An Aids memorial is being unveiled in New York City today. While it is fitting to have right here in Greenwich Village a grand Jenny Holzer-designed, Walt Whitman-inscribed memorial to the 35 million people who have died from Aids and the 37 million people currently living with HIV, there is little to celebrate locally or globally.

Just across the street, St Vincent’s hospital – an epicenter of the epidemic in its early years – has died, just as so many gay men did within its walls in the 1980s. It is being converted into luxury condos. That a hospital which served the most marginalized would be replaced by real estate for the super wealthy is a fitting metaphor in the age of a real estate developer-turned-president. Indeed, Donald Trump is set to preside over a newly harmful period in HIV history.

HIV/Aids is no scourge of the past in the US. The Centers for Disease Control estimates that one in two black men who has sex with men will become HIV positive, despite having “fewer partners and lower rates of recreational drug use than other gay men”. While the drug PrEP (which can greatly reduce the likelihood of becoming HIV positive) is often heralded as some kind of panacea, it cannot address some of the biggest epidemiological factors fanning modern HIV: access to employment, housing and healthcare. Indeed, in cities like Atlanta, half of HIV diagnoses have already progressed to Aids – precisely because people most likely to be exposed to HIV don’t have healthcare.

And this is why my mind drifts uptown to Trump Tower.

It’s not just that Trump literally doesn’t mention HIV/Aids in his healthcare policy, nor that he’s generally anti-science. It’s not even just that every single Trump cabinet pick so far has some kind of anti-LGBT record. I am terrified that two of his most important picks – vice-president elect Mike Pence and Health and Human Services secretary nominee Tom Price – know exactly how to harm Americans (disproportionately black and/or LGBT Americans) by way of HIV/Aids. If Reagan was remembered for his inaction on the plague, Trump may be remembered for explicitly dismantling the Aids safety net and for enacting policies that will make the virus move more freely between people. As Carolyn Guild Johnson, director of prevention of services at St Louis Effort for Aids, recently told me: “I’m not only worried about our clients, but also the public health emergency that will result from the increased community viral load.”

After waging war on Planned Parenthood in congress, Pence presided over one of the fastest HIV outbreaks in US history as governor of Indiana. Pence believes in abstinence-only education, which is known to foster higher rates of sexually transmitted diseases. And Pence wrote in 2002 that “Congress should support the reauthorization of the Ryan White Care Act,” the main federal support for combatting HIV/Aids, “only after completion of an audit to ensure that federal dollars were no longer being given to organizations that celebrate and encourage the types of behaviors that facilitate the spreading of the HIV virus.” A large component of the important work organizations like Gay Men’s Health Crisis and St Louis Effort for Aids do to tackle HIV precisely means combating homophobia and stigma. (Pence instead believed that “resources should be directed toward those institutions which provide assistance to those seeking to change their sexual behavior,” for example dangerous so-called conversion therapy.)

Meanwhile, Price, the potential HHS secretary, has supported a constitutional amendment against same-sex marriage and voted against hate crimes legislation. He also is also vehemently opposed to the Affordable Care Act. In guaranteeing coverage for people with pre-existing conditions such as HIV who had been locked out of insurance, covering HIV testing and funding prevention efforts, the ACA has earned its claim to be “one of the most important pieces of legislation in the fight against HIV/Aids in our history”.

When I reluctantly made the decision to vote for Hillary Clinton, I didn’t want to focus on being anti-Trump, but to think of ways I could be excited about her despite my many reservations. The moment I picked was when she boldly denounced the criminalization of HIV, whereby individuals can be prosecuted for exposing someone else to the virus (while corporations and governments, which fan transmission on much larger scales through malfeasance and neglect, elude punishment). Her finest moment, to me, never registered in the media – and yet, she is calm, medically sensible and ethically admirable.

What a contrast with Trump and his team.

As we remember today the tens of millions who have died from Aids and who live with HIV, we must recommit ourselves to fighting a virus which will likely be allowed to flourish by a the incoming administration.

