says “that’s gay as AIDS,” what is that? And he didn’t blink. He called it ignorance at its finest. He pointed out that half the people still using the phrase don’t even know what AIDS stands for — Acquired Immunodeficiency Syndrome. He pointed out that if you’re still saying AIDS in 2026, you’re stuck in 1986. You equating a virus to a demographic of human beings. That’s the receipts on how shallow the thinking still is.The conversation I had with Dr. Morrison wasn’t really about a slur. It was about what that slur reveals — that we are operating with an archaic, decades-old understanding of HIV inside Black communities, while a federal administration is actively dismantling the funding that keeps Black folks alive. Two things are true at the same time, and both of them are killing us.HIV Is Not AIDS — And Knowing the Difference MattersBefore I go further, let me handle some basic education, because Dr. Morrison was right — folks don’t know. HIV is the human immunodeficiency virus. It’s a virus that attacks your immune system. AIDS, on the other hand, is the most advanced stage of HIV infection, a syndrome that develops only when HIV has gone untreated long enough to severely compromise the immune system. With consistent antiretroviral therapy, a person living with HIV today can suppress the virus to undetectable levels, live a full lifespan. Undetectable equals untransmittable — U=U is settled science.Saying “AIDS” the way folks said it in the eighties is not just rude. It’s wrong and stigmatizing and pathological It collapses a manageable chronic condition back into a death sentence in your mouth, and that linguistic time travel does material harm. It keeps people from testing. It keeps people from disclosing. It keeps Black women from asking their men hard questions. It keeps the church from doing the work. Education is elevation. Same pill Magic Johnson takes, regular folks take. You do not need Magic Johnson money to survive HIV-positive in 2026. Period.The Trump Cuts Are Not AbstractDr. Morrison is a public health doctor. He earned that degree. And last year, he woke up one morning to a phone call telling him his program had been cut overnight. The federal government, under this administration, signed away the funding for the work he had been doing for over twenty years — sexual health and HIV education in the Black community, with a particular focus on the Black church. One signature, no notice, gone. That’s not a hypothetical. That’s a brother who put in the work, doing the work without unemployment, watching his livelihood get dismantled in the name of America First.And the receipts on this are public. The Trump administration came into office in January 2025 and immediately froze foreign aid. The President’s Emergency Plan for AIDS Relief — PEPFAR — got hit. The Office of Management and Budget released only about half of the $6 billion Congress appropriated for PEPFAR’s 2025 funding. Nearly 70,000 community healthcare workers were laid off in 2025 according to the PEPFAR data release, and many specialized outreach services were shut down. The number of PEPFAR-funded HIV tests declined by 14 million in 2025 compared to the year before — a 17 percent decrease. As of this week, the administration is now trying to divert another $2 billion in global health funding to pay for the shutdown of USAID itself.Let that marinate. They are taking money meant to keep people alive and using it to pay the legal bills for dismantling the agency that was keeping people alive. Every accusation is a confession. They told us they were going to gut foreign aid. They told us American leadership in global health was over. We just didn’t believe them because we were taught the United States was the leader. And here is where I have to give the receipts on what we are actually losing.The United States Was the Global Leader on HIV/AIDS — On PurposeI want y’all to understand something. The U.S. did not become the global leader in HIV/AIDS research and response by accident. It happened through deliberate, bipartisan policy across multiple administrations, and Black-led advocacy was central to forcing it to happen. The U.S. first provided funding to address the global HIV epidemic in 1986. In 1999, President Clinton announced the Leadership and Investment in Fighting an Epidemic Initiative to address HIV in 14 African countries and India. Then in 2003, President George W. Bush created PEPFAR.PEPFAR is not a small thing. As of August 2024, PEPFAR has provided cumulative funding of $120 billion for HIV/AIDS treatment, prevention, and research, making it the largest commitment by any nation focused on a single disease in history. It is credited with saving more than 26 million lives over the past two decades and preventing millions of HIV infections, particularly in Africa. PEPFAR accounts for more than 90 percent of PrEP initiations globally. Translation: nine out of every ten people on the planet getting access to HIV prevention medicine were getting it through American funding.That is the program this administration is choking out. The administration’s FY 2026 budget request includes a $1.9 billion reduction for PEPFAR. As of February 2026, only 16 country agreements have been completed, and overall current pledges will result in a $4.5 billion decrease in U.S. funding for PEPFAR countries over a 5-year period. Notably, South Africa — the country with the highest HIV burden globally — has not been included. Read that again. The country where the most Black people in the world are dying of this disease is not at the table. That is not an accident. That is policy.The Global Becomes the Local — Because We Are the Same PeopleSome of y’all might be reading this thinking, “That’s overseas, that ain’t us.” Liberalism is a hell of a drug. Pan-Africanism is not a vibe — it’s an analysis. The same logic that pulls funding from clinics in Lagos and Kampala pulls funding from clinics in Atlanta and Jackson. The same administration that froze PEPFAR also went after Title X, also went after CDC HIV prevention budgets, also went after community-based programs serving Black queer folks here in the States. Dr. Morrison’s program was domestic. The brothers and sisters who lost their jobs were here. The Black women who are not getting the workshops, not getting the lunch and learns, not getting the pamphlets at their hair salons — they are here.And the disparities in this country are already brutal. Compared to White non-Hispanic heterosexually-active persons, Black heterosexually-active people have a 20-fold higher HIV diagnosis rate. A 20-fold higher rate. Two thousand percent. Among African American women, 92 percent of new HIV diagnoses were attributed to heterosexual contact. Dr. Morrison hammered this point and I want to drag it into the light: stop blaming the down low. Stop blaming gay men. There are cisgender heterosexual men contracting HIV and passing it to cisgender heterosexual women, and the gay community has nothing to do with that transmission chain. Two things can be true. Black gay men carry their own disproportionate burden. Black straight women are catching HIV from Black straight men. Both of these things are happening simultaneously, and both require funded, culturally specific intervention.The Faithful and the ForgottenThis is where Dr. Morrison’s work cuts deepest. He is the author of “Faithful and Forgotten: Navigating Race, Sexuality, and Belonging in the Black Church,” and the title alone tells you everything. The Black church is the most powerful institution we built ourselves. It was the only institution White society left relatively alone, which made it the staging ground for abolition, the civil rights movement, and Black social life as we know it. And that same church has, in too many corners, become a place where Black queer folks — particularly Black men who have sex with men — experience spiritual violence dressed up as scripture.Dr. Morrison made a point in our conversation that I’m still chewing on. He said a lot of folks are quietly rooting for Trump’s HIV cuts because they don’t like gay people, because they still associate HIV with homosexuality, and because they have a skewed approach to Christianity that supports white supremacy. Read that one more time. The same Black folks who claim they want liberation are clapping for the dismantling of the very programs that keep their cousins, their aunties, their nephews, their sisters alive — because they think God is anti-gay. That is theology imported from the same plantation logic that taught our ancestors that their humanity was conditional. Where is the smoke for that?Faithful and Forgotten is not an attack on the Black church. It’s a call for the Black church to do what it claims to do — to be the moral conscience of the community, to leave the ninety-nine and go after the one. You can’t preach Jesus and silently celebrate a policy that cuts off the antiretrovirals keeping your nephew alive. You can’t say you love Black people and only love the Black people whose sexuality you approve of. Two things can be true. The Black church is sacred. The Black church is also implicated. We grow by holding both.What Dr. Morrison Is Still Doing — Without the MoneyHere is the part that should hit every reader in the chest. Dr. Morrison lost his funding. He didn’t lose his calling. He compared himself to a TSA worker — pissed off, unpaid, but still showing up because lives are still at risk. He’s still hosting conversations. He’s still doing free interviews like the one we just did. He’s still writing books. He’s still showing up at churches and conferences and community spaces because he understands that without the money, all we got is word of mouth, and word of mouth is what built every Black liberation movement we have ever had.Word of mouth has a ceiling, and that ceiling is real. He told me directly: without the money, we can’t host the workshops, we can’t host the conferences, we can’t have the virtual lunch and learns, we ain’t got no raffle tickets, we ain’t got no Target gift cards. People show up to information sessions partly because there’s something tangible attached. Y’all who have done community organizing know exactly what he means. The defunding doesn’t just kill the big infrastructure. It kills the small incentives that get a sister in her sixties to walk through the door of a church basement and learn that HIV is not what she thought it was when she was twenty-five. That’s what’s been stolen.What This Moment Demands of UsDr. Morrison left me with a charge I want to pass directly to y’all. Black folks need to wake up and realize we are living in a country that is not for us. The performative outrage at one man — Trump — is a distraction. As Dr. Morrison said, this is not 100 percent about him; he is one person, but he is supported by individuals that think like him, and that group think is taking us all backwards. The folks rooting for these cuts because they think God is doing it through Trump need to be confronted, not coddled. Liberalism is a hell of a drug. So is bad theology.So here’s what I’m asking. Get tested. Get your people tested. Stop saying “AIDS” when you mean HIV. Stop saying “gay as AIDS,” period. Read “Faithful and Forgotten.” Talk to your church about HIV like it’s a community health issue, not a sin problem — because that’s what it is. Talk to the Black women in your life about how transmission actually works, because the data says they are catching it from cisgender heterosexual men, not from a phantom down-low boogeyman. Support the doctors and educators like Dr. Morrison who are doing the work without the funding. And the next time somebody tells you the federal government cutting global health funding doesn’t affect you, hand them this article.Same pill Magic Johnson takes, I take. Same pill regular folks take. The science exists. The medicine exists. What’s being dismantled is access. And access is the whole game.Learn more about Dr. Dontá Morrison’s work, his book Faithful and Forgotten: Navigating Race, Sexuality, and Belonging in the Black Church, and his ongoing HIV education and advocacy at www.dontamorrison.com Follow him on YouTube to learn more and follow Dr. Morrisons work. https://www.youtube.com/@dontamorrison5 Key Takeaways1. HIV is not AIDS, and using “AIDS” as a slur is decades-out-of-date misinformation that actively harms Black communities.HIV is a manageable chronic condition with treatment. AIDS is the advanced stage that develops only when HIV goes untreated. Undetectable equals untransmittable. The vocabulary you use shapes the testing, disclosure, and treatment behavior of everyone around you.2. The Trump administration’s dismantling of HIV funding is killing people — domestically and globally — and the data backs that up.PEPFAR-funded HIV testing dropped by 14 million in 2025, nearly 70,000 community healthcare workers were laid off, and OMB has slow-walked half of the $6 billion Congress appropriated. Domestic programs like Dr. Morrison’s were cut overnight. This is structural violence with a budget line.3. The United States became the global leader on HIV/AIDS through deliberate, bipartisan policy — and that leadership is being dismantled in real time.PEPFAR has provided $120 billion in cumulative funding since 2003, saved 26 million lives, and accounts for 90 percent of global PrEP initiations. The administration’s FY 2026 budget cuts it by $1.9 billion and excludes South Africa — the country with the highest HIV burden globally — from new agreements.4. Black women carry a disproportionate HIV burden, and the transmission story is being told wrong.92 percent of new HIV diagnoses among Black women come from heterosexual contact. Black heterosexually-active people have a 20-fold higher diagnosis rate than their White counterparts. The down-low narrative is a distraction from the actual transmission chain: cisgender heterosexual men passing HIV to cisgender heterosexual women.5. The Black church is both a critical resource and a site of harm — and Dr. Dontá Morrison’s “Faithful and Forgotten” demands we hold both at once.Eurocentric interpretations of Christianity have made the Black church a place of spiritual violence for Black queer folks, while simultaneously being one of the few institutions positioned to do mass HIV education. Two thingsEXPLICIT ASK TO BECOME PAID SUBSCRIBERLet me be transparent with y’all. The conversation you just read with Dr. Dontá Morrison happened because two independent Black workers — one a public health doctor, one a media educator — sat down to do work that used to be funded by federal dollars and is no longer funded by anybody. He lost his program. The corporate media is not covering Black HIV stigma with this level of cultural specificity. The federal government is actively defunding the prevention infrastructure. The void is real, and it is being filled by people like Dr. Morrison and people like me, out of pocket and on principle.If this piece taught you something, sharpened your analysis, or gave you ammunition to use in your own community, I’m asking you to convert that value into material supportEducation Is Elevation is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.CITED SOURCESMorrison, Dontá. Faithful and Forgotten: Navigating Race, Sexuality, and Belonging in the Black Church. 2025.U.S. Department of State, Bureau of Global Health Security and Diplomacy. “The President’s Emergency Plan for AIDS Relief (PEPFAR).” state.gov/pepfar.Kaiser Family Foundation (KFF). “The Trump Administration’s Foreign Aid Review: Status of PEPFAR.” October 2025.CNN. “The Trump administration is trying to divert $2 billion in global health funding to pay for USAID shutdown.” May 2026.Centers for Disease Control and Prevention (CDC). “Health Disparities in Black or African American People” and “HIV Among African Americans” fact sheets.amfAR (Foundation for AIDS Research) and UNAIDS. Reports on PEPFAR Stop Work Order Impact, 2025–2026.The Leaflet. “How US Funding Cuts Created a Double Threat to HIV Progress in Africa.” April 2026.Thanks for reading Education Is Elevation! This post is public so feel free to share it. This is a public episode. 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