There’s so much to be brokenhearted about, living in the United States in the midst of a fascist, damaging regime. But whatever frustration and sorrow there may be from within this once great nation, the feeling changes when one leaves it. The heartache becomes a self-conscious shame.

At least, that’s the feeling I anticipate, and have already begun to internalize, as I prepare to attend AIDS2026, the 26th annual international AIDS conference being held July 26-31, 2026, in Rio de Janeiro. 

The federal cuts to global health are devastating and criminally cruel. Funding for prevention strategies like PrEP have taken a nosedive. Global condom distribution networks – condoms! – have been obliterated. Hundreds of millions of dollars in research has been simply abandoned, with no hope of restarting the trials. To say nothing about South Africa, to which the administration has raised its middle finger and turned its back completely.

This environment has made it uncomfortable, if not overwhelmingly embarrassing, to show my face as an American at the international conference. 

At a recent media webinar hosted by the International AIDS Society, which produces AIDS2026, various embargoed studies that will be presented at the conference were discussed. There on my screen were officials working in public health from around the world, gingerly referring to massive cuts in global HIV funding. My heart sank for the entire hour. 

I wanted to scream into a pillow, or worse. The elephant in the room, and in most global rooms these days, was the Trump Administration, in this case its draconian cuts to public health and its stupidity about the nature of HIV around the world. It is difficult to wrap your head around the short-sightedness, the abject cruelty, and all those dead bodies yet to come. (UNAIDS estimates the Trump administration cuts will lead to 3 to 6 million preventable deaths in the next few years.)

Finally, I submitted a written question to the esteemed panel. It read:

This is Mark S. King, a USA advocate and 41 year HIV survivor, writing for my site, “My Fabulous Disease,” and POZ Magazine. I have witnessed the USA ignore AIDS in the early years and then eventually become a leader in global funding for HIV prevention and treatment. I am ashamed of the cuts to PEPFAR and other programs that will lead to illness and death, as proven by the embargoed research studies. My question: how does it feel for the international community to view our administration, if not the USA generally, as “the bad guys?” Personally, I will be ashamed and self-conscious at AIDS2026. We have drastically changed from an ally to a villain.

First, the kindly moderator assured me I should not feel ashamed and that people were able to disassociate the person from the country’s policies. Okay.

There has been extensive sociological research and volumes of literature written about the collective guilt and shame of the German people after World War II. Hitler murdered 6 million Jewish people. The American cuts to foreign HIV prevention and care, as above, will approach that number within a few years if nothing is done. Am I overreacting? Fair enough. But I stand by my shame, and my fear of an existential threat. 

The other panelists, accomplished public health leaders all, responded to my question carefully, as if not to wake a sleeping monster napping nearby. We know who that monster is. 

I honestly do not know how it will feel once I am in Brazil and the conference is underway. I imagine I will have the soothing balm of being in the company of thousands of like-minded advocates from around the world, and there will likely be carnival parades and colorful displays throughout my favorite aspect of this conference, The Global Village.

But nothing can shake my feelings of profound guilt and shame for the murderous damage my country has unleashed upon the world. By God, there had better be protests at AIDS2026 against the policies of the United States and the blood on our hands. 

Americans have learned the consequences of apathy in the face of political turmoil. We have been rewarded with chaos and death, here and abroad. It would behoove the attendees of AIDS2026 to name the monster and begin to fight back. 

Mark