Donald Trump, the Republican nominee for U.S. president, has no official policy on HIV/AIDS. Trying to determine what a Trump administration policy might be is nearly impossible if you focus only on Trump himself. For the interested voter, the past actions and policies of Trump's running mate Mike Pence may be a more useful gauge of how people living with HIV/AIDS in America and abroad would fare with a Trump White House.
Given recently confirmed reports that Trump Jr. tried to entice John Kasich to join the ticket by vowing he'd be a vice president with unprecedented control over both foreign and domestic policy, it is reasonable to assume that selected running mate Mike Pence would have a leading role in shaping Trump's HIV/AIDS policy.
By that measure, their election doesn't look good -- and could be an unmitigated disaster -- for people living with HIV/AIDS. There is nothing in Pence's statements or actions to suggest that he has learned anything from the HIV outbreak that ran rampant through Scott County, Indiana, when he governed the state. As one indication of his HIV priorities, his advocacy for LGBT conversion therapy while in the U.S. House of Representatives included proposing that the Ryan White Care Act be reauthorized only if monies were redirected towards organizations "which provide assistance to those seeking to change their sexual behavior."
Over the past 30 years, vice presidential picks have been unlikely to sway public opinion much, though the screw-ups (Dan Quayle in '88/'92, Sarah Palin in '08) have had a greater impact than the successes (Al Gore in '92/'96, Joe Biden in '08/'12). Given this recent history and the fact that Donald Trump is such a polarizing figure within the Republican Party, it's not surprising that he chose a seemingly vanilla running mate like Mike Pence.
However, it is vital that voters -- and especially HIV-positive voters -- not mistake Pence's "awww shucks," Midwestern demeanor for harmlessness because he is anything but. As governor of Indiana, Pence and the state's overwhelmingly Republican legislature facilitated one of the more alarming HIV outbreaks in recent memory by promoting unnecessary, harmful and ideologically driven health policies that left the state's most vulnerable populations at risk of infection. From the tail end of 2014 until this past spring, there were 188 confirmed new cases of HIV in small, rural Scott County, Indiana, the bulk of which occurred in and around the town of Austin.
To put those numbers into perspective, there were 288 new cases of HIV last year in Travis County, Texas, which includes the state capital of Austin. The city of Austin, Texas, by itself is home to more than one million people. The town of Austin, Indiana, has a little over 4,000.
The onus for this horrific HIV outbreak in Scott County falls squarely on the shoulders of Governor Pence and the GOP legislature in Indiana. Pence entered the governor's mansion determined to continue the work of his predecessor, Mitch Daniels, and to shut down Planned Parenthood in the state of Indiana for good. Due to a series of draconian funding cuts aimed at crippling the organization's ability to operate, Planned Parenthood was forced to shutter five of its clinics in Indiana, including one in Scott County, which closed in early 2013.
Pence's and the Indiana GOP's crusade against Planned Parenthood was grounded in fierce, dogmatic opposition to the small portion of the organization's resources that go towards providing abortion services. Yet the Planned Parenthood clinic in Scott County didn't even perform abortions. Contrary to public health best practices, common sense and his party's stated reasons for opposing Planned Parenthood in the first place, Mike Pence led the charge to shut down the only HIV testing facility in a county with a burgeoning IV drug crisis, while remaining staunchly opposed to syringe access programs that can cheaply and effectively prevent outbreaks such as the one that later took place in Scott County.
In the immediate aftermath of the Scott County HIV outbreak, which was driven primarily by widespread injection drug abuse of the prescription opiate Opana, Pence did not display any of the qualities of sound leadership that we would hope for in a man who is a heartbeat away from the presidency. Instead of acknowledging the detrimental effects of his failed policies on the lives of his constituents and quickly adopting measures that have proven effective time and time again in reducing HIV transmission rates, Pence doubled down on his ideologically driven agenda.
With an intransigence that has become the hallmark of modern day American conservatism, Pence was forcibly dragged toward best practices by his fellow lawmakers and the Centers for Disease Control and Prevention, digging his heels in just enough at every turn to ensure that the public health measures put in place were as anemic and cumbersomely designed as possible. Pence may have eventually relented and signed legislation lifting the statewide ban on needle exchanges, but he didn't give already financially struggling counties any money to run the exchanges and explicitly forbade the use of state funds to purchase syringes.
Ignorance and discrimination come in different shapes and sizes. Just because Trump's appear bigger and bolder than Pence's doesn't mean that the hate Pence harbors is any less harmful. If Mike Pence is allowed to become vice president, he will bring the unnecessary pain and suffering of Scott County with him -- and more and more of us will be made to feel its sting.