Plus 153, May-June 2023

BECAUSE YOU’RE MORE THAN YOUR STATUS

THIS REALITY STAR IS USING HIS VOICE TO FIGHT FOR US

ELTON JOHN’S OSCAR PARTY

THE GAY MAN LEADING

THE AMERICAN MEDICAL ASSOCIATION

21 ON THE COVER KEEPING IT REAL

The star of reality series Mathis Family Matters (and son of TV’s beloved Judge Mathis), Greg Mathis Jr. is carving his own path as an advocate for people of color, the LGBTQ+ community, and those living with HIV.

FEATURES

26 THE POWER OF U=U

Not only has the “undetectable equals untransmittable” movement changed people’s lives, it may also be the key to ending the HIV epidemic.

28 GLAAD TO KNOW YOU LGBTQ+ organization GLAAD is helping to reduce HIV stigma in entertainment.

34 DOCTOR OF THE PEOPLE

The new out gay president of the American Medical Association is focused on LGBTQ+ health and protecting queer and trans youth.

38 POLITICS OF BLOOD

The FDA has “relaxed” its rules on gay and bi men donating blood. But what does it all really mean?

ON THE COVER Greg Mathis Jr. photographed by Tommy Garcia/E! Entertainment/NBCU Photo Bank via Getty Images

ABOVE photo by Roger Kisby/Getty Images for Google

editorial director NEAL BROVERMAN

editor in chief DESIRÉE GUERRERO

executive creative director RAINE BASCOS

EDITORIAL

senior copy editor TRUDY RING

contributing editor MARK S. KING

mental health editor GARY MCCLAIN

contributing writers ALEX GARNER, SCOTT SCHOETTES, ANDREW J. STILLMAN

ART

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EQUALPRIDE EDITORIAL

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THOUGH THE BEGINNING of the movement truly goes back decades, in 2023 we celebrate seven official years of U=U. If you haven’t already heard about it, U=U is the globally-accepted scientific consensus which states that when an HIV-positive person is on treatment and reaches an undetectable level of the virus in their system, they then have zero chance of transmitting it to a sexual partner — even without the use of a condom.

This fact is known as “undetectable equals untransmittable,” or U=U, and is now endorsed by over 1,000 organizations in 105 countries, including the Centers for Disease Control and Prevention and the World Health Organization. Not only has the U=U movement freed many people living with HIV to enjoy more liberated sex lives and less stigma, but experts also feel it may be the key to eradicating the virus once and for all. Read more about U=U’s history and the people who helped it succeed on page 26.

The fight against HIV also has more allies than ever. Our cover star, Greg Mathis Jr., known for the reality series Mathis Family Matters , is using his voice and platform to advocate for a variety of marginalized communities.

After coming out as gay on TV, Mathis Jr. says he felt “more connected” than ever to the communities that he was a part of, like people of color and LGBTQ+ folks, and the issues that affect them. For that reason, he has also started to focus on advocating for people living with HIV. Read more about Mathis Jr.’s journey to activism (and love) on page 21.

We also feature some other longtime HIV allies in this issue who continue to fight the good fight — and have fun doing it! On page 16, check out which stars showed up to let loose (and help raise funds for HIV causes) at Elton John’s annual Oscar viewing party, one of the most sought-after invites in Hollywood. Then flip to page 46 to see some stunning pics from the recent Broadway Backwards event that also helped raise money for HIV and AIDS causes.

And now, finally, let’s talk about sex. In this issue you’ll find a fascinating essay by HIV activist and educator Alex Garner (page 7) on what it means to have condomless sex, a.k.a. going “bareback,” as a gay man in 2023. He ponders if, in the age of PrEP and U=U, going bare is still a radical act. We also highlight the progress made to combat HIV stigma and the spread of the virus by the dating app Grindr, which recently added a button to its main menu so any user can order a free, at-home HIV testing kit (page 13). So for all this and much more, dive into this issue!

Be well,

As the spring season unfolds and we prepare for Pride month in June, I am delighted to share some exciting happenings here at equalpride.

I am thrilled to announce our recent Out March/April cover featuring the incomparable Billy Porter (above). A trailblazer in every sense of the word, including HIV advocacy, Billy continues to break barriers and inspire us all with his unwavering commitment to authenticity. We recently toasted Billy and the cover with an amazing party at the Somewhere Nowhere NYC nightclub, with none other than ballroom legend Kevin Aviance spinning tunes.

We are also elated to share that The Advocate has won Outstanding Magazine for Overall Coverage at the 34th GLAAD Media Awards ceremony. This recognition is a testament to our team’s dedication to telling inclusive, accurate, and impactful stories about the LGBTQ+ community.

As we look ahead to the rest of 2023, we remain steadfast in our commitment to creating a more equitable world for all. We couldn’t be more grateful for your continued support, and we invite you to join us on this journey toward a brighter future. Please share your feedback with me at advocatemarkb@equalpride.com, and on Instagram @advocatemarkb.

Warm regards,

Mark Berryhill CEO, equalpride

HAS BAREBACKING BECOME BASIC?

In the age of PrEP and U=U, is condomless sex still a radical act or just an average Tuesday?

Sex without condoms has value and meaning. It’s pleasurable and all around delightful. To make such an affirmative statement in public 20 years ago would have evoked a savage response from most of the LGBTQ+ community. But times, and science, have certainly changed, and now condomless sex and “Dawson’s 20 Load Weekend” seem a humdrum happening in gay culture.

Bareback used to be a dirty word. It was coined in1997 in a Poz magazine article to describe condomless sex. It was the birth of the bareback phenomenon but also the bareback backlash. Barebackers were portrayed as murderers, lunatics, and traitors to their community. Some of that panic still lingers, but now open displays of condomless sex are ubiquitous online, in porn, and in sex clubs.

Tony Valenzuela was one of the first to speak publicly about the joys and political power of bareback sex and he was immediately criticized. He became the bareback poster boy and leaned into that image with his infamous Poz magazine cover photo naked and riding a horse, sans saddle, for the article entitled, “They Shoot Barebackers Don’t They?”

I tested positive in ’96 right before the bareback phenomenon took off. When I wrote or spoke honestly about the value of condomless sex I was called “dangerous,” “reckless,” and “irresponsible.” Later, during the early years of gay dating apps, I would regularly get messages accusing me of “spreading AIDS.”

The fury against speaking openly and positively about condomless sex was fierce and extreme. Various gay

writers, from Michelangelo Signorile to Larry Kramer to Gabriel Rotello, heaped vicious attacks on “barebackers.” Gay pundit Dan Savage went so far as to compare bareback porn to kiddie porn.

Bareback porn became a flashpoint in this queer culture war. It was banned from events like International Mr. Leather. Porn producers, like Chi Chi LaRue, vowed to never make bareback porn. And AIDS Healthcare Foundation tried to get a law passed in California making condomless porn illegal.

But in the midst of all of this hysteria and HIV-phobia, two sensational things happened: HIV-positive gay men got a sexual identity and Treasure Island Media was born.

The word “bareback” became a word of resistance. It described HIV-positive sexual outlaws who had the audacity to pursue sex even while living with HIV. This was before the science of undetectable was known and so these men were seen as “infectious.” They were choosing to do things forbidden by gay culture and HIV prevention — enjoy condomless sex. Gay men had always enjoyed condomless sex throughout the HIV epidemic but now it had a name, and that name was associated with the danger and bravado of HIV-positive sexuality. A new queer sexual outlaw was born, and the world would never be the same.

Treasure Island Media was the original gay bareback porn studio. They understood that there was an unquenchable appetite for bareback porn, and they helped gay men embrace their hidden desires. What was so revolutionary about Treasure Island porn in its early years was that it explicitly and unashamedly showed HIV-positive men

having sex. In the late ‘90s there was a distinct look that many HIV-positive people had because of antiretrovirals and living with the virus. But Treasure Island didn’t run away from that look. They embraced it and showed that even these men, the ones who were physically and literally stigmatized, still had a right to pursue sex and they could be sexy while doing it. It was radical to show HIV-positive sexuality. It was empowering and transgressive.

Fast forward to 2023 and bareback sex can certainly be empowering — but is it still transgressive? PrEP, the HIV prevention pill, and the understanding that an undetectable viral load means it’s impossible to transmit the virus are two scientific advancements that changed the trajectory of the epidemic and unleashed the second wave in our queer sexual revolution amidst the ongoing epidemic.

Undetectable equals untransmittable, or U=U, helped remove some of the stigma associated with HIV-positive sexuality

and gave much needed freedom to many positive men yearning to pursue sexual pleasure. PrEP allowed HIVnegative men to experience the freedom that HIVpositive men had known for decades: having condomless sex without the fear of getting HIV. Men who had grown up on forbidden bareback porn could embrace their sexual desires involving skin to skin sex and semen exchange.

In 2023, condomless porn has become the norm. At sex parties or saunas, you’d be hardpressed to find men using condoms, and there are various bareback themed parties, websites, and merchandise.

All of this is great. The goal of a queer sexual revolution is that gay men pursue pleasure without shame and seize control of our bodies and sexualities. But the revolution has not reached everyone. HIV treatment and PrEP are still not available to all. HIV stigma and homophobia flourish. Gay sex is criminalized in nearly 70 countries around the globe, and our sexuality continues to be devalued and pathologized.

Our world is still filled with queer sexual outlaws. From Uganda to Russia to Indonesia, gay men still confront enormous risks to pursue pleasure. Queer people fight for fulfilling sex against considerable odds every single day. We can’t forget the political power of queer sex and we must integrate it into our global fight for queer liberation.

Now that condomless sex is as omnipresent in our culture as smartphones, let’s not forget the work that still needs to be done. Revel in your pleasure. But take a moment to think about how we can ensure all of our queer community can experience their own sexual ecstasy.

ALEX GARNER is a regular contributor for Plus with over 25 years of experience working as a community organizer, with a focus on uplifting the LGBTQ+ community and people living with HIV.

(COUPLE); COURTESY ALEX GARNER (AUTHOR PHOTO)

Want to stay undetectable* with fewer medicines?

Important Facts About DOVATO

This is only a brief summary of important information about DOVATO and does not replace talking to your healthcare provider about your condition and treatment.

What is the most important information I should know about DOVATO?

If you have both human immunodeficiency virus-1 (HIV-1) infection and Hepatitis B virus (HBV) infection, DOVATO can cause serious side effects, including:

• Resistant HBV. Your healthcare provider will test you for HBV infection before you start treatment with DOVATO. If you have HIV-1 and hepatitis B, the HBV can change (mutate) during your treatment with DOVATO and become harder to treat (resistant). It is not known if DOVATO is safe and effective in people who have HIV-1 and HBV infection.

• Worsening of HBV infection. If you have HBV infection and take DOVATO, your HBV may get worse (flare-up) if you stop taking DOVATO. A “flare-up” is when your HBV infection suddenly returns in a worse way than before.

° Do not run out of DOVATO. Refill your prescription or talk to your healthcare provider before your DOVATO is all gone.

DOVATO is different: unlike other HIV treatments that contain 3 or 4 medicines, DOVATO contains just 2 medicines in 1 pill.

DOVATO is a complete prescription regimen for adults new to HIV-1 treatment or replacing their current HIV-1 regimen when their doctor determines they meet certain requirements.

Learn

° Do not stop DOVATO without first talking to your healthcare provider.

° If you stop taking DOVATO, your healthcare provider will need to check your health often and do blood tests regularly for several months to check your liver function and monitor your HBV infection. It may be necessary to give you a medicine to treat hepatitis B. Tell your healthcare provider about any new or unusual symptoms you may have after you stop taking DOVATO.

For more information about side effects, see “What are possible side effects of DOVATO?”

What is DOVATO?

DOVATO is a prescription medicine that is used without other HIV-1 medicines to treat human immunodeficiency virus-1 (HIV-1) infection in adults: who have not received HIV-1 medicines in the past, or to replace their current HIV-1 medicines when their healthcare provider determines that they meet certain requirements. HIV-1 is the virus that causes Acquired Immune Deficiency Syndrome (AIDS). It is not known if DOVATO is safe and effective in children.

Please see additional Important Facts About DOVATO on the following page.

Ask your doctor about staying undetectable with fewer medicines in 1 pill.

No other complete HIV pill uses fewer medicines to help keep you undetectable.†

Important Facts About DOVATO (cont’d)

Who should not take DOVATO?

Do not take DOVATO if you:

• have ever had an allergic reaction to a medicine that contains dolutegravir or lamivudine.

• take dofetilide. Taking DOVATO and dofetilide can cause side effects that may be serious or life-threatening.

What should I tell my healthcare provider before using DOVATO?

Tell your healthcare provider about all of your medical conditions, including if you:

• have or have had liver problems, including hepatitis B or C infection.

• have kidney problems.

• are pregnant or plan to become pregnant. One of the medicines in DOVATO (dolutegravir) may harm your unborn baby.

° Your healthcare provider may prescribe a different medicine than DOVATO if you are planning to become pregnant or if pregnancy is confirmed during the first 12 weeks of pregnancy.

° If you can become pregnant, your healthcare provider may perform a pregnancy test before you start treatment with DOVATO.

° If you can become pregnant, you and your healthcare provider should talk about the use of effective birth control (contraception) during treatment with DOVATO.

° Tell your healthcare provider right away if you are planning to become pregnant, you become pregnant, or think you may be pregnant during treatment with DOVATO.

• are breastfeeding or plan to breastfeed. Do not breastfeed if you take DOVATO.

° You should not breastfeed if you have HIV-1 because of the risk of passing HIV-1 to your baby.

° DOVATO passes to your baby in your breast milk.

° Talk with your healthcare provider about the best way to feed your baby. Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Some medicines interact with DOVATO. Keep a list of your medicines and show it to your healthcare provider and pharmacist when you get a new medicine.

• You can ask your healthcare provider or pharmacist for a list of medicines that interact with DOVATO.

• Do not start taking a new medicine without telling your healthcare provider. Your healthcare provider can tell you if it is safe to take DOVATO with other medicines.

What are possible side effects of DOVATO?

DOVATO can cause serious side effects, including:

• See “What is the most important information I should know about DOVATO?”

What are possible side effects of DOVATO? (cont’d)

• Allergic reactions. Call your healthcare provider right away if you develop a rash with DOVATO. Stop taking DOVATO and get medical help right away if you develop a rash with any of the following signs or symptoms: fever; generally ill feeling; tiredness; muscle or joint aches; blisters or sores in mouth; blisters or peeling of the skin; redness or swelling of the eyes; swelling of the mouth, face, lips, or tongue; problems breathing.

• Liver problems.People with a history of hepatitis B or C virus may have an increased risk of developing new or worsening changes in certain liver tests during treatment with DOVATO. Liver problems, including liver failure, have also happened in people without a history of liver disease or other risk factors. Your healthcare provider may do blood tests to check your liver. Tell your healthcare provider right away if you get any of the following signs or symptoms of liver problems: your skin or the white part of your eyes turns yellow (jaundice); dark or “tea-colored” urine; light-colored stools (bowel movements); nausea or vomiting; loss of appetite; and/or pain, aching, or tenderness on the right side of your stomach area.

• Too much lactic acid in your blood (lactic acidosis).Too much lactic acid is a serious medical emergency that can lead to death.Tell your healthcare provider right away if you get any of the following symptoms that could be signs of lactic acidosis: feel very weak or tired; unusual (not normal) muscle pain; trouble breathing; stomach pain with nausea and vomiting; feel cold, especially in your arms and legs; feel dizzy or lightheaded; and/or a fast or irregular heartbeat.

• Lactic acidosis can also lead to severe liver problems, which can lead to death. Your liver may become large (hepatomegaly) and you may develop fat in your liver (steatosis). Tell your healthcare provider right away if you get any of the signs or symptoms of liver problems which are listed above under “Liver problems.”

• You may be more likely to get lactic acidosis or severe liver problems if you are female or very overweight (obese).

• Changes in your immune system (Immune Reconstitution Syndrome) can happen when you start taking HIV-1 medicines. Your immune system may get stronger and begin to fight infections that have been hidden in your body for a long time. Tell your healthcare provider right away if you start having new symptoms after you start taking DOVATO.

• The most common side effects of DOVATO include: headache; nausea; diarrhea; trouble sleeping; tiredness; and anxiety.

These are not all the possible side effects of DOVATO. Call your doctor for medical advice about side effects.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Where can I find more information?

• Talk to your healthcare provider or pharmacist.

• Go to DOVATO.com or call 1-877-844-8872, where you can also get FDA-approved labeling.

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Produced in USA.

BOOK BATTLE

Protesters converged on the headquarters of Simon & Schuster to demand the publisher cancel a book filled with HIV lies.

BY TRUDY RING

Protesters organized by GLAAD and ACT UP New York demonstrated March 27 at Simon & Schuster’s headquarters in Manhattan to demand that the publisher cease distributing a book that questions if HIV causes AIDS.

The Real AIDS Epidemic: How the Tragic HIV Mistake Threatens Us All by Rebecca Culshaw was released the next day from Skyhorse Publishing, a distribution client of Simon & Schuster. That means Simon & Schuster is responsible for shipping the book and other functions.

An open letter led by ACT UP NY and signed by more than 500 organizations

and individuals was delivered to Simon & Schuster before the protest. It’s addressed to the company’s president and CEO, Jonathan Karp.

“In the midst of coexisting pandemics and public health outbreaks, we know the dire and deadly consequences of spreading misinformation and denialism,” it reads in part. “It is disappointing that a book like Culshaw’s is on a roster of your releases in 2023, but you still have a chance to reverse this decision. We are asking you to reconsider this book deal and stop its distribution.

“The thesis of Culshaw’s book is that HIV does not conclusively cause

AIDS, but that this was a ‘mistake’ made in the 1980s and never amended or corrected. To the contrary, that HIV causes AIDS was demonstrated first in the 1980s, when the virus was discovered, and subsequently research has only strengthened that causal link in the subsequent decades, including via in vitro systems, in animal models, including non-human primates, via molecular phylogenetics, and in human samples. Research has shown conclusively that misinformation and denialism do material harm to HIV/AIDS prevention, testing, and treatment.”

For instance, the letter notes, there is great reluctance among Black

Americans to use HIV prevention medication in a strategy known as pre-exposure prophylaxis, or PrEP. “While 67 percent of white people recommended for PrEP have access to the drug, astonishingly, only 8 percent of Black people eligible — who also disproportionately make up a majority of new HIV transmissions — are currently using the medication,” it says.

Culshaw has authored other works that ACT UP calls denialist, including the 2007 book Science Sold Out: Does HIV Really Cause AIDS? and the 2006 paper “Mathematical Modeling of AIDS Progression: Limitations, Expectations, and Future Directions.”

The letter demands that Simon & Schuster end plans to distribute the book, assess the public health impact of other planned releases, and “create a public health working group to assure community members that this will not happen again.”

“It is unimaginable that Simon & Schuster, one of the largest and most respected publishing companies in America, would distribute a book by an author with a history of spreading false and scientifically disproven beliefs regarding HIV,” said a statement from Sarah Kate Ellis, president and CEO of GLAAD. “In an era where misinformation spreads faster

than truth, Rebecca V. Culshaw’s rhetoric has the potential to result in devastating consequences for people living with HIV. While HIV is now manageable, it is still an epidemic, particularly in the South, where racism, homophobia, HIV stigma, and the lack of access to high-quality healthcare continue to fuel an HIV crisis in communities of color. With the release of Culshaw’s book, Simon & Schuster is choosing profit over public health in an alarming partnership that should concern us all.”

“Research has shown conclusively that misinformation and denialism do material harm to HIV/AIDS prevention, testing, and treatment,” said a statement from ACT UP NY. “As a major publishing house, Simon & Schuster has a duty to prevent the spread of HIV/AIDS misinformation and denialism. Every occurrence adds needless life to an epidemic that has persisted for far too long.”

As part of the protest, messages from ACT UP NY were displayed all day on a billboard truck outside Simon & Schuster headquarters.

A Simon & Schuster representative told Salon that the company has no say in Skyhorse’s editorial decisions and cannot choose to distribute certain titles and not others.

GRINDR GIVES BACK

Now knowing your status is faster, easier, and more discreet — thanks to the popular gay dating app.

BY DESIRÉE GUERRERO

ONE OF THE original (and still one of the most popular) gay dating apps, Grindr, continues its commitment to helping the LGBTQ+ community enjoy happy, healthy sex lives. The hookup helpers are continuing to promote a health initiative called Together TakeMeHome, which now allows Grindr users to order free, at-home HIV tests with the click of a button.

Together TakeMeHome is a collaboration between Grindr and several leading health institutions: Emory University, Building Healthy Online Communities, the U.S. Centers for Disease Control and Prevention, NASTAD, OraSure, and Signal.

U.S.-based users will now see a new “Free HIV Home Test” button in the app’s main menu, with both English and Spanish instruction options. Those who click on it and order (about a two-to-three-minute process) will receive an OraQuick kit — an FDAapproved, over-the-counter test that works by swabbing the gums. The test arrives to your home within three to five days after ordering, and results are ready within 20 minutes.

Since HIV continues to affect those in queer communities more so than other groups of sexually active people, Grindr feels a particular responsibility to promote HIV prevention and treatment.

“Access to HIV testing is one of the biggest limitations in the fight against the persistent HIV epidemic,” stated Jack HarrisonQuintana, Grindr’s director for equality, in a recent blog post. “Many Grindr users face barriers to testing in person, including clinic operating hours, transportation, costs, concerns about privacy, and fear of judgment. Over the last three years, TakeMeHome has given away 125,000 HIV test kits, and more of those have gone to gay, bi, and trans people using Grindr than any other dating app platform.”

The program received more than 10,000 orders on its first day, according to Emory University.

“This project is currently aiming to give out one million kits over five years,” added HarrisonQuintana. “We’re incredibly proud of this partnership, so please check out Together TakeMeHome, know your status, tell your friends, and let’s continue to fight the epidemic together.”

Check out your Grindr app or visit together.takemehome.org for more information.

Dancing for Life

Students at the University of California, Los Angeles, use their feet (and youth!) to stage one of the most innovative HIV fundraisers in the nation.

BY NEAL BROVERMAN

SURE, ONE CAN raise money for HIV causes by going to a fancy black-tie dinner, sponsoring a friend for an AIDS walk, or even riding a bike across an entire state, but what about dancing for nearly a day straight? That’s what the Pediatric AIDS Coalition at the University of California, Los Angeles, have been doing for over a decade. As the the largest student-run nonprofit organization on the West Coast, PAC raises millions of dollars for research and services and informs young people about the HIV epidemic and the value of giving back.

This year’s Dance Marathon was held in early April and returned to

UCLA’s Pauley Pavilion — the university’s on-campus basketball arena — for the first time since the COVID pandemic. Before COVID scrambled plans, the dance marathon lasted for 26 hours; when it returned last year it was 13 hours, but 2023’s marathon bumped it up to 19.

The marathon is an exhilarating experience for the students who participate, and even those who watch on the sidelines. Aside from the nonstop movement, there are speakers, artists, and musical performances to entertain the crowd. While final numbers weren’t available by press time for 2023’s haul, the 2022 event brought in over $112,000, which benefits pediatric HIV services at the Elizabeth Glaser Pediatric AIDS Foundation, the researchers at the UCLA AIDS Institute, and the recipients of the Laurel Foundation, which provides services for youth affected by HIV via education and camp programs. During its 13 years of philanthropy, PAC’s dance marathons have raised over $6 million for pediatric HIV causes.PAC also hosts mentorships, community-building events, and a Life Skills retreat for youth affected by HIV. The goal of all these programs is for all kids, whether living with a parent with HIV or dealing with the disease themselves, to know their value and realize that HIV doesn’t define them.

“UCLA’s Pediatric AIDS Coalition was founded in 2010 not only to fundraise money to help end the mother to child transmission of HIV/AIDS. It was also founded to reduce and end stigmas surrounding the disease and to better the lives of those living with it,” PAC spokesperson William McReynolds tells Plus. “At Dance Marathon, when there is a cure for everyone worldwide we’ll dance for joy. Until then, we dance for life.”

BELOW The charitable UCLA students of the Pediatric AIDS Coalition

Triumph and Tragedy

ACT UP’s Oral History Project celebrate a funding windfall while also mourning the sudden death of two beloved longtime members.

BY DESIRÉE GUERRERO

Earlier this year, the AIDS Coalition To Unleash Power Los Angeles (ACT UP/LA) announced it had received the first major funding for its Oral History Project, provided by the Los Angeles County Board of Supervisors. ACT UP/LA credited much of this big step forward to former L.A. County supervisor Sheila Kuehl, a lesbian politician who lobbied for the funding while in office.

The Oral History Project is “mainly motivated by the continuing deaths of ACT UP/LA members whose histories have not been preserved,” stated a press release. The project — announced on World AIDS Day, 2021, by ACT UP/LA members Mary Lucey, Nancy MacNeil, Jordan Peimer, Helene Schpak, and Judy Ornelas Sisneros — aims to capture the stories of AIDS street activism from 1987 to 1997, “from the voices of those people who lived through those times.”

“Not only were voices silenced by AIDS, but we are now continually at risk of losing the stories of the people who championed their fight — some with HIV/AIDS, some without — but all people who put their lives and freedom on the line to address this loss,” said project member MacNeil.

Luis Pardo, one of the activists interviewed for the project, said, “Looking back on the actions we carried out made me remember that AIDS activism was a major part of my life and left me transformed. After leaving ACT UP/LA around 1993, my life changed profoundly. I went back to school in Berkeley... and I joined advisory committees and research task forces focused on finding cures and vaccines for HIV, but of course never felt the same level of excitement as with ACT UP.”

Sadly, shortly after receiving the funding news this year, tragedy struck. On February 11, MacNeil and her wife and fellow member on the project, Mary Lucey, suddenly passed, sending shockwaves through the community.

In an official statement from ACT UP/LA, their colleagues expressed “shock and deep sorrow at the deaths of co-producers Mary Lucey and Nancy Jean MacNeil…. We launched this project together in 2021. It was an honor to work alongside these two incredible warriors.”

No further details of Lucey and MacNeil’s deaths had been released as of press time.

ABOVE Wives Mary Lucey (left) and Nancy MacNeil died within hours of each other.

Pride of the Oscars

One of the best aspects of the annual Academy Awards is Elton John’s HIV fundraising gala, which coincides with Hollywood’s biggest night.

THE 31ST ANNUAL Elton John AIDS Foundation Academy Awards Viewing Party, one of Hollywood’s most glamorous events and a stalwart fundraiser for HIV causes, took place in West Hollywood in March. Hosted by rock icon and EJAF founder Sir Elton John and his spouse David Furnish, and co-hosted by Will & Grace star Eric McCormack and Pose actress Michaela Jaé Rodriguez, the party raised over $9 million for global efforts to battle HIV and AIDS. On top of appearances by superstars like Donatella Versace, Emma Watson, Hilary Duff, Noah Schnapp, Kesha, Tyga, and Rege Jean-Page, the event featured a performance by singersongwriter and actress Rina Sawayama. John and Sawayama also teamed up for a duet during the party, performing their song “Chosen Family.”

“I’m delighted to have reunited with all of my friends tonight after such a long time apart and better yet, to have raised over $9 million for the fight against AIDS,” John said in a statement. “We mustn’t forget that HIV is still causing needless suffering around the world and we must protect those most vulnerable to this disease with testing and compassionate care. We can see an end to AIDS in our lifetimes, but first we must break down stigma and discrimination and provide equal access to healthcare to finally end the epidemic for everyone, everywhere.”—NB

Since launching in 1992, the Elton John AIDS Foundation has sprinkled money, resources, and love on millions of people living with HIV. See pictures of the 2023 Academy Awards viewing party on the next pages and visit eltonjohnaidsfoundation.org to find out more about the organization’s work.

CLOCKWISE FROM TOP LEFT Eric McCormack, David Furnish, Michaela Jaé Rodriguez, and Elton John GETTY IMAGES FOR ELTON JOHN AIDS FOUNDATION

Emma Watson

LEFT TO RIGHT Elton John, Rina Sawayama, and David Furnish

LEFT TO RIGHT David Furnish, Tan France, Antoni Porowski, and Bobby Berk

LEFT TO RIGHT Lucien Laviscount, Jeremy O. Harris, Soo Joo Park, and Evan Mock

Hilary Duff

LEFT TO RIGHT Chris Levine, David Furnish, and Charlotte Tilbury

LEFT TO RIGHT Brooke Shields and Thuso Mbedu

LEFT TO RIGHT Elton John and David Furnish

Rina Sawayama

Welcome to long-acting HIV treatment.

Jayson

Stays undetectable with CABENUVA

Results may vary.

CABENUVA is the only complete, long-acting injectable prescription used to replace daily HIV pills in certain adults and adolescents who have their doctor’s approval.

Every-other-month CABENUVA is given by a healthcare provider as 2 injections, initially 1 month apart for 2 months. It works continuously to help you stay undetectable* for 2 months.

Attend all appointments.

Important Facts About CABENUVA

This is only a brief summary of important information about CABENUVA and does not replace talking to your healthcare provider about your condition and treatment. (kab’ en ue vah)

ABOUT CABENUVA

CABENUVA is a complete prescription regimen used to treat HIV-1 infection in adults and adolescents ≥12 years who weigh at least 77 lbs (35 kg) and are replacing their current HIV-1 treatment when their healthcare provider determines that they meet certain requirements.

HIV-1 is the virus that causes Acquired Immune Defi ciency Syndrome (AIDS).

CABENUVA contains 2 different medicines:

• cabotegravir

• rilpivirine

It is not known if CABENUVA is safe and effective in children younger than 12 years of age or weighing less than 77 lbs (35 kg).

DO NOT RECEIVE CABENUVA IF YOU

• have ever had an allergic reaction to cabotegravir or rilpivirine.

• are taking the following medicines:

° carbamazepine

° oxcarbazepine

° phenobarbital

° phenytoin

° rifabutin

° rifampin

° rifapentine

° dexamethasone (more than a single-dose treatment)

° St John’s wort (Hypericum perforatum)

Ask your doctor about CABENUVA

BEFORE RECEIVING CABENUVA

Tell your healthcare provider about all your medical conditions, including if you:

• have ever had a skin rash or an allergic reaction to medicines that contain cabotegravir or rilpivirine.

• have ever had liver problems, including hepatitis B or C infection.

• have ever had mental health problems.

• are pregnant or plan to become pregnant. It is not known if CABENUVA will harm your unborn baby. CABENUVA can remain in your body for up to 12 months or longer after the last injection.

Please see additional Important Facts About CABENUVA on the following page.

*Undetectable means the amount of HIV in the blood is below the level that can be measured by a lab test. Results may vary. Jayson has been compensated by ViiV Healthcare.

“With every-other-month CABENUVA, I’m good to go.”

Important Facts About CABENUVA (cont'd)

BEFORE RECEIVING CABENUVA (cont'd)

Tell your healthcare provider about all your medical conditions, including if you: (cont'd)

• are breastfeeding or plan to breastfeed. Do not breastfeed if you take CABENUVA.

° You should not breastfeed if you have HIV-1 because of the risk of passing HIV-1 to your baby. It is not known if CABENUVA can pass to your baby in your breast milk.

° Talk with your healthcare provider about the best way to feed your baby during treatment with CABENUVA.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Some medicines interact with CABENUVA. Keep a list of your medicines and show it to your healthcare provider and pharmacist when you get a new medicine. You can ask your healthcare provider or pharmacist for a list of medicines that interact with CABENUVA. Do not start taking a new medicine without telling your healthcare provider. Your healthcare provider can tell you if it is safe to take CABENUVA with other medicines.

POSSIBLE SIDE EFFECTS OF CABENUVA

CABENUVA may cause serious side effects, including:

• Allergic reactions. Call your healthcare provider right away if you develop a rash with CABENUVA. Stop receiving CABENUVA and get medical help right away if you develop a rash with any of the following signs or symptoms:

° fever

° generally ill feeling

° tiredness

° muscle or joint aches

° trouble breathing

° blisters or sores in mouth

° blisters

° redness or swelling of the eyes

° swelling of the mouth, face, lips, or tongue

• Post-injection reactions have happened within minutes in some people after receiving their rilpivirine injection. Most symptoms resolved within minutes after the injection. Symptoms may include:

° trouble breathing

° narrowing of airways

° stomach cramps

° sweating

° numbness of your mouth

° pain (e.g., back and chest)

° feeling anxious

POSSIBLE SIDE EFFECTS OF CABENUVA (cont’d)

CABENUVA may cause serious side effects, including:(cont’d)

• Liver problems. People with a history of hepatitis B or C virus or people who have certain liver function test changes may have an increased risk of developing new or worsening changes in certain liver tests during CABENUVA treatment. Liver problems have also happened in people without history of liver problems or other risk factors. Your healthcare provider may do blood tests to check your liver function. Call your healthcare provider right away if you develop any of the following signs or symptoms of liver problems:

° your skin or the white part of your eyes turns yellow (jaundice)

° dark or “tea-colored” urine

° light-colored stools (bowel movements)

° nausea or vomiting

° loss of appetite

° pain, aching, or tenderness on the right side of your stomach area

° itching

• Depression or mood changes. Call your healthcare provider or get emergency medical help right away if you have any of the following symptoms:

° feeling sad or hopeless

° feeling anxious or restless

° have thoughts of hurting yourself (suicide) or have tried to hurt yourself

The most common side effects of CABENUVA include:

• pain, tenderness, hardened mass or lump, swelling, redness, itching, bruising, and warmth at the injection site

• fever

• tiredness

• headache

• muscle or bone pain

• nausea

• sleep problems

• dizziness

• rash

These are not all the possible side effects of CABENUVA. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

GET MORE INFORMATION

° feeling warm

° rash

° feeling light-headed or feeling like you are going to pass out (faint)

° blood pressure changes

• Talk to your healthcare provider or pharmacist.

• Go to CABENUVA.com or call 1-877-844-8872, where you can also get FDA-approved labeling.

March 2022 CBN:4PIL

Trademarks are property of their respective owners.

BY ANDREW J. STILLMAN

Reality star and advocate GREG MATHIS JR. breaks down the importance of education and using your voice to fight for HIV resources.

When Greg Mathis Jr. came out on national television — on his family’s reality series Mathis Family Matters — he had an idea in mind for how best to use his newfound platform. The son of Judge Greg Mathis, best known for his long-running syndicated courtroom reality show, Judge Mathis , Mathis Jr. knew he wanted to be a representative not only for the LGBTQ+ community, but also for those living with HIV.

Mathis Family Matters, which just aired its first season in 2022 and is available to stream on Peacock TV and various other streaming platforms, introduced Mathis Jr. to life on a more public scale. His coming out storyline on the show culminated with Elliott Cooper, Mathis Jr.’s longtime boyfriend, asking for his hand in marriage in front of the whole family in the season finale.

He, of course, said yes.

A breakaway star from the show, Mathis Jr. hit the ground running as a leading voice for LGBTQ+ causes. He joined forces with foundations like the Elizabeth Taylor AIDS Foundation as an advocate for those living with

and susceptible to HIV, a topic that hits close to home.

Although Mathis Jr. spent some time working at the U.S. Senate learning about policies and how they’re implemented, his support for the HIV community was inspired by his Uncle Steve, who passed away due to complications from HIV and cancer.

“It’s always been a really important issue for our family, even before me coming out publicly as gay [on Mathis Family Matters], something that we’ve kind of taken on as a family,” Mathis Jr. tells Plus. “But my new platform and coming out publicly as gay has given me an opportunity to really take this issue on in a much more direct way…even beyond my uncle.”

That direct way led him to headlining the 30th annual AIDSWatch Rally on Capitol Hill in March alongside John Roberts (Bob’s Burgers) and Daniel Franzese (Mean Girls, Looking). Mathis Jr.’s participation in the rally was on behalf of Us Helping Us and the National Gay Men’s Advocacy Coalition’s work to support Black LGBTQ+ people in advocacy and leadership.

On leading the rally, Mathis Jr. said, “I think when I look around my friend group, we’re

ABOVE LEFT TO RIGHT Elliott Cooper, Greg Mathis Jr., Linda Mathis, Greg Mathis Sr., and Amir Mathis attend Apple Original Films’ Emancipation premiere OPPOSITE Elliot Cooper (L) and Greg Mathis Jr. attend the #SeenOnPixel for PRIDE: A Night With Google Pixel, GLAAD + Out + The Advocate

impacted and it’s all around us. So knowing that there really is an opportunity for us to end this epidemic, and that the focus is on testing, treatment, prevention, and the community work that we could do to get rid of this epidemic once and for all. It really made me want to be more outspoken and more active on these issues, and to do my part to make sure that folks are learning more about this.”

As to how AIDSWatch tapped him as the leader of the rally, Mathis Jr. said he’d posted something on social media in regard to key dates for various HIV/AIDS awareness days, and someone reached out to him to gauge his interest.

“I jumped at the opportunity,” he said, noting that the work was similar to a “really exciting” partnership he had with the Elizabeth Taylor AIDS Foundation on HIV Is Not a Crime Awareness Day in February.

“I think folks saw my work on that day, in addition to some other things that I did that led to an opportunity to be active in this conference here, which I’m really excited about because they haven’t done it since 2019. Not only is it the 30th anniversary [of the rally], it’s coming back for the first time since the pandemic — which is really exciting because I know how important it is to get on Capitol Hill and have these conversations.”

Reflecting on his own time in D.C., Mathis Jr. says, “I worked down there for 10 years, and

I know that if you aren’t making your views known, if you aren’t telling the people who represent you the resources that you need and what’s important to you, it has a high probability of falling completely by the wayside because there’s so many other competing priorities in D.C.”

Upward of 300 volunteers also joined the rally, which partially influenced something Mathis Jr. wanted to address in his speech.

“I wanted to talk about the importance of people using their voice, because at this rally, there [were] people there who are living with HIV, those of us who are vulnerable, and everyone in between. I really wanted to impress upon folks the importance of using your voice to advocate for the resources that we need to end this epidemic. Like I said before, we are so close to ending this epidemic once and for all.”

The addition of the volunteers at the rally made work like going door-to-door, state-to-state, and talking to congressional representatives about those resources more feasible. The issues were also presented directly to those representatives to make sure they were educated on the topics.

“The issues that get the most attention are the ones that staffers and the representatives hear the most about. Oftentimes, in my experience, you hear from large companies who can afford

Brothers Amir Mathis (L) and Greg Mathis Jr. celebrate at the Mathis Family Matters screening at Casita Hollywood.

to hire big fancy lobbyists and fly people into D.C. and talk about the issues that are important to them. But maybe those aren’t always the issues that are impacting marginalized communities.”

“When I worked on Capitol Hill, I was a health policy advisor to Senator Mark Warner [of Virginia] on the Finance Committee,” he adds. “We did a lot of work with Medicare and Medicaid and those programs, the Ryan White HIV AIDS program, and learning how close we are to really ending this pandemic. I mean, the science is there, the prevention is there. Everything we need is there. The only thing that’s missing is the public education and the community work to get people comfortable with where we need to go.”

With the knowledge and everything needed at our fingertips, Mathis Jr. hopes there will be additional investment in community resources so people can have the education needed to make the best decisions for their sexual health.

That said, he noted, “If you’re having unprotected sex in the gay community, particularly as a gay Black man, you probably want to be protecting yourself somehow, for sure.”

Within the education and treatment department, Mathis Jr. also says addressing stigma and discrimination head-on are key factors to winning the fight against HIV, too.

“We worked on highlighting the issues around HIV criminalization and how that contributes to stigma and people not wanting to get treatment. I saw my uncle go through that, just being afraid to talk about his diagnosis [or] to seek treatment at times because of the fear of being criminalized or treated differently. So that is absolutely one of the big pushes that we need to make. And one of the things that we need to deal with is reducing stigma so that people feel comfortable getting the care that they need, and also openly having those conversations about prevention is necessary as well.”

Greg Mathis Jr. (L) and Elliott Cooper attend the 33rd Annual GLAAD Media Awards

U=U, YOU’VE COME A LONG WAY, BABY

A look back on the movement that continues to smash stigma — and just might be the key to eliminating HIV once and for all.

BY DESIRÉE GUERRERO

Though it may still seem like a relatively new concept to many, the U=U movement has been evolving alongside the HIV epidemic for decades.

“Undetectable equals untrans-mittable,” more popularly known as U=U, is the globally-accepted scientific consensus that continues to change the lives of people living with HIV — and has also become one of our number one tools in the fight to eliminate the virus. It simply means that an HIV-positive person on treatment and who has undetectable levels of HIV in their body has a nearly zero percent chance of transmitting the virus to a sexual partner — even without the use of a condom.

Throughout the 1980s and early ’90s, during what is now referred to as the “AIDS era,” the medications available to treat HIV were largely ineffective and often toxic. Many diagnosed as HIVpositive at this time ultimately did not survive, and those who did typically suffered from debilitating drug side effects and other complications, not to mention PTSD (post-traumatic stress disorder) from losing so many friends and lovers over the years. It was a dark and difficult time, and one we still bear the scars of.

Despite the fact that tens of thousands were dying from the virus, the government (primarily, the right-wing Reagan and Bush administrations) largely ignored the epidemic, most likely since it only seemed to affect queer communities. This lack of federal response would end up birthing a powerful rise in activism, with the formation of groups like ACT UP, which staged radical demonstrations and protests in order to bring national awareness to the issue of HIV and AIDS.

Then, in 1996, huge scientific advancements in HIV treatment changed everything. Antiretroviral treatment (ART) drugs were developed and proved to be highly effective in stopping the spread of HIV within the body. And researchers soon after discovered that, once on treatment, people living with HIV could reach undetectable levels of the virus.

Dr. Julio Montaner, a pioneering HIV physician and researcher, first introduced the concept of “Treatment as Prevention,” also known as TasP, in 2006. Montaner was

one of the first experts to really focus on the idea that people being on treatment was a means to prevent transmission of HIV. The introduction of TasP marked the true beginnings of the U=U movement.

Over the next decade, continued research constantly reinforced the science behind this idea. In 2016, a group of HIV activists formed the Prevention Access Campaign and first coined the term U=U. The organization was formed with the priority of getting the message out about this gamechanging concept.

“U=U is my calling,” Bruce Richman, a lawyer-turnedactivist and founder of the Prevention Access Campaign, told Plus in 2020. “It grabbed me by the gut and yanked me forward. I’ve never felt such a compulsion and clarity. I knew that undetectable equals untransmittable, but millions of people were suffering because they were not being told, and people in positions of great influence to alleviate that suffering were sitting on their hands. I had no choice.”

Richman also reflected on what first discovering U=U meant to him.

“I was depressed, suicidal at times, because I’d really internalized the stigma and felt toxic, dangerous,” he explained. However, in 2012, Richman discovered that when you are on treatment and your viral load is undetectable, it is impossible for you to transmit the virus to others. That’s when says he “started to see the possibility of love and real intimacy in my life without fear. It was like a new world.”

Today, over 1,000 partners in 105 countries officially support the U=U consensus, including the World Health Organization, the President’s Emergency Plan for AIDS Relief, Joint United Nations Program on HIV/AIDS, the U.S. Centers for Disease Control & Prevention, and the National Institutes of Health.

And the movement continues to grow. Plus magazine’s 2022 person of the Year, Deondre Moore, was instrumental in getting the White House to officially endorse U=U.

When Moore appeared on our cover in October, he explained how some public comments he made at the President’s Advisory Council on HIV/AIDS meeting in March

2022 would set the wheels into motion of bringing the message of U=U to the White House.

“Please recommend that the White House officially endorse U=U, so that the U.S. can join Canada, Vietnam, and other countries across the globe in choosing science over stigma,” said Moore at the PACHA meeting. “With your leadership and support, we can measure, optimize, and scale up the impact U=U has on improving the health, well-being, and emotional wellness of people living with HIV. This will also prevent new transmissions. Embracing U=U is a win-win.”

“The following week I was approached by the [White House’s] Office of National AIDS Policy to provide my written transcript [of my comments] to share with them,” Moore added. “Which is what sparked the beginning of conversations with HHS, Dr. Fauci, and the CDC to coordinate a collaborative effort with U=U to announce their support and plans to integrate U=U into programming and federal guidelines.”

Soon after, the White House announced its official endorsement of U=U — and the movement continues to be a powerful force in the fight against HIV and its stigma.

To learn more about U=U and for additional resources, visit preventionaccess.org.

TELO/SHUTTERSTOCK (MANCHESTER PRIDE); KOLLIN BENSON (MOORE); COURTESY BRUCE RICHMAN (U=U EVENT)

CLOCKWISE FROM TOP 2019 Manchester Pride Parade

Deondre Moore helped bring the message of U=U to the White House Prevention Access Campaign founder Bruce Richman (center) poses with fellow U=U activists OPPOSITE ACT UP activists stage a “die-in” in the streets of NYC in the early 1990s

The State of HIV TV

Media monitoring organization

GLAAD has good and bad news when it comes to TV depictions of LGBTQ+ people and individuals living with HIV.

BY TRUDY RING

Racial diversity of LGBTQ+ television characters and depictions of people living with HIV on TV is up, but LGBTQ+ representation overall is down slightly, according to the latest edition of GLAAD’s annual “Where We Are on TV” report, released in March.

“Where We Are on TV” assesses and analyzes the number of LGBTQ+ and HIV-positive regular and recurring characters on scripted series on primetime broadcast and cable as well as eight major streaming platforms. This year’s report covers shows that premiered or are expected to return between June 1, 2022, and May 31, 2023. This marks the 27th year that GLAAD has tracked the presence of LGBTQ+ characters on television and the 18th edition of the “Where We Are on TV” report.

This year’s report counted eight LGBTQ+ characters living with HIV. That is an increase from last year’s study, but none of these characters will return. Six were on the anthology series American Horror Story: NYC , and the remaining two were on the canceled series The Midnight Club on Netflix and the Queer as Folk reboot on Peacock. GLAAD’s most recent “State of HIV Stigma” study found that only 31 percent of adults have seen stories about people with HIV in the media. With approximately 1.2 million Americans living with HIV, GLAAD continues to call for diverse stories of people living with HIV.

This year, GLAAD counted 596 regular and recurring LGBTQ+ characters across broadcast, cable, and streaming, a decrease of 6.4 percent from the previous

year’s 637 LGBTQ+ characters. There were 141 LGBTQ+ characters on broadcast, 139 on cable, and 356 on the streaming services Apple TV+, Amazon Prime, Disney+, HBO Max, Hulu, Netflix, Peacock, and Paramount+.

“We have seen with shows like The Last of Us, Stranger Things, The Umbrella Academy, and more, that when networks and streamers put their full brand influence into LGBTQ-inclusive shows, our stories are successful critically and commercially,” GLAAD President and CEO Sarah Kate Ellis said in a press release. “As the media landscape continues to grow and change, it is imperative that these companies stand behind the excellent LGBTQ storytelling their creative teams are telling, so these series are able to more deeply explore the lives and stories of characters audiences have come to love. With attacks on the

FIN ARGUS played HIV-positive Mingus on Queer as Folk

LGBTQ community in political and news spaces, Hollywood has more influence than ever and it’s critical the stories they invest in telling include fair and accurate depictions of LGBTQ people that reflect the humanity of our community.”

GLAAD continues to call for higher representation of LGBTQ+ people of color across television to reflect the true demographics of the community. This year, racial diversity is up on cable and streaming, with at least 50 percent of LGBTQ+ characters on each platform being people of color.

For the past four years, over 50 percent of LGBTQ+ characters on broadcast have been people of color, but this year that is down slightly to 48 percent. For the first time in this report’s history, streaming features a majority of LGBTQ+ people of color (53 percent of all LGBTQ+ characters across the platforms tracked). In total, 51 percent (304) of the 596 LGBTQ+ characters are people of color.

There were 32 transgender characters, a decrease of 10 from last year. (Several transinclusive series will take an extended break between seasons and will return in future reports but are not counted in this study’s research period.) Of those 32 transgender characters, 16 are trans women, 11 are trans men, and five are nonbinary.

“At a time when transgender Americans are facing a growing number of dangerous and discriminatory attacks in rhetoric and policy, Hollywood players who are real allies to our community have a responsibility and an opportunity to create stories that humanize trans people and educate viewers about being transgender,” Ellis said in the release.

RUSSELL TOVEY starred in American Horror Story: NYC

LEFT William Chris Sumpter played HIV-positive Spencer on The Midnight Club SHUTTERSTOCK

LONG- C ING

APRETUDE is a prescription medicine used for HIV-1 PrEP to reduce the risk of getting HIV-1 infection in adults and adolescents who weigh at least 77 pounds (at least 35 kg).

i he fi n nl l ng- ing, inje le f e ing he i f ge ing HIV-1

I ’ n inje i n given eve he m n h, in e f pill e eve

S ie in HIV-1 neg ive i gen e men, n gen e w men, n i gen e w men i f ge ing HIV-1

APRETUDE is given every other month by a healthcare provider after initiation injections have been given 1 month apart for 2 consecutive months. Stay under a provider’s care while receiving APRETUDE. You must receive it as scheduled. If you will miss a scheduled injection by more than 7 days, call your provider right away.

IMPORTANT FACTS ABOUT APRETUDE

This is only a brief summary of important information about APRETUDE and does not replace talking to your healthcare provider about your medicine.

AP-reh-tood

MOST IMPORTANT INFORMATION ABOUT APRETUDE

Important information for people who receive APRETUDE to help reduce their risk of getting human immunodeficiency virus-1 (HIV-1) infection, also called pre-exposure prophylaxis or “PrEP”:

MOST IMPORTANT INFORMATION ABOUT APRETUDE (cont'd)

Before receiving APRETUDE to reduce your risk of getting HIV-1:

• You must be HIV-1 negative to start APRETUDE. You must get tested to make sure that you do not already have HIV-1 infection.

• Do not receive APRETUDE for HIV-1 PrEP unless you are confirmed to be HIV-1 negative.

• Some HIV-1 tests can miss HIV-1 infection in a person who has recently become infected. If you have flu-like symptoms, you could have recently become infected with HIV-1. Tell your healthcare provider if you had a flu-like illness within the last month before starting APRETUDE or at any time while receiving APRETUDE. Symptoms of new HIV-1 infection include: tiredness; joint or muscle aches; sore throat; rash; enlarged lymph nodes in the neck or groin; fever; headache; vomiting or diarrhea; night sweats. Please see additional Important Facts About APRETUDE at right.

Eligible patients may p li le $0 -p pe inje i n on prescribed APRETUDE.

IMPORTANT FACTS ABOUT APRETUDE (cont'd)

MOST IMPORTANT INFORMATION ABOUT APRETUDE (cont'd)

While you are receiving APRETUDE for HIV-1 PrEP:

• APRETUDE does not prevent other sexually transmitted infections. Practice safer sex by using a latex or polyurethane condom to reduce the risk of getting sexually transmitted infections.

• You must stay HIV-1 negative to keep receiving APRETUDE for HIV-1 PrEP.

° Know your HIV-1 status and the HIV-1 status of your partners.

° Ask your partners with HIV-1 if they are taking anti-HIV-1 medicines and have an undetectable viral load. An undetectable viral load is when the amount of virus in the blood is too low to be measured in a lab test. To maintain an undetectable viral load, your partners must keep taking HIV-1 medicine as prescribed. Your risk of getting HIV-1 is lower if your partners with HIV-1 are taking effective treatment.

° Get tested for HIV-1 with each APRETUDE injection or when your healthcare provider tells you. You should not miss any HIV-1 tests. If you become HIV-1 infected and continue receiving APRETUDE because you do not know you are HIV-1 infected, the HIV-1 infection may become harder to treat.

° Get tested for other sexually transmitted infections such as syphilis, chlamydia, and gonorrhea. These infections make it easier for HIV-1 to infect you.

° If you think you were exposed to HIV-1, tell your healthcare provider right away. They may want to do more tests to be sure you are still HIV-1 negative.

° Get information and support to help reduce sexual risk behaviors.

° Do not miss any injections of APRETUDE. Missing injections increases your risk of getting HIV-1 infection.

° If you do become HIV-1 positive, you will need to take other medicines to treat HIV-1. APRETUDE is not approved for treatment of HIV-1.

If you have HIV-1 and receive only APRETUDE, over time your HIV-1 may become harder to treat.

ABOUT APRETUDE

APRETUDE is a prescription medicine used for HIV-1 PrEP to reduce the risk of getting HIV-1 infection in adults and adolescents who weigh at least 77 pounds (at least 35 kg). HIV-1 is the virus that causes Acquired Immune Deficiency Syndrome (AIDS).

It is not known if APRETUDE is safe and effective in children younger than 12 years of age or weighing less than 77 pounds (less than 35 kg).

DO NOT RECEIVE APRETUDE IF YOU:

• already have HIV-1 infection. If you are HIV-1 positive, you will need to take other medicines to treat HIV-1. APRETUDE is not approved for treatment of HIV-1.

• do not know your HIV-1 infection status. You may already be HIV-1 positive. You need to take other medicines to treat HIV-1. APRETUDE can only help reduce your risk of getting HIV-1 infection before you are infected.

• are allergic to cabotegravir.

• are taking any of the following medicines: carbamazepine; oxcarbazepine; phenobarbital; phenytoin; rifampin; rifapentine.

BEFORE RECEIVING APRETUDE

Tell your healthcare provider about all your medical conditions, including if you:

• have ever had a skin rash or an allergic reaction to medicines that contain cabotegravir.

• have or have had liver problems.

• have ever had mental health problems.

• are pregnant or plan to become pregnant. It is not known if APRETUDE will harm your unborn baby. APRETUDE can remain in your body for up to 12 months or longer after the last injection. Tell your healthcare provider if you become pregnant while receiving APRETUDE.

BEFORE RECEIVING APRETUDE (cont'd)

• are breastfeeding or plan to breastfeed. It is not known if APRETUDE can pass to your baby in your breast milk. Talk with your healthcare provider about the best way to feed your baby while receiving APRETUDE.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Some medicines may interact with APRETUDE. Keep a list of your medicines and show it to your healthcare provider and pharmacist when you get a new medicine. You can ask your healthcare provider or pharmacist for a list of medicines that interact with APRETUDE.

Do not start a new medicine without telling your healthcare provider. Your healthcare provider can tell you if it is safe to receive APRETUDE with other medicines.

POSSIBLE SIDE EFFECTS OF APRETUDE

APRETUDE may cause serious side effects, including:

• Allergic reactions. Call your healthcare provider right away if you develop a rash with APRETUDE. Stop receiving APRETUDE and get medical help right away if you develop a rash with any of the following signs or symptoms: fever; generally ill feeling; tiredness; muscle or joint aches; trouble breathing; blisters or sores in mouth; blisters; redness or swelling of the eyes; swelling of the mouth, face, lips, or tongue.

• Liver problems. Liver problems have happened in people with or without a history of liver problems or other risk factors. Your healthcare provider may do blood tests to check your liver function. Call your healthcare provider right away if you develop any of the following signs or symptoms of liver problems: your skin or the white part of your eyes turns yellow (jaundice); dark or "tea-colored" urine; lightcolored stools (bowel movements); nausea or vomiting; loss of appetite; pain, aching, or tenderness on the right side of your stomach area; itching.

• Depression or mood changes. Call your healthcare provider or get medical help right away if you have any of the following symptoms: feeling sad or hopeless; feeling anxious or restless; have thoughts of hurting yourself (suicide) or have tried to hurt yourself.

The most common side effects of APRETUDE include: pain, tenderness, hardened mass or lump, swelling, bruising, redness, itching, warmth, loss of sensation at the injection site, abscess, and discoloration; diarrhea; headache; fever; tiredness; sleep problems; nausea; dizziness; passing gas; stomach pain; vomiting; muscle pain; rash; loss of appetite; drowsiness; back pain; upper respiratory infection. These are not all the possible side effects of APRETUDE.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

GET MORE INFORMATION

• Talk to your healthcare provider or pharmacist.

• Go to APRETUDE.com or call 1-877-844-8872 where you can also get FDA-approved labeling.

December 2021 APR:1PIL

Trademark is owned by or licensed to the ViiV Healthcare group of companies. ©2022 ViiV Healthcare or licensor.

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Produced in USA.

TURNING THE TIDE

The incoming (and first gay) president of the American Medical Association discusses LGBTQ+ health and his plans to protect trans and queer youth.

BY JOHN CASEY

Mid-March was the annual LGBTQ+ Health Awareness Week, designated by the National Coalition for LGBTQ+ Health. The week, according to organization, is “intended to help the healthcare community advocate for reducing barriers to LGBTQ persons by creating and maintaining safe, inclusive, and welcoming environments — and ensuring quality, accessible, and non-discriminatory health care.”

However, for the incoming president of the American Medical Association — who will be the first queer person to head the 173-year-old organization — health awareness among members of our community should stretch beyond one week.

“At present, we have so many health issues affecting our community, particularly among our trans youth, so it’s more important than ever to be vigilant,” said Dr. Jesse M. Ehrenfeld, who will become the AMA president in June after being elected during the organization’s annual meeting last summer.

Ehrenfeld is currently a senior associate dean and a tenured professor of anesthesiology and director of Advancing a Healthier Wisconsin Endowment at the Medical College of Wisconsin. He was elected to the AMA’s Board of Trustees in 2014. He is also a combat veteran who deployed to Afghanistan during both Operation Enduring Freedom and Resolute Support Mission.

In a wide-ranging interview about health issues affecting the LGBTQ+ community, Ehrenfeld vowed to continue his fight for LGBTQ+ health equity, which he described

as “a cause very close to my heart. I’ve been advocating on behalf of the community for over 20 years and am proud to have founded the National LGBT Health Education Center, which offers education and training to healthcare providers on LGBTQspecific health concerns.”

In 2018, in recognition of his outstanding research contributions, Ehrenfeld received the inaugural Sexual and Gender Minority Research Investigator Award from the director of the National Institutes of Health.

One question that continues to circulate among the community is if we should still be worried about mpox?

“As of mid-March, the CDC is averaging about one case a day, and that compares to mid-August of last year when they were seeing 450 cases a day,” Ehrenfeld pointed out. “But we need to be cautious here, since the low figures are during months where most of us are inside or not as active.”

He added, “We know that spring and summer will bring events, festivals, parties — so we may see some more community outbreaks. The best thing anyone can do who feels they might be at risk is to make sure to be vaccinated. The vaccine is safe and effective, so if you’re at high risk, make sure to get one. Overall, we still need to continue to monitor the spread of monkeypox and work to prevent any possible additional transmission.”

In previous articles for The Advocate, Dr. Anthony Fauci has talked about the possible future of injectables as a treatment for HIV patients, and Ehrenfeld said that he and the AMA are deeply committed to stopping the spread of HIV.

“Long-acting therapies will become an important tool for HIV treatment, and some are already receiving once a month treatment through injectables. But more work needs to be done — not only in finding a cure and finding better treatment options, but also to make sure that marginalized communities are receiving the proper care, and that members of these communities are getting screened for HIV on a regular basis.”

Ehrenfeld suggested that at the very least people should be getting tested once a year. “We must continue to invest in research and public education to ensure that HIV treatment is accessible and affordable to everyone who needs it.”

“And one other thing that we still need to do is to help get rid of the stigma that still exists behind the disease,” he added. “It’s so important to remember that HIV is not limited to any group of people, and the stigma that remains is an unfortunate part of its legacy. We need to do all we can to fight it.”

Another matter that is critical to confront is the assault, by state governments, on the health of trans youth.

“It is imperative that we expand, not contract, care for trans youth,” Ehrenfeld implored. “We have to reassess how we improve the quality of healthcare for trans youth and adults in the face of government intrusion into the practice of medicine.”

Ehrenfeld also said that it’s a long-standing position of the AMA to oppose any laws that limit access to medically necessary care and restrict the ability of health care professionals to care for their patients. “In the past, the AMA has also called on lawmakers to recognize the rights of patients to make their own informed decisions about their own health care needs.”

Ehrenfeld said instead of being singled out, “Transgender youth should be celebrated and embraced for their strength and courage in being their true selves. People don’t realize how much bravery that takes. They should not be ostracized or be shamed for who they are and who they feel like they

should be. Our transgender youth need our support more than ever, and they need our understanding, compassion, and acceptance so that they can reach their full potential.”

Some other priorities of Ehrenfeld’s are LGBTQ+ youth and mental health. “LGBTQ+ youth face unique challenges for mental health, and more must be done to ensure that they have access to the care and support they need. We also need to better understand the mental health challenges for trans, nonbinary, and queer youth who are more likely to [die by] suicide than their straight peers. It’s a problem and we need to correct it.”

“We also need to reduce the stigma around mental health. These are all top priorities for the AMA and will be for me once I become president in June.”

BLOODY CONFUSING

What to know about the FDA’s new policies on blood donation from gay and bi men.

THE FEDERAL DRUG Administration recently proposed changes to blood donation policy to replace the deferral for sexually active gay and bisexual men with an individual risk assessment applied to all potential blood donors regardless of sexual orientation or gender. This move from an identity-based deferral to one based on a potential donor’s recent sexual activities is a transformative change in the FDA’s management of blood safety and marks the end of the overtly discriminatory policy that has been in place for 35 years.

BY SCOTT A. SCHOETTES

1983, little was known about AIDS beyond that it was deadly, the majority of those affected were gay men, and it could be transmitted sexually and via blood transfusion. Given the substantial number of blood/plasma users diagnosed by 1985, the indefinite deferral for all gay and bisexual men implemented at that time was the only practical way to reestablish the safety of the blood supply.

The FDA’s capitulation should be heralded as a significant if long overdue victory in LGBTQ+ civil rights. Instead, misconceptions regarding the basis for the now discarded identity-based deferrals, the fitful way the FDA updated the policy over the past decade, rhetoric used to argue against the discriminatory policy, and imprecise communications rolling out the new policy all combined to obscure the historic nature of the change and to temper celebration of the victory.

When the FDA first recommended deferring “sexually active gay and bisexual men with multiple partners” in

Almost simultaneously, HIV was identified as the cause of AIDS and, shortly thereafter, scientists developed the first test to detect HIV antibodies in blood. All blood donations could now be tested to ensure the donor did not have HIV. However, this test sometimes resulted in a false negative if the donor was recently infected. Deferrals, therefore, were still needed to ensure the blood of people infected within the previous six months — referred to as the “window period” — did not end up in the blood supply.

Those deferrals, however, only needed to cover the window period, with a “cushion” to account for faulty memory or the unusually late false negative, and the FDA started using 12-month deferrals for some risk categories in 1992. But the lifetime deferral for gay and bisexual men continued.

Without a valid reason for a deferral of more than a year, the policy became discriminatory. Over time, more sensitive tests were developed, and the window period was reduced to 9-11 days. Nonetheless, the deferral for gay and bisexual men remained lifelong.

In addition to significantly reducing the window period, scientists soon established that some activities, such as oral sex, present little to no risk of HIV transmission and others, such as receptive anal sex, present 13 times the risk (or more) of vaginal sex. That is why, in the early 2010s, advocates began calling for an individual risk assessment inquiring about specific sexual activities and a deferral of no more than 60 days for those that assessment determined to be at higher risk.

Unfortunately, those calls went unheeded. Instead of taking swift action based on well-established science, the FDA slow-walked the process by maintaining the focus on gay and bisexual men and first studying a five-year deferral (2012), and then a one-year deferral (2014), and then implementing a one-year deferral (2015), and then — when the blood supply ran short during COVID — implementing a 3-month deferral (2020).

This sudden shift in stance merely confirmed in the eyes of many that the FDA’s intransigence was never based on significant risk to the blood supply or the need for more data. And tellingly, after 2015, there was no longer a deferral for transgender women, among whom HIV prevalence is higher than for gay and bisexual men. The policy had become completely untethered from the science, and the FDA lost credibility continuing to defend it.

That is why the proposed changes announced in late January are monumental: deferrals will finally be based on the science of HIV transmission and will be applicable to every blood donor, not just to gay and bisexual men. Essentially anyone who has anal sex with new or multiple partners in the previous three months will be deferred. And though the current science also supports an even shorter deferral and only for those who have had receptive anal sex with a new or multiple partners, those refinements can be made down the line. The change to deferral based on individual risk assessment — and not sexual orientation — is the critical turning point to a fair, inclusive, and non-stigmatizing policy.

But even this transformational change is not without its miscues and controversies; resulting in these three contrarian statements:

1. Contrary to some media accounts, the proposed changes are not simply for people in monogamous relationships; they are instead rooted in one’s number of anal sex partners. Having one sex partner makes a person monogamous, but it does not put that person in

a monogamous relationship. Lots of people who think they are in a monogamous relationship are not. And though this will be a constriction of the current policy for heterosexuals, a donor can have multiple partners for all kinds of non-anal sex and still donate blood.

2. Contrary to statements from some advocates, continuation of the bar for people currently taking PrEP — a daily medication to prevent HIV — is not discriminatory. Discrimination is one group treated differently from another group without a valid reason. PrEP, a great HIV prevention tool, may cause a false negative test result when a person’s blood is tested post donation. Understandably, the continued inability to donate is frustrating for gay and bisexual men who are taking PrEP; but the potential false negative is a valid reason for maintaining this deferral. Donating in contravention of this rule is a donor unilaterally deciding they are not at risk and that their blood does not need to be tested like everyone else’s — but it does. Until the FDA establishes a way to confirm a PrEP user’s HIV-negative status at time of donation, PrEP users need to forego donating.

3. Contrary to some well-meaning but confused people, people living with HIV also cannot donate blood, no matter how much their viral load is suppressed by effective treatment. Though it indeed is not possible for an HIV-positive person with an undetectable viral load to transmit HIV sexually — a concept popularized as “Undetectable = Untransmittable” or “U=U” — the same does not hold true for blood donation. Even a person with an undetectable viral load has HIV in their blood — and when a large enough amount of blood is infused directly into another person’s circulatory system, HIV transmission will possibly occur. At least for now, people living with HIV will also need to find other ways to be of service.

For years, the LGBTQ+ community cried: “Science Not Stigma” and “Follow the Science!” Now that the FDA is (finally) doing just that, the community needs to follow its own advice. The past 35 years have demonstrated that good things come to those who wait, and if patience can be exercised just a bit longer, a good thing called “pathogen inactivation” will make safe blood donation possible for everyone! Let’s celebrate that — and the elimination of a discriminatory policy before it was rendered moot.

Scott A. Schoettes is an attorney and advocate who lives openly with HIV. He engages in impact litigation, public policy work, and education to protect, enhance, and advance the rights of people living with HIV.

GOOD CHOICES

regimen — and finds that having more options is a major benefit.

BY NEAL BROVERMAN & ANDREW J. STILLMAN

Ayear-long study from ViiV Healthcare comparing the every two-month regimen of injectable Cabenuva with the daily oral pill Biktarvy showed that both drugs keep HIV at bay, but that the long-acting option was a benefit for many patients.

Earlier this year, ViiV presented 12-month findings from a study — called the SOLAR study — of people with virally-suppressed HIV and how they responded to Cabenuva, which is produced by ViiV along with Janssen Pharmaceutical, and Biktarvy, produced by Gilead Sciences, Inc. The first head-to-head Phase IIIb study of its kind, the SOLAR findings showed that doses of Cabenuva every two months achieved virologic efficacy similar to the daily oral option of Biktarvy. Additionally, 90 percent of participants who switched also preferred the long-acting regimen.

A total of 670 participants who were already virally suppressed due to Biktarvy were randomly selected to switch, with 447 participants taking the every-two-month regimen, and the other 223 remaining on the daily pill.

Forty-seven percent of participants reported always or often experiencing challenges with taking their daily pills at the beginning of the study — with worry of judgment, forgetting,

or unintentionally disclosing their HIV status being among the most predominant fears.

The main reasons participants preferred the long-acting regimen was less worry about remembering, convenience, not having to carry the medication on them, not having to be reminded of their status day-to-day, and not having to worry about someone accidentally finding their medications.

“There are many people living with HIV who are virally suppressed but experience challenges taking a daily oral pill, including fears of accidentally

disclosing their HIV status due to discovery of their medicine,” Moti N. Ramgopal of Florida’s Midway Immunology Research Center and principal investigator for the SOLAR study, said in a statement. “These findings raise the critical reminder that healthcare providers who prescribe HIV medicines should identify and incorporate patient preferences when making treatment recommendations, in addition to standard efficacy and safety data, to ensure that people living with HIV have the best treatment option for their needs.”

A study looks at how some people with HIV can transition from daily pills to a six-times-a-year injectable

WONDER WOMAN

The New York Patient makes history after being cured of HIV for over two years.

A STEM CELL transplant has seemingly freed a woman, known as the “New York Patient,” from HIV.

The news was first published in March in the Cell scientific journal. The patient is likely the fourth person to successfully achieve remission from HIV after a stem cell transplant.

A Lucky Number

Like other successful cases, including the Düsseldorf Patient (see below), the New York Patient had blood cancer. The mixedrace, middle-aged woman suffered acute myeloid leukemia four years after receiving her HIV diagnosis. However, unlike the three men who

A German man joins the elite ranks of people who’ve been apparently cured of HIV.

Following on the heels of “The New York Patient,” a 53-yearold man, dubbed “The Dusseldorf patient,” has become the fifth confirmed person cured of HIV.

The details of the successful treatment were first revealed at a conference in 2019, but researchers couldn’t confirm at the time that the man was, in fact, cured. Today, after being off medication for more than four years, researchers confirm that the Dusseldorf patient has no detectable virus in his body.

“It’s really [a] cure, and not just, you know, long term remission,” said Dr. Bjorn-Erik Ole Jensen in a statement. “This obviously positive symbol [gives us] hope, but there’s a lot of work to do.”

The Dusseldorf patient joins a small group of people who have been cured after a stem cell transplant, a high-risk procedure that effectively replaces a person’s entire immune system.

The first documented case of an HIV cure from “the Berlin patient” came in 2009, with the patient ultimately being identified as Timothy Ray Brown. “The London patient” followed in 2019, and 2022 saw “The City of Hope patient” and “The New York patient” (see above) find a cure.

“I think we can get a lot of insights from this patient and from these similar cases of HIV cure,” Jensen said. “These insights give us some hints where we could go to make the strategy safer.”

Dr. Todd Ellerin, director of infectious diseases at South Shore Health in Massachusetts, said, “When you hear about these HIV cures, it’s obviously incredible, given how challenging it’s been. But, it still remains the exception to the rule.”

have received stem cell transplants, she also received umbilical cord blood cells in her transplant.

Yvonne Bryson, an infectious disease specialist at the University of California Los Angeles, and a member of the team who worked with The New York patient, addressed the remission during a video press conference, saying, “She’s currently clinically healthy. She is cancerfree and HIV-free. We’re calling it a possible cure rather than a definitive one because we want to observe her for a longer follow-up period.”

The current observation has covered 30 months without a trace of the virus. Although this particular procedure wouldn’t work for all HIVpositive people, it’s still a step in the right direction.

There’s still miles to go in the fight against HIV, but more studies with the stem cell procedure are underway. —AJS

The exception shows that only 1 percent of the total population carries the genetic mutation necessary to make them resistant to HIV with a stem cell transplant.

Still, Ellerin adds, “It is obviously a step forward in advancing the science and having a sort of understanding in...what it takes to cure HIV.”—AJS

Dusseldorf, Germany

A NEW WAY TO PREP?

An insertable pill for the anus or vagina showed good results at preventing HIV transmission.

PRE-EXPOSURE PROPHYLAXIS, or PrEP, has been huge in fighting the spread of HIV. What started with the pills Truvada and Descovy transitioned into a PrEP ring and a recent long-acting injectable to help people avoid the day-to-day doses.

Outside of the medically prescribed daily dose of PrEP, however, some take PrEP pills only before and after sex instead of all the time, and the Centers for Disease Control and Prevention has noted that some off-label, “on-demand” PrEP is protective for men having anal sex with no condom.

With all that in mind, a group of researchers under the National Institute of Health’s Contraceptive Research and Development program are studying whether a quick-dissolving pill inserted into the rectum or vagina would be an effective form of on-demand PrEP. According to Managed Healthcare Executive , the experimental pill contains 20 milligrams of tenofovir alafenamide (Descovy) and 16 milligrams of elvitegravir (Vitekta).

“In nonhuman primates, the insert provided protection from infection when used in the vagina and the rectum,” said Sharon A. Riddler, M.D., professor of infectious diseases at the University of Pittsburgh School of Medicine.

Riddler presented the findings alongside her colleague at the Conference on Retroviruses and Opportunistic Infection in Seattle in February.

Twenty-three HIVnegative participants at the Universities of Pittsburgh and Alabama at Birmingham were chosen, six of whom were assigned female at birth. Each volunteer received a single dose of the insert in the clinic and blood, rectal fluid, and rectal tissue are collected. They repeated the process seven weeks later.

The tests showed positive results but indicated that two inserts are more likely to provide better protection than one. At that, the study showed limited side effects — only one mild case of anal erythema — which led Riddler and her colleagues to believe insertion would be another important choice for HIV prevention.

“Although the currently available products for prevention (oral, injectable, ring) have all been proven to be effective, there remain many barriers to these being used by people with the greatest need for prevention,” Riddler said.“Additionally, even people who can access PrEP often do not because of cost, side effects, inconvenience, etc., so the continued development of a safe, discreet, on-demand, flexible option would be a great outcome of this small Phase 1 clinical trial.”—AJS

A MAJOR INTERNATIONAL clinical trial led by the Kirby Institute at the University of New South Wales, Sydney, presented results on two simplified second-line HIV treatment options that were shown to be at least as effective as current approaches.

“Second-line” refers to treatment options available to those with HIV whose initial treatment is ineffective. Initial treatment failure, sometimes known as drug resistance, impacts nearly 10 percent of the global HIV population, according to the Kirby Institute.

Resistance Is Futile

For HIV-positive patients dealing with initial treatment failure, new research brings hope.

The new discovery from Australia could provide treatment options for over 3 million HIV-positive people globally whose initial treatment fails. This could also prove a critical improvement in increasing treatment accessibility in low- and middleincome nations.

The new treatment options from the study were designed to compare a standard approach for second-line HIV treatment against two alternative regimens. They were found to be at least as good as the standard of care in achieving viral suppression, but also carry potential benefits in cost, tolerability, and simplification.

“Recommendations for secondline therapy are generally effective at achieving viral suppression; however, some involve drug resistance testing which can be a strain on health systems. Furthermore, many treatments require multiple pills, and they can have some side effects,” says Professor Gail Matthews from the Kirby Institute, who presented the findings at the recent Conference on Retroviruses and Opportunistic Infections in Seattle. “Understanding the pros and cons of different treatment approaches is important to guide decision making.”

The study enrolled 831 patients from 14 countries, where the patients were randomized to one of the three secondline options.

“The finding of non-inferiority has significant implications for the management of HIV globally,” Professor Matthew Law of the Kirby Institute said during the results presentation at CROI. “Adopting either of these simplified treatments could mean administering fewer pills, avoids the need for specialized resistance tests, and reduces the cost of medication.”—AJS

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THE REALITY OF RESILIENCE

BY ANDREW J. STILLMAN

THE PSYCHOLOGICAL TRAUMA experienced by aging people living with HIV is mostly going untreated and affecting their general health, according to a new study out of New Jersey’s Rutgers University.

Older patients who endured a time when HIV was considered a death sentence have much fear and trauma around being treated, the findings showed. Although people with the virus are now living longer, healthier lives, the aging population faces many mental health challenges that not only impact their well-being but also the overall trajectory of the virus in their bodies, researchers found.

“Our findings support the need to target post-traumatic stress disorder and substance dependence and use among the older [HIV-positive] people and suggest that resilience might help increase adherence to antiretroviral therapy regimes,” said lead study author, Kristen D. Krause, in a statement.

Krause and a team of colleagues at the Rutgers Center for Health, Identity, Behavior and Prevention Studies surveyed 250 HIV-positive gay men between 50 and 69 in New York City recruited from dating apps, events, and organizations. The resilience observed was the ability to thrive amid challenging situations.

Those with higher levels of HIV-related resilience were shown to be more likely to have lower levels of PTSD and substance dependence, as well as more likely to feel financially secure.

Around 16 percent of participants experienced PTSD, 14 percent met the criteria for serious depression, 18 percent reported a substance dependency, while 18 percent suffered generalized anxiety, and 33 percent expressed suicidal tendencies.

“As we wait for a vaccine or a cure, it’s important to continue building a toolbox of methods and best practices to bring this epidemic to an end,” Krause said. “Resilience is one tool in that box.”

How does one foster resilience in their diagnosis and in life? Dr. Gary McClain, a psychotherapist who specialized in patients living with chronic illnesses, says practicing gratitude builds resilience.

“Practicing gratefulness enhances your coping skills,” McClain says. “It helps you to stay focused on your strengths, your foundation, during those times when the going gets rough. Gratefulness helps you to maintain a positive attitude in the face of adversity and challenge.”

For long-term survivors of HIV, being able to emotionally cope with pain and stress often translates to longer, healthier lives.

Broadway Really Does Care

While raising hundreds of thousands for HIV causes, the stars of live theater celebrated the queer community.

BY NEAL BROVERMAN

THE BROADWAY COMMUNITY has always been one of the most charitable when it comes to raising money for HIV causes, and the live theater community didn’t disappoint at its annual Broadway Backwards event. Held in March at Manhattan’s New Amsterdam Theatre, 2023’s Broadway Backwards raised over $765,000 for Broadway Cares/Equity Fights AIDS and New York’s LGBT Community Center. As described by Broadway Cares, the performance “is the only annual show on Broadway celebrating the LGBTQ+ community.” Over 65 Broadway performers, including legends like Anthony Rapp and Lea Salonga, recreated beloved musical numbers from a queer lens. Host Jenn Colella helped put on “Willkommen” (from Cabaret, of course), while Corbin Bleu took on “Mein Herr.” Salonga put her twist on “Love Who You Love” from A Man of No Importance, while Les Misérables’ “One Day More” was brought to a life as a modern group of people protesting at an LGBTQ+ equality march in Washington, D.C.

Since 1988, Broadway Cares/Equity Fights AIDS has provided over $300 million for essential services for people with HIV, AIDS, COVID-19, and other critical illnesses. The LGBT Community Center has been serving the local queer community since 1983. Find out more about Broadway Backwards and Broadway Cares at broadwaycares.org.

Adrianna Hicks

“One Day More” Cast

photos by curtis brown and rebecca j . michelson

Corbin Bleu

Dormeshia

Lea Salonga

parting shot

Len Cariou

AJ Shively and Kyle Scatliffe

Robbie Fairchild

Ali Stroker

Goofing around “Backwards”

Beth Leavel

U=U and you

Today, a major goal for HIV treatment is helping you reach an undetectable viral load. When your viral load is undetectable, there is so little virus in your blood that a lab test can’t measure it.

Current research shows that taking HIV treatment as prescribed and getting to an undetectable viral load and staying undetectable prevents the transmission of HIV to others through sex. Reaching and staying undetectable is only possible by sticking with your treatment.

There are many resources for education and information to help you get to and stay undetectable, including the link below.

And always remember, speak openly and honestly with your healthcare provider to learn about HIV and what is best for you.