Today Mark feels much older than his age. He says that what has saved him from depression and loneliness is his activism, particularly with the association Act Up. By turning to others, he has “turned the tragedy round to his own advantage” he told Equal Times.

But he is very worried about consequences of the latest US elections for his health.

“As someone living with both AIDS and cancer, I know how much the Affordable Care Act (editor’s note: ACA or Obamacare, a universal health insurance scheme set up by the Obama administration) is important for people living with serious illnesses and pre-existing conditions”.

Abolishing Obamacare is the first priority for the new administration led by Donald Trump.

The President wants to privatise access to health care, with no further detail for the time being. The Republicans recognise that after years of fierce opposition to Obamacare, they don’t have a replacement plan. What is urgent for them is to abolish the system put in place by the former President, to keep their electoral promise.

The decision will obstruct access to health care for millions of people in financial difficulty or under-employed.

According to official figures, 20 million Americans have had access to health care thanks to Obamacare.

The great majority of them could lose their insurance this year, and health insurance rates are likely to rise sharply for those who still have insurance, if the Republicans in Congress carry out their threat, according to a report by one of the Capitol’s bipartisan committees, the Congressional Budget Office.

According to this report the number of people without health insurance in the United States could rise by 18 million in 2017 alone. And the longer term forecasts are even more pessimistic. No less than 32 million Americans could lose their access to health care by 2026.

The United States already has the world’s most expensive health system and the least effective compared to other industrialised countries.

It cost USD 8,500 per person in 2014, about 3,000 dollars more than in Norway, where the standard of care is infinitely better on every level.

Even senators belonging to the new majority, such as Susan Collins, from Maine, have expressed serious concern about the new government’s desire to abolish Obamacare so hastily, especially without having a serious alternative to offer. A decision which, according to a personal statement from Collins, would lead to a “death spiral”.

Organised resistance

To prevent the situation from getting worse, as far as they can, citizens groups are forming all over the country to put pressure on members of Congress, who have the power to block or support the measures proposed by the Trump administration.

One example is Rise & Resist, a New York pressure group recently created “to protect individuals and communities whose life and liberties are at risk following the 2016 election”, and of which Mark Milano is a member.

Their resistance plan is based on that of the right wing Tea Party movement, whose methods the activists admire just as much as they abhor its ideology.

Their plan is taking the form of demonstrations outside the offices and residences of senators and of direct action. One such example was the “cough-in” on 15 January in the Jean-Georges restaurant in Trump International Hotel and Tower, in New York. The establishment was targeted for its symbolic location, the menu prices and because the new US President is a regular.

“The gay community and HIV positive people are not direct targets of the administration, but they will be affected indirectly” says Jeremiah Johnson, an Act-up activist, member of Rise&Resist and a participant in the Jean-Georges cough-in.

“People living with HIV are in the persons at risk category. They are often poor, particularly intra-venous drug users.”

It’s a paradox: with the rise in the use of hard drugs among the rural white working class, Trump’s electoral heartland will be among the most affected by the new measures.

Jeremiah Johnson is worried about the political influence of the new vice-President, Mike Pence, former governor of Indiana, on Donald Trump.

Mike Pence has a heavy legacy in the State of Indiana, of which he was governor until the elections. Jeremiah Johnson recalls there was a worrying and sudden AIDS outbreak in Scott County, a rural county in Indian bordering on Kentucky, in 2015, following the use of intravenous drugs with dirty needles.

Instead of promoting urgent, common sense solutions such as a needle exchange programme for the county’s drug users, Governor Pence “preferred first of all to advise prayer”.

“Before the needle exchange programme was set up in Scott County, a total of 190 people were infected with the AIDS virus” says an angry Johnson.

“Trump and his team have shown that they are concerned only about their careers, that they hate black, gay and mixed raced minorities...and the poor. They are mercilessly preparing laws that will put our lives in danger” points out Isha Rasho, a member of Rise&Resist.

“Their cuts to health spending prove how much our rights have no value in their eyes”.

“My sister and her family came very close to losing their home when the health bills for their child’s disability piled up in their office” explains Terry Roethlein, treasurer and spokesperson for the Centre for the Study of Social Difference at Columbia University.

Roethlein adds that “the welfare of the working class and the poor in the United States is bound to come under attack if Donald Trump, Tom Price (the future Health Secretary) and Paul Ryan (speaker of the House of Representatives) put their plan into action.”

“The Republican’s zealous desire to abolish the ACA is simply heartless and cruel. Trump has no plan for helping people in my situation” deplores Mark Milano.

“‘Trumpcare’ is making me ill, because ‘Trumpcare’ doesn’t even exist!”