A federal appeals court has upheld the U.S. military's HIV enlistment ban, dismissing scientific evidence that people with undetectable viral loads pose no transmission risk. The Fourth Circuit ruling reverses a lower court decision that had allowed qualified recruits with well-managed HIV to serve. Judge Paul Niemeyer authored the opinion, emphasizing judicial deference to military authority over constitutional rights. The decision affects three plaintiffs living with HIV who sought to join the armed forces, including Isaiah Wilkins, Carol Coe, and Natalie Noe, all of whom maintain undetectable viral loads through antiretroviral therapy.

The court accepted the Pentagon's arguments that HIV creates operational complications, higher costs, and diplomatic issues, despite acknowledging the medical consensus on U=U (undetectable equals untransmittable). This ruling marks a significant setback for LGBTQ+ advocates who view the ban as rooted in stigma rather than evidence-based policy.