Medication abortion is safefor now. But why is the HIV community consistently silent on reproductive rights? 

April 24, 2023Last Friday, the Supreme Court granted a stay to maintain nationwide access to a safe, effective and commonly-used medication abortion drug, mifepristone (“mife”), which is used along with misoprostol (“miso”) to terminate pregnancies. This was in response to a ruling earlier this month by a radically conservative, Trump-appointed judge in Texas to invalidate the Federal Drug Administration’s (FDA) approval of mife.  

Friday’s Supreme Court decision means that mife remains on the market for the foreseeable future. Science and commonsense prevailed. But, like the recent Braidwood decision, we should never be in a position where judges are deciding whether people can get safe, effective medicines. 

We are also not out of the woods. Mife remains on the market while the Fifth Circuit hears the appeal from the Department of Justice (DOJ) and Danco in Alliance for Hippocratic Medicine et al v. U.S. Food and Drug Administration et al. Oral arguments are currently scheduled for Wednesday May 17th. There may also be additional appeals to the Supreme Court after the Fifth Circuit rules. 

We will stay vigilant. We know that anti-abortion politicians and their allies will not stop until abortion is banned nationwide. Medication abortion is very much still under threat—as is abortion and access to other sexual and reproductive health care. 

While the initial ruling from Judge Kacsmaryck and the 5th Circuit was widely anticipated by reproductive justice advocates, who have been preparing for this moment, it was still devastating. We are heartbroken and worried for our communities. As we said last year, the overturning of Roe v. Wade was just the beginning of many attacks on reproductive freedom and bodily autonomy. 

Medication abortion accounted for more than half of all abortions in 2020. If a mife ban goes into effect, Black, Indigenous, People of Color (BIPOC) and low-income communities will be most harmed, once again. Medication abortion is the most common, least invasive, most private, least expensive, and most available method for people to terminate pregnancies. Losing legal access to mife means that communities that are already hyperpoliced and surveilled will face greater risk of interactions with police, based on personal health decisions. 

More than 100 studies conducted in 26 countries over a 30 year period have shown that abortion pills are safe and effective. This ruling was not about science, just like the recent PrEP ruling out of Texas was not about science; just like the hateful legislation sweeping state legislatures that targets people who are trans and gender non-conforming, and those who love them, is not about science. This is, instead, about ideology and a desire to control the bodies, freedom, human rights and autonomy of people who are BIPOC, queer, trans and femme. This is about hatred for Blackness and brownness and indigeneity. This is about contempt for women. This is about feeling threatened by joy and liberation, truth and authenticity and Pride. This is about fear of our growing and collective power.

And once again, the silence from the HIV communityas in, zero acknowledgment of the devastating mife court decision on federal HIV policy listservs; as in, PWN members and allies being asked by partners on a recent state HIV advocacy day to remove “abortion access” language from a list of policy prioritiesspeaks volumes. The continued failure to address reproductive rights and sexual freedom for all people living with HIV in the National HIV/AIDS Strategy 2022-2025 Federal Implementation Plan is just another example of the ways misogynoir is baked into the domestic HIV response. (Don’t believe us? Search the implementation plan for the word “reproductive”. It appears twice, both in the context of primary HIV prevention.)

Just in the past few weeks, there is an obvious escalation of attacks on our communities if you’re paying attention. 

Judge O’Connor’s recent decision to radically undermine the Affordable Care Act (ACA) preventive services requirement by singling out PrEP was deeply rooted in homophobic, dangerous, and harmful beliefs around PrEP and those who use it. We are currently in the midst of a coordinated attack on the rights, dignity and humanity of trans people. Meanwhile, in Tennessee, the state House of Representatives attempted to expel two, democratically-elected Black lawmakers for leading a protest against gun violence. This was a shocking and racist move by the Tennessee Republican supermajority to suppress legitimate political dissent. Both lawmakers have been reinstated. This is part of a larger pattern of majority-white state leaders attempting to remove power from Black and Latinx voters and consolidate control in their own hands. For example, a supermajority of white politicians in the Mississippi state legislature are attempting to create a separate, unelected court system and an expanded police force in Jackson, Mississippi, which is a majority-Black city with a pro-Black mayor. 

This is the tyranny of white supremacy, anti-Blackness, misogyny, and queer- and transphobia in action. There is a scary through-line from the attacks on transgender bodies, reproductive freedom, PrEP, and democracy.

Let’s break it down. Unelected judges hold immense power to dole out rulings that affect the entire nation and can upend policies that otherwise have democratic support. As recent elections in California, Kansas, Kentucky, Michigan, Montana, Vermont, and Wisconsin show, voters support and will protect abortion access when it’s on the ballot. This is why radically conservative groups are successfully petitioning extremist judges to use junk science, stigma, and discriminatory beliefs to undercut the administrative state and restrict access to basic healthcare, human rights, and dignity. To expand their ability to do this, conservatives are also using tactics to suppress voters and dissenting voices, especially BIPOC, queer, trans, and femme voices. This is a deliberate strategy to narrow the democratic pathways we have to push back against these threats to our basic freedom and human rights.

Is it confusing to understand that misogyny, anti-Blackness, transphobia and fear of our growing collective power are at the shared root of these coordinated attacks on our communities, and that we will have to rise in solidarity to combat them and to create the world we want and that our communities deserve? 

Or is it the misogynoir in our own community that results in silence?

 The reproductive justice and reproductive health community is literally shouting and HIV community leadership cannot hear.

We can’t fight for PrEP and for decriminalization of HIV and not also fight for abortion medications and for science, not ideology, to be centered in FDA approval processes. These struggles are interconnected.

Courts, judges, and elected leaders don’t keep us safe. We keep us safe. Here are three actions you can take right now:

  1. Stay informed and stay ready to mobilize. PWN will continue to send updates to anyone who signs the pledge to fight for reproductive freedom
  2. Demand change at the federal level. Tell the U.S. Congress that they must pass the Women’s Health Protection Act (WHPA) today. The WHPA is federal legislation that would protect abortion access in every U.S. state, no matter what the Supreme Court has said or will say about the right to abortion. All people – regardless of where they live, their gender, race, ethnicity, immigration status or ability to pay – should be able to control what does and does not happen to their bodies, including choosing the method of abortion that works best for them without barriers or delay. Learn more about the WHPA, here.
  3. Get ready to hold elected officials and candidates running for office in 2024 accountable to reproductive freedom. More on this soon. Stay tuned to PWN’s work for updates.

      We will never stop building power and working to transform these racist, oppressive, patriarchal systems. We are in the fight for our lives.