With the third Democratic primary debate likely to bring the focus back to health care, nuances, six candidates have paid extra attention to combating the HIV epidemic, putting forward plans that rely heavily on expanding medical access across the country. 

AIDS United, a non-profit organization working to end the HIV epidemic in the United States, sent a questionnaire to every candidate running for president to increase awareness of the HIV issue, which is of global urgency. In the United States, over one million people are living with HIV. 

“The presidential candidates in 2020 have a unique opportunity to make history,” William McColl, Vice President of Policy and Advocacy at AIDS United, told The Daily Beast. “For the first time since the Centers for Disease Control originally reported a few HIV cases in its Morbidity and Mortality Weekly Report 38 years ago, we are able to end the HIV epidemic in the United States.” 

The group sent out 15 questions and received detailed responses, reviewed exclusively by The Daily Beast, from nearly every candidate in the Democratic primary’s top-tier: Sens. Bernie Sanders (I-VT), Elizabeth Warren (D-MA), Kamala Harris (D-CA), Cory Booker (D-NJ), South Bend Mayor Pete Buttigieg, and former Rep. Beto O’Rourke (D-TX). Along with the campaign of former Vice President Joe Biden, who previously pledged to end the epidemic within five years of being elected, President Trump’s campaign did not respond to the survey, which is part of a broader effort by the Act Now: End AIDS Coalition of organizers working to end the HIV epidemic.

Though surveyed individually, the White House aspirants pointed to similar ways to tackle the epidemic if elected next year, including emphasizing that all people living with and affected by HIV in the United States must have health care. Multiple candidates also proposed devoting significant resources toward ending the overdose epidemic and combating the stigma that follows HIV criminalization laws across many states.

The White House announced a new strategy earlier this year to reduce new cases of HIV by 90 percent by 2030, creating a rare point of bipartisan agreement amid the ongoing division between Trump and Democrats in Washington. 

Still, some Democratic contenders are looking to rebuild key areas that Trump has worked to unravel. Calling for a revitalization of the White House Office of National AIDS Policy, which was shut down under the Trump administration, Buttigieg said that within the first six months of his administration, the office would develop a revised National HIV/AIDS Strategy.

“Everyone with HIV should be in treatment so they can lead longer and higher quality lives and so they won’t transmit HIV, since we know that U=U (undetectable equals untransmittable),” Buttigieg wrote in the survey. 

The South Bend mayor, along with other candidates who provided lengthy responses to AIDS United’s questions, pointed to the prevalence of individuals affected by a substance abuse disorder in the country, including through the use of opioids, fentanyl or methamphetamine.

Sanders, whose campaign is built around a Medicare-for-All platform, set a more immediate goal of ending the epidemic by 2025, five years earlier than the White House’s benchmark of 2030. He pointed to legislation he introduced in 2016 that would create a prize model to help prompt innovation for new HIV/AIDS medications and pointed to working with Rep. Jim Clyburn (D-SC) to expand community health centers, among other measures.

Warren, who also called for making sure community health centers receive robust funding and stressed the importance of Medicare-for-All, said she would expand research and treatment, and ensure equal access to pre-exposure prophylaxis (PrEP) and HIV testing. She also called for lowering drug prices and holding pharmaceutical companies accountable, themes she often references on the campaign trail. In addition, Warren is a co-sponsor of the REPEAL HIV Discrimination Act, which would review all federal and state laws and regulations that criminalize people living with HIV and to eliminate discriminatory laws. Currently, 26 states have laws that criminalize HIV exposure.

Harris pointed to her introduction of the PrEP Access and Coverage Act, which would require public and private health insurers to cover PrEP so that access to preventative medication is not determined by an individual’s financial status. In pledging to hold pharmaceutical companies accountable—a common theme in candidates’ responses—the California senator said she would “fight to give the Department of Health and Human Services the authority to set ceilings for prescription drug prices to put them in line with countries such as Canada and Germany.” While health care has been a recent point of contention for Harris’ campaign, she cited Medicare-for-All as a critical component in ending the epidemic. 

Booker called for comprehensive sex education on a range of topics, including preventing sexually transmitted infections, which is included in his Real Education for Healthy Youth Act. The New Jersey Democrat is a co-sponsor of the Equality Act, which would protect LGBTQ people from discrimination in housing, the workplace, and public accommodations.

He also called for vacancies on the Presidential Advisory Council on HIV/AIDS to be filled immediately, writing, “When appointing members of the council I would seek leaders who would center the needs of communities that are disproportionately impacted by HIV, including LGBTQ communities and communities of color.”

O’Rourke, who said he is committed to increasing HIV care to minority populations, pointed to discrimination facing older Americans who can face additional hurdles accessing assisted living facilities or nursing homes where homophobia can be prevalent.

“Recognizing that nearly half of people living with HIV are more than 50 years old, we must ensure that these Americans are not forced to hide their health status or sexual orientation for fear of losing their access to nursing home facilities,” O’Rourke wrote in the questionnaire. 

He also said he is in favor of providing additional funding to the National Significance and AIDS Education and Training Centers and the Minority AIDS Initiative. 

“We’re pleased that many who are running in 2020 have already shown that ending the epidemic would be a priority should they be elected,” McColl said. “Throughout this election and beyond, the HIV Community is ready to engage in a dialogue with all of those who are willing to be a partner in this fight.”