I never recognized how politics played a role in my life until my HIV diagnosis. Actually, I never voted or paid any attention to politics or policy decisions—because, in my mind, I worked and supported myself regardless of who was in power—so I didn’t vote. At the time, I had health insurance through my job as a public-school teacher. Then, I moved to Florida. In the process, I lost my health coverage while I secured another teaching job. This is a situation that millions of people who rely in the Affordable Care Act for health insurance could face in the upcoming months if the Supreme Court repeals Obamacare, a reality that seems closer than ever with the new vacancy left by the death of Justice Ruth Bader Ginsburg. Elections have clear consequences that can impact even your health. Voting is a privilege I am not willing to just give up because I am somewhat jaded about the system. The stakes are just too high.
I voted for the first time in the 2008 election. I voted because I was uninsured and I had to rely on the government for my health and well-being, which was scary. Thankfully, I qualified for the federally funded Ryan White program, which provides basic health care and medications to people living with HIV. The goal was to remain undetectable and healthy, and in turn, protect others. During the presidential campaign, then-candidate Barack Obama faced policy challenges that were pressing and important to the HIV community. Now, I always vote with my preexisting condition in mind first. Secondly, I think of those policy issues that impact me directly. There are approximately 117,000 people living with HIV in Florida and about 1.2 million in the United States. As a swing state, our elections have been won by razor-thin margins. The infamous 2000 election was decided by fewer than 113,000 votes.
Voting can be riddled with barriers. In fact, my first two tries were not very successful. The first time, I made a mistake and showed up to the wrong voting precinct. Finding a polling place can be challenging, especially for those without reliable transportation. After waiting over two hours in line, a polling officer informed me that I could vote there, but my vote would not be counted. I did not want to wait in line again, so I voted there knowing my vote would go in the trash. It didn’t cross my mind how voter suppression is very much alive. Voters in Georgia have experienced excessive wait times and long lines to vote. I tried voting again during the primaries of 2012, only to find out I could not vote if I was registered as an Independent; I had to claim a party affiliation. Just choosing candidates other than the major candidacies can feel like an impossibly overwhelming experience. I have struggled in the past with taking the time prior to casting my ballot to research every candidate and their positions.
As a Latinx Puerto Rican voter whose first language is Spanish, I can attest to the confusing nature of the electoral lexicon. Not all campaigns and candidates directly address constituents in other languages. Not every state offers translation in their ballots, which might discourage people from engaging in the process. Right now, Black, indigenous, and other people of color must recognize our vulnerable position in the United States, where our rights seem to be in constant jeopardy, threatened by the government and enforced by unscrupulous law-enforcement agencies that target minority populations.
As an HIV advocate, I see firsthand how these political decisions impact the health and well-being of people across the nation. The Affordable Care Act, Medicaid expansion, access to reproductive health services, the price of medication, and even COVID-19 are all on the ballot. The Florida Department of Health released the HIV transmission data for 2019 showing little has changed in recent years. The Black (39%) and Latinx (34%) communities are disproportionately impacted by HIV transmissions, while whites made up 25% of all transmissions, reminding us that racial inequities are ever-present in health care–related issues, especially with communicable diseases like HIV. All this is taking place in a state that has not updated its HIV laws since 1986 at the height of the HIV pandemic, ignoring four decades of medical advancements and research. Without criminal justice reform, the United States will not be able to End the HIV Epidemic by the year 2030 as proposed by the current administration.
The community of people with HIV and those who love them have a civic duty and a personal interest in what the government and politicians are doing regarding our public health. COVID-19 has had an impact on the treatment and prevention of HIV and other sexually transmitted infections (STIs), because resources have been redirected and focused on this new public health threat. These political decisions have repercussions that affect us all, not just those already impacted. If you have not been part of the election process before, I implore you, it is time for you to get involved. Get out and vote or request your mail-in ballot, educate others in what is at stake when it comes to our health and the elections, and most of all, speak openly and frankly about sex, STIs, and HIV. It is the only way to normalize the conversation.
Politicians often forget about people like us, those who they do not see as a deciding factor or a population they need to try to influence because, for most of them, we are invisible. Let’s make sure this time we can proudly say we came out and made our voices heard. For people living with HIV, COVID-19—with over 225,000 deaths—has been a painful reminder of how politics and politicians have the power to influence public-health decisions. This means we must vote for the right candidate, because it literally means the difference between life and death.