POZ December 2025 by Smart + Strong

Carl Baloney Jr.

Jesse Milan

“I am more than my HIV diagnosis.”

A treatment backed by broad experience.

IMPORTANT FACTS FOR BIKTARVY®

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

MOST IMPORTANT INFORMATION ABOUT BIKTARVY

BIKTARVY may cause serious side e ects, including:

 Worsening of hepatitis B (HBV) infection. Your healthcare provider will test you for HBV. If you have both HIV-1 and HBV, your HBV may suddenly get worse if you stop taking BIKTARVY. Do not stop taking BIKTARVY without ﬁ rst talking to your healthcare provider, as they will need to check your health regularly for several months, and may give you HBV medicine.

ABOUT BIKTARVY

BIKTARVY is a complete, 1-pill, once-a-day prescription medicine used to treat HIV-1 in adults and children who weigh at least 55 pounds. It can either be used in people who have never taken HIV-1 medicines before, or people who are replacing their current HIV-1 medicines and whose healthcare provider determines they meet certain requirements.

BIKTARVY does not cure HIV-1 or AIDS. HIV-1 is the virus that causes AIDS.

Do NOT take BIKTARVY if you also take a medicine that contains:

 dofetilide

 rifampin

 any other medicines to treat HIV-1

BEFORE TAKING BIKTARVY

Tell your healthcare provider if you:

 Have or have had any kidney or liver problems, including hepatitis infection.

 The clinical and These

 Have any other health problems.

 Are pregnant or plan to become pregnant. Tell your healthcare provider if you become pregnant while taking BIKTARVY.

 Are breastfeeding (nursing) or plan to breastfeed. Talk to your healthcare provider about the risks of breastfeeding during treatment with BIKTARVY.

Tell your healthcare provider about all the medicines you take:

 Keep a list that includes all prescription and over-thecounter medicines, antacids, laxatives, vitamins, and herbal supplements, and show it to your healthcare provider and pharmacist.

Tell your any new You e ects www.FDA.gov/medwatch Your your HOW Take GET

 BIKTARVY and other medicines may a ect each other.

Ask your healthcare provider and pharmacist about medicines that interact with BIKTARVY, and ask if it is safe to take BIKTARVY with all your other medicines.

 BIKTARVY and other medicines may a ect each other. Ask your healthcare provider and pharmacist about medicines that interact with BIKTARVY, and ask if it is safe to take BIKTARVY with all your other medicines.

This about pharmacist

BIKTARVY® and condition

(bik-TAR-vee)

POSSIBLE SIDE EFFECTS OF BIKTARVY

BIKTARVY may cause serious side e ects, including: Those in the “Most Important Information About BIKTARVY” section.

Changes in your immune system. Your immune system may get stronger and begin to ﬁght infections that may have been hidden in your body. Tell your healthcare provider if you have any new symptoms after you start taking BIKTARVY.

Changes in your immune system. Your immune system get stronger and begin to ﬁght infections that may been hidden in your body. Tell your healthcare provider if you have any new symptoms after you start taking BIKTARVY.

much lactic acid in your blood (lactic acidosis), which is a serious but rare medical emergency that can to death. Tell your healthcare provider right away you get these symptoms: weakness or being more tired usual, unusual muscle pain, being short of breath or breathing, stomach pain with nausea and vomiting, or blue hands and feet, feel dizzy or lightheaded, or fast or abnormal heartbeat.

Kidney problems, including kidney failure. Your healthcare provider should do blood and urine tests to check your kidneys. If you develop new or worse kidney problems, they may tell you to stop taking BIKTARVY. Too much lactic acid in your blood (lactic acidosis), which is a serious but rare medical emergency that can lead to death. Tell your healthcare provider right away you get these symptoms: weakness or being more tired than usual, unusual muscle pain, being short of breath or fast breathing, stomach pain with nausea and vomiting, cold or blue hands and feet, feel dizzy or lightheaded, or fast or abnormal heartbeat.

Severe liver problems, which in rare cases can lead death. Tell your healthcare provider right away you get these symptoms: skin or the white part your eyes turns yellow, dark “tea-colored” urine, light-colored stools, loss of appetite for several days or longer, nausea, or stomach-area pain.

The most common side e ects of BIKTARVY in clinical studies were diarrhea (6%), nausea (6%), and headache (5%).

are not all the possible side e ects of BIKTARVY. your healthcare provider right away if you have new symptoms while taking BIKTARVY. are encouraged to report negative side ects of prescription drugs to the FDA. Visit www.FDA.gov/medwatch or call 1-800-FDA-1088.

healthcare provider will need to do tests to monitor health before and during treatment with BIKTARVY.

These are not all the possible side e ects of BIKTARVY. your healthcare provider right away if you have new symptoms while taking BIKTARVY. are encouraged to report negative side ects of prescription drugs to the FDA. Visit www.FDA.gov/medwatch or call 1-800-FDA-1088. healthcare provider will need to do tests to monitor health before and during treatment with BIKTARVY.

HOW

TO TAKE BIKTARVY

BIKTARVY 1 time each day with or without food.

MORE INFORMATION

is only a brief summary of important information about BIKTARVY. Talk to your healthcare provider or pharmacist to learn more.

to BIKTARVY.com or call 1-800-GILEAD-5. you need help paying for your medicine, visit BIKTARVY.com for program information. BIKTARVY.com

Theron

to BIKTARVY.com or call 1-800-GILEAD-5. you need help paying for your medicine, BIKTARVY.com for program information. BIKTARVY.com On BIKTARVY

On BIKTARVY for 6 years

#ADVOCACY

Fighting against HIV and AIDS has always been a struggle. Much work remains to end the epidemic. POZ encourages you to get involved in advocacy. Go to poz.com/ advocacy to ﬁnd the latest news and learn how you can make a difference in the ﬁght. D #CRIMINALIZATION

Advocates around the world are working to change laws that criminalize HIV, which harm people living with the virus. For more information and to learn how to get involved in reform efforts to make such laws reﬂect current science, go to poz.com/criminalization

D #UNDETECTABLE

The science is clear: People who have an undetectable viral load don’t transmit HIV sexually. In addition to keeping people healthy, effective HIV treatment also means HIV prevention. Go to poz.com/undetectable for more.

POZ DIGITAL

Scan the QR code (le ) with your smartphone camera or go to poz.com/digital to view the current and past issues online.

Jesse Milan Jr. (le ) and Carl Baloney Jr.

20 THE 2025 POZ ICONS The honorees are: Earvin “Magic” Johnson, Larry Kramer, Rae Lewis-Thornton, Elizabeth Taylor and Pedro Zamora. INTRO BY JENNIFER MORTON

26 AIDS UNITED ADVOCACY Interviews with Carl Baloney Jr. and Jesse Milan Jr. BY ALICIA GREEN

16 BASICS

HIV and your liver

17 RESEARCH NOTES

Matt Nadel, the director of a new documentary titled Cashing Out, spotlights an important part of early AIDS history.

6 POZ PLANET

Cookie Johnson and Tina Knowles honored for their HIV advocacy by the Elizabeth Taylor AIDS Foundation • the cost of Medicaid cuts • settlement in HIV prison lawsuit • POZ Stories: Ravyn Whinehouse • Everyday: milestones in the HIV epidemic

12 VOICES Advocates urge attention to public health and demand action on trans rights. 14

A look back at the 2025 U.S. Conference on HIV/AIDS and related events and protests

PrEP implant could offer prolonged protection from HIV • experimental HIV maturation inhibitor • do women control HIV better? • fall risks among older people

18 CARE & TREATMENT

CDC recommends twice-yearly injectable PrEP • HIV guidelines add chapter on heart and metabolic health • federal HIV funding cuts will spur new cases • STI numbers are down, with one exception

32 HEROES

Long-term survivor Martina Clark first learned she was HIV positive in 1992. She’s been an advocate ever since.

EDITOR-IN-CHIEF

ORIOL R. GUTIERREZ JR.

MANAGING EDITOR

JENNIFER MORTON

DEPUTY EDITOR

TRENT STRAUBE

SCIENCE EDITOR

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JOE MEJÍA

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ART DIRECTOR

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ART PRODUCTION MANAGER

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CONTRIBUTING WRITERS

SHAWN DECKER, OLIVIA G. FORD, ALICIA GREEN, MARK S. KING, TIM MURPHY, MATHEW RODRIGUEZ, CHARLES SANCHEZ

CONTRIBUTING ARTISTS

JOAN LOBIS BROWN, LIZ DEFRAIN, ARI MICHELSON, JONATHAN TIMMES, BILL WADMAN

FOUNDER

SEAN STRUB

LEGACY ADVISER MEGAN STRUB

ADVISORY BOARD

GUILLERMO CHACÓN, SABINA

HIRSHFIELD, PHD, KATHIE HIERS, TIM HORN, PAUL KAWATA, NAINA

KHANNA, JESSE MILAN JR., DANIEL TIETZ, MITCHELL WARREN

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Ring of Fire I

CELEBRATED MY

55th birthday earlier this year by jumping out of a plane. I’m deathly afraid of heights, so you can imagine how much of a challenge skydiving was for me. If not, take my word for it—I was quite terrified, until I wasn’t.

The free fall was overwhelming. After all, I was literally falling to the ground, which if the parachute hadn’t opened would have resulted in catastrophe. But it did open. And when it did, not only was I relieved, but I also felt safe enough to enjoy the rest of the experience, which was wonderful. It became peaceful, beautiful and joyful.

recently retired former head of the organization. Jesse was the first Black gay man to lead AIDS United. Carl is now the second. Go to page 26 to read how Carl is planning for the future of AIDS United and how Jesse passed the torch and is contemplating what’s next.

By skydiving, I confronted being afraid of heights head-on. I’m not cured of my fear, but I am much more aware of how to help myself manage it. I have more tools in my self-help toolbox. That’s priceless to me.

The metaphor of free fall is not lost on me. In fact, it’s very on the nose for what many of us are feeling this year when it comes to our politics and the cultural ripple effects. To cope, I’ve been reflecting on the wisdom of the saying “What doesn’t kill you makes you stronger.” Hence my thinking that skydiving was a good idea.

For many of us living with HIV and those of us affected by the virus, the end result of HIV not killing us is indeed often a sense of feeling stronger. But even if the virus does get the better of us, many of us become stronger along the way regardless.

Each of the 2025 POZ Icons are excellent examples of rising above and beyond the hurdles HIV presented on their journeys. The honorees are: Earvin “Magic” Johnson, Larry Kramer, Rae Lewis-Thornton, Elizabeth Taylor and Pedro Zamora. Go to page 20 to learn how they used their voices to advocate for the HIV community.

In this special issue of POZ spotlighting advocacy, we also highlight the efforts of Carl Baloney Jr. and Jesse Milan Jr. Carl is the current CEO and president of the HIV advocacy group AIDS United. Jesse is the

In deciding who would be our cover subject for this issue, we came to the conclusion that choosing only Carl or just Jesse wouldn’t do the moment justice. So we split the difference, literally. Half of the print copies feature Carl on the front cover, and the other half depict Jesse. Congratulations to both of them.

This year’s United States Conference on HIV/AIDS was yet another example of advocates taking action against the virus and for people living with it. Go to page 14 for an overview of the conference and related events.

Our sister publication Real Health, which covers Black wellness, is also focusing its current print issue on HIV advocacy. The feature addresses how NMAC’s Gay Men of Color Fellowship connects advocacy veterans and newbies. Go to the center of this issue for more.

ORIOL R. GUTIERREZ JR. EDITOR-IN-CHIEF editor-in-chief@poz.com Want to read more from Oriol? Follow him on X @oriolgutierrez and check out blogs.poz.com/oriol.

CASHED OUT

A new documentary indicts a system that forced people to sell their life insurance.

AT ONE TIME, AN AIDS DIAGNOSIS WAS MORE THAN JUST A health issue—it was a major financial hit. Between potentially losing work and having to pay for medications and other bills, people with AIDS often faced financial problems on many fronts. Viatical settlements, arrangements in which an investor paid cash (a percentage of the full death benefit) for the life insurance policy of a person with AIDS and received the full payout upon the person’s death, became one potential Band-Aid solution to AIDS-related money woes. Matt Nadel’s new film, Cashing Out, part of The New Yorker Documentary series, available on YouTube, highlights the experience of people who accessed these settlements as well as those who were unable to. For Nadel, viatical settlements were not only a peculiarity of AIDS history but also a part of his family history. Nadel began making the film after he learned that his father was an investor in viatical settlements. Nadel spoke to POZ about the “moral responsibility” he felt upon learning that he was a beneficiary of the profits from these settlements and why this film serves as an indictment of our public health system. This interview has been edited and condensed for length and clarity.

When did you first hear about viatical settlements?

It was 2020, back home in Florida in the early days of COVID-19. People were just starting to talk about a vaccine. I was out on a walk with my dad, and I said, “Obviously, I want there to be a vaccine, but I can’t help but chafe at the fact that some executives at pharmaceutical companies are going to make a ton of money off of this pandemic

that has robbed so many people of so much.” And my dad was like, “What do you mean?” I was like, “Why such a defensive response?”

He shared that he was involved in this industry as an investor. Frankly, my initial response was disgust. I was like, “How could this happen? That’s so ghoulish.” He said, “A lot of people really needed the money,” and “It’s not all bad.” I was like, “OK, you’re just trying to protect your own reputation.”

I started doing my own research. I read a bunch of the coverage of this industry in the gay rags from the ’80s and ’90s and watched archival footage. It became clear to me that this wasn’t just a story of pure evil but that the government was giving people so little that people were clinging to whatever options they had to access resources, dignity and joy. I thought, OK, there’s some

(POSTER AND FILM STILLS) COURTESY OF MATT NADEL

Clockwise from left: Promotional poster for Cashing Out ; Scott Page promoting viatical settlements in the early days of the AIDS crisis; Scott Page (left) on The Phil Donahue Show ; Sean Strub (left) with Megan Strub; Dee Dee Ngozi Chamblee

genuine moral ambiguity here. But also, I would like to spend my time exploring it as part of a personal reckoning process. I did interviews with more than a dozen people who had interacted with this industry, and among them were Scott Page, Sean Strub and Dee Dee Ngozi Chamblee. Meeting them was when it became clear that there needed to be a film.

How did you find them?

I spoke to lots of people I could track down who appeared in old news coverage. I found Scott [who used a settlement to provide for his partner and is now an expert in the field] because he appeared in an old Donahue episode. Sean was mentioned in an article in POZ. [Strub founded POZ magazine using money from his viatical settlement.] Dee Dee obviously did not come up in my search for stories around viatical settlements because she could not access one. That’s her role in the film. It became clear to me that there’s a bigger question: What is this country doing that to have some dignity, people need to sell their life insurance to live? What do people who don’t have life insurance policies then do?

When I spoke with Dee Dee, she said, “I had this whole fantasy of what I would do if I had the money. I was going to go to the beach and wait out these days, and the pain of it wouldn’t even be able to affect me. And it was seeing that other people got to realize those fantasies and that I didn’t that was part of what motivated me to stand up and start fighting.”

The fact that this industry had sort of played a role in her fantasy life and then played a role in motivating her to pursue activism, which, of course, culminated in her becoming the first Black trans woman ever honored at the White House—I was like, “You need to be in this movie.” [In 2011, Chamblee was honored as a Champion of Change by President Obama.]

How did you balance the historical aspects of the film with the personal story about your family?

For me to make this film and not let the

audience know about my personal connection would be dishonest. Scott, Sean and Dee Dee were showing up with total vulnerability, sharing with me so indiscriminately, so vulnerably, so beautifully in such detail about incredibly difficult parts of their lives. For me to turn around and say, “Well, I’m going to protect my privacy, because I don’t want the world to judge me” or “I want to preserve my own reputation as an objective storyteller” would have felt totally wrong. I don’t believe that there is such a thing as an objective storytelling standpoint. We all come at these questions about America and about history from our particular positions, so let’s just disclaim it.

our public health system that had to come to this, that people had to cash in on their life insurance to live.

For the film, you spoke to people who sold their policies. Did you try to get people on camera who had bought policies, aside from your dad?

I tried to find them in the preinterview process, and I did not have a lot of luck. I understand why: A lot of those folks did not have a very emotional connection to this industry. It was marketed to them as an investment. That’s when I turned to the archive. I did not have a hard time finding people who were willing to go on camera and complain in the ’90s,

“This industry serves as an indictment.”

After your research, in editing the film, did you come to a thesis about viatical settlements?

Going in, I did not have a thesis, and that is rare for me. I went in feeling suspicious. Then I met Scott and was feeling like, What do I do with the disgust that was my initial reaction to this industry now that I know that it actually did help some people?

I say in the film that I think this industry was a net good at a time when people were so desperate for this kind of help, whether it be to buy medication or pay rent or because they knew they were going to die. To go on one last vacation and just experience joy at a time when the world told them joy shouldn’t be available to them, that really matters. I don’t want to sit on this decades-later high horse and be like, “Capitalism: bad!” but also capitalism: bad! The fact that this industry had to exist in the first place—that is the object of my disgust. This history serves as an indictment of

when it was much less out of fashion to appear frustrated that folks with HIV hadn’t died.

How willing were you to implicate yourself or your family in terms of having benefited from viatical settlements?

I was reluctant, but I felt like I had a moral responsibility. Those profits trickled down into my life. I am a beneficiary. And I’m also a gay man who benefits every day from activists and from people living with HIV who submitted their bodies to science and screamed in the streets and fought for an accelerated drug approval process.

I am a beneficiary of their work. I was reluctant, but it felt like this is such a small submission of my privacy compared to the incredible bravery that Scott, Sean and Dee Dee displayed by participating in the film, but also the incredible bravery that people with HIV have displayed for so many decades fighting for basic human rights. Q

Matt Nadel

COOKIE JOHNSON AND TINA KNOWLES HONORED FOR HIV ADVOCACY

They were recognized at “The Elizabeth Taylor Night of Compassion.”

It was ladies’ night in a big way at a recent Elizabeth Taylor AIDS Foundation (ETAF) fundraising gala. Cookie Johnson was recognized as ETAF’s 2025 Champion, and Tina Knowles was presented with the Elizabeth Taylor Commitment to End AIDS Award. Plus, singer Jordin Sparks wowed the audience at the September 19 Beverly Hills HIV event titled “The Elizabeth Taylor Night of Compassion.”

Johnson has been in the global spotlight for nearly four decades as the wife of Earvin “Magic” Johnson, the basketball icon who in 1991, at the height of his career, shocked the world by announcing that he had tested positive for HIV and was retiring. He’s perhaps the most famous face of the epidemic, and his wife has used her platform to continuously share education and compassion. Cookie, a renowned entrepreneur, author and philanthropist, was recognized with the 2025 Champion award for “her work standing up for people affected by HIV and AIDS, just as Elizabeth Taylor did before,” according to an ETAF statement.

“This is, of course, something that is very near to my heart. This foundation has been around almost as long as my husband and I have been fighting against this disease,” Johnson told the audience.

woman and author—plus a fashion designer and mom to singers Beyoncé and Solange— Knowles used her moment to recognize ETAF’s “tireless work,” stating: “I have been a longtime admirer of the organization and its founder, Elizabeth Taylor. Tonight, I ask you all to stand for Elizabeth Taylor in reverence and appreciation of her commitment and impact on the world. I dedicate this award to her.”

Knowles’s acceptance speech included a prerecorded video detailing her HIV advocacy work narrated by Beyoncé: “To my mother and my hero, Tina Knowles, we are all grateful for your hard work, love, empathy, acceptance and belief in the human spirit to thrive. Tonight, we are proud to honor you with the 2025 Elizabeth Taylor Commitment to End AIDS Award.”

“Elizabeth was so brave and stood up and fought against this disease. She stood by her friends, and she stood by the LGBTQ community.”

Similarly, Tina Knowles was honored for “her ongoing support for people living with HIV and her long-standing allyship with the LGBTQ+ community.” Also a business-

Knowles lost a gay nephew, Johnny, to AIDS in 1998. She has described him as more like a brother and best friend growing up. What’s more, Beyoncé dedicated her 2022 album, Renaissance, an homage to gay house music, to her “Uncle Johnny.”

Hosted by Emmy Award–winning TV personality Melvin Robert, the gala included an exclusive look at items from the Elizabeth Taylor Archive and was presented by sponsor Gilead Sciences, a major HIV drugmaker.

Actress and icon Elizabeth Taylor became a global AIDS activist in the 1980s and founded ETAF in 1991. Among several other initiatives and programs, the group supports HIV Is Not a Crime Awareness Day, marked each February 28 in honor of her February 27 birthday. She died in 2011 at age 79. —Trent Straube

At “The Elizabeth Taylor Night of Compassion,” from le : Cookie Johnson, who was recognized as the ETAF 2025 Champion; Gilead Sciences chairman and CEO Daniel O’Day with Tina Knowles; Jordin Sparks

Melvin Robert

THE COST OF MEDICAID CUTS

Major job losses and reduced economic output are expected.

As the federal government and states move to cut about $1 trillion from Medicaid over the next decade, researchers estimate that by 2034, hundreds of thousands of jobs and billions of dollars in state and local tax revenue will be lost.

The research, published in the peer-reviewed journal JAMA Health Forum, looked at the long-term economic effects of the Medicaid provisions in President Donald Trump’s signature tax and spending bill, which cuts the joint state-federal health insurance program for people with lower incomes or with disabilities and provides tax cuts that disproportionately benefit wealthier Americans.

By 2034, the researchers estimated the annual economic impact to reach 302,000 jobs lost and $135.3 billion in reduced economic output, leading to

$11.1 billion in annual state and local tax revenue reductions.

Coverage losses could generate $7.6 billion in medical debt, triggering a further $3.8 billion re duction in economic activity, according to the study.

As the single largest source of health coverage in the nation covering 72 million people, or a fifth of the U.S. population, Medicaid is a key source of revenue to health care providers as well as a significant funding stream for health facilities. Hospitals are major employers and drivers of local economies.

In New York, for example, Democratic Governor Kathy Hochul’s office estimates that 65,000 jobs and $14.4 billion could be lost due to cuts to hospitals and community health centers and hospital-related economic activity.

—Stateline

Settlement in HIV Prison Lawsuit

Honesty Bishop spent six years in solitary confinement.

A settlement in an HIV discrimination lawsuit against the Missouri Department of Corrections will result in updates to the prison system’s policy regarding solitary confinement. The case was brought on behalf of Honesty Bishop, a Black transgender woman living with HIV who was held in solitary confinement from 2015 to 2021 after she was allegedly attacked by a cellmate.

According to the lawsuit and reporting by The Marshall Project and the Midwest Newsroom, Bishop was sexually assaulted by a cellmate while at the Jefferson City Correctional Center, a men’s prison. She took HIV medication regularly and therefore maintained an undetectable viral load, making it impossible for her to transmit HIV (a fact referred to as Undetectable Equals Untransmittable, or U=U). Nonetheless, as a matter of policy, the Missouri prison system categorized her as a sexually active person with HIV and required that she be kept in solitary confinement.

The lawsuit was filed in 2023 while Bishop was released on parole. Unfortunately, she took her own life in 2024. She was 34.

“My sister, Honesty, was a fighter who never gave up,” said Latasha Monroe, Bishop’s sister and personal representative for the Estate of Honesty Jade Bishop, in a statement issued by Lambda Legal, the MacArthur Justice Center and law firm Shook, Hardy & Bacon, which filed the case on Bishop’s behalf.

Monroe added that her sister “endured years of cruel treatment because of her HIV status, but she never stopped believing that things could change. This settlement honors her memory and ensures that others won’t have to suffer what Honesty went through. Her courage in speaking out has created lasting changes.” —TS

Honesty Bishop

IMPORTANT FACTS FOR BIKTARVY®

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

MOST IMPORTANT INFORMATION ABOUT BIKTARVY

BIKTARVY may cause serious side e ects, including:

` Worsening of hepatitis B (HBV) infection. Your healthcare provider will test you for HBV. If you have both HIV-1 and HBV, your HBV may suddenly get worse if you stop taking BIKTARVY. Do not stop taking BIKTARVY without ﬁ rst talking to your healthcare provider, as they will need to check your health regularly for several months, and may give you HBV medicine.

ABOUT BIKTARVY

BIKTARVY does not cure HIV-1 or AIDS. HIV-1 is the virus that causes AIDS.

Do NOT take BIKTARVY if you also take a medicine that contains:

` dofetilide

` rifampin

` any other medicines to treat HIV-1

BEFORE TAKING BIKTARVY

Tell your healthcare provider if you:

` Have or have had any kidney or liver problems, including hepatitis infection.

` Have any other health problems.

` Are pregnant or plan to become pregnant. Tell your healthcare provider if you become pregnant while taking BIKTARVY.

` Are breastfeeding (nursing) or plan to breastfeed. Talk to your healthcare provider about the risks of breastfeeding during treatment with BIKTARVY. Tell your healthcare provider about all the medicines you take:

` Keep a list that includes all prescription and over-thecounter medicines, antacids, laxatives, vitamins, and herbal supplements, and show it to your healthcare provider and pharmacist.

` BIKTARVY and other medicines may a ect each other. Ask your healthcare provider and pharmacist about medicines that interact with BIKTARVY, and ask if it is safe to take BIKTARVY with all your other medicines.

POSSIBLE SIDE EFFECTS OF BIKTARVY

BIKTARVY may cause serious side e ects, including:

` Those in the “Most Important Information About BIKTARVY” section.

` Changes in your immune system. Your immune system may get stronger and begin to ﬁ ght infections that may have been hidden in your body. Tell your healthcare provider if you have any new symptoms after you start taking BIKTARVY.

` Kidney problems, including kidney failure.Your healthcare provider should do blood and urine tests to check your kidneys. If you develop new or worse kidney problems, they may tell you to stop taking BIKTARVY.

` Too much lactic acid in your blood (lactic acidosis) , which is a serious but rare medical emergency that can lead to death. Tell your healthcare provider right away if you get these symptoms: weakness or being more tired than usual, unusual muscle pain, being short of breath or fast breathing, stomach pain with nausea and vomiting, cold or blue hands and feet, feel dizzy or lightheaded, or a fast or abnormal heartbeat.

` Severe liver problems, which in rare cases can lead to death. Tell your healthcare provider right away if you get these symptoms: skin or the white part of your eyes turns yellow, dark “tea-colored” urine, light-colored stools, loss of appetite for several days or longer, nausea, or stomach-area pain.

` The most common side e ects of BIKTARVY in clinical studies were diarrhea (6%), nausea (6%), and headache (5%).

These are not all the possible side e ects of BIKTARVY. Tell your healthcare provider right away if you have any new symptoms while taking BIKTARVY. You are encouraged to report negative side e ects of prescription drugs to the FDA. Visit www.FDA.gov/medwatchor call 1-800-FDA-1088. Your healthcare provider will need to do tests to monitor your health before and during treatment with BIKTARVY.

HOW TO TAKE BIKTARVY

Take BIKTARVY 1 time each day with or without food.

GET MORE INFORMATION

` This is only a brief summary of important information about BIKTARVY. Talk to your healthcare provider or pharmacist to learn more.

` Go to BIKTARVY.com or call 1-800-GILEAD-5.

` If you need help paying for your medicine, visit BIKTARVY.com for program information.

People featured take BIKTARVY and are compensated by Gilead.

Ask your healthcare provider if BIKTARVY is right for you.

*Source: , 04/19/2019 through 05/19/2023. IQVIA NPA Weekly #1 PRESCRIBED HIV TREATMENT*

MORE TO LOVE

BIKTARVY® is approved for more people than ever before.

BIKTARVY is a complete, 1-pill, once-a-day prescription medicine used to treat HIV-1 in certain adults. BIKTARVY does not cure HIV-1 or AIDS.

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Pain Into Purpose

Ravyn Whinehouse uses her voice to show others living with HIV that they’re not alone.

My name is Ravyn, and I am a Black trans woman. I was diagnosed with HIV when I was 19 years old, just a couple of years after aging out of foster care. At that time, I thought my biggest challenges were finally behind me. But when I began my transition, I was also given the news about my status.

In that moment, I realized my fight wasn’t over. Life was pushing me to speak up—not just for myself but for others going through the same journey. I felt called to be a voice for those who were, and still are, forced into silence.

The stigma hit me hard, but I also found support in the most unexpected people and spaces. Growing up, I had to overcome so many challenges on my own, but being diagnosed opened my eyes to a community of others fighting the same battle.

Now, 10 years later, I’ve turned that pain into purpose. I’ve had the honor

EVERYDAY

December

of speaking on panels and attending conferences where I use my voice to educate, break down stigma and remind people that life is not over after diagnosis. My story is about survival, resilience and finding strength in community, and I hope it inspires others to know that they are never alone.

What adjectives best describe you? Determined, resilient and passionate.

What is your greatest achievement? Turning my own challenges into fuel for change. Every challenge I’ve faced has shaped me and reminds me that I have the strength to keep going and to help others do the same.

If you could change one thing about living with HIV, what would it be? Ending the stigma so people see us for who we are, not just our diagnosis.

What keeps you up at night? Finding ways to improve society—to make it safer, more inclusive and better for people who look like me, think like me or share similar struggles.

What is the best advice you received?

“Keep moving forward,” from the movie Meet the Robinsons. Even in failure, there’s growth, and that mindset has carried me through my journey.

What person in the HIV community do you most admire?

I admire the HIV community as a whole— the people who share their stories, fight stigma and support one another. Their resilience and courage inspire me every day to speak up and be an advocate.

Read other POZ Stories or share your own at poz.com/stories.

These dates represent milestones in the HIV epidemic. Visit poz.com/aidsiseveryday to learn more about the history of HIV and AIDS. BY

The World Health Organization establishes WORLD AIDS DAY to raise HIV awareness, show support for people living with HIV and commemorate those who have died of AIDS-related illnesses. (1988)

1 6

Protesters from HEALTH GAP, QUEEROCRACY, VOCAL-NY and HOUSING WORKS march through New York City’s Financial District while wearing Robin Hood costumes to highlight the coalition’s demand for a “Robin Hood” tax on speculative financial transactions. Activists say the small tax could fund housing and services for lowincome New Yorkers living with HIV. (2010)

Professional tennis player ARTHUR ASHE announces the formation of the Arthur Ashe Institute for Urban Health in response to concerns about health care delivery in urban America. He died two months later of AIDS-related pneumonia at age 49. (1992)

Gilead Sciences announces the launch of the Commitment to Partnership in Addressing HIV/AIDS in Southern States (COMPASS) Initiative, a 10-year, $100 million commitment to support organizations working to address the HIV and AIDS epidemic in the Southern United States. (2017)

The Food and Drug Administration approves Invirase (saquinavir), the FIRST PROTEASE INHIBITOR for use in combination with other medications for the treatment of HIV. (1995)

The Health Resources and Services Administration reports a record 87.1% viral suppression rate among RYAN WHITE HIV/AIDS PROGRAM clients in 2018. More than half of people with diagnosed HIV in the United States receive Ryan White services. (2019)

JENNIFER MORTON

Ravyn Whinehouse

THE POWER OF CHOICE

In an opinion piece titled “HIV, Democracy and the Power of Choice,” advocates Venton Jones and Kelley Robinson argue that choice sustains freedom and saves lives. Below is an edited excerpt.

IN TEXAS, WE STAND AT A DECISIVE crossroads, where public health and democracy intersect, collide and demand bold leadership. From Dallas to communities across this state, we see parallels that hold the keys to overcoming the challenges we face— from the HIV epidemic to attacks on our democracy through gerrymandering. Texas is facing one of the worst public health outbreaks in the nation and still lags in responding to the ongoing HIV crisis. And yet in this moment, we also witness the power of communities rising.

Texas tells a story of struggle, yes— but more importantly, it tells a story of hope. It reminds us of the grit, the long game and the unshakable tradition of a people who have always overcome. When the voices of those impacted are heard, when they lead, we all move closer to a future where health, equity and democracy truly belong not just to some of us but to all of us! In these times of crisis, it is our shared strength that allows us to rise—and rise we will.

The HIV response was never just about medicine. It was about dignity. Access to testing, treatment and prevention changed the trajectory of the epidemic only when people had the ability to choose—when individuals could decide to get tested, to take PrEP [pre-exposure prophylaxis], to begin

treatment and to live openly without fear. These choices were not imposed; they were offered, respected and protected. That access, rooted in human rights, is what shi ed HIV from a crisis to a manageable condition for millions.

We also know that choice means nothing without trust. HIV taught us that stigma, misinformation and institutional neglect can undo the best scientiﬁc advances. Communities impacted— Black and brown people, LGBTQ+ people, people living in the South— often faced systems that failed them. But it was precisely those communities, organizing and demanding action, that drove forward an evidence-based, compassionate response. That’s a lesson democracy must take to heart.

Democracy, like public health, thrives when people have the tools and the trust to participate. Voting and civic engagement are the democratic equivalent of testing and treatment: They allow communities to shape their futures. But when barriers are erected, the result is the same: disempowerment, inequity and lives put at risk.

Political leadership is what bridges these two worlds. In public health, we’ve seen how leadership can expand or restrict access. Programs like the Ryan White HIV/AIDS Program, Medicaid expansion and PEPFAR [the President’s

Emergency Plan for AIDS Relief] saved lives because leaders invested in them. Conversely, stigma and silence cost lives when leaders failed to act. The same dynamic shapes democracy. Voting rights protections, investment in civic participation and the defense of democratic norms all depend on the choices made by leaders.

Freedom, in both contexts, is not abstract. It is tangible. It is the freedom to know your HIV status, to choose treatment that lets you thrive, to love openly without stigma. It is the freedom to cast a ballot, to have a say in the laws that govern your life and to live in a society where your voice matters. In both cases, freedom is realized only when individuals are empowered with knowledge, access and choice.

The lesson of HIV is clear: Choice saves lives. The lesson of democracy is just as urgent: Choice sustains freedom. When we invest in public health and defend democracy, we are making the same fundamental commitment—to trust people, to empower them and to let them decide their own futures. Q

Venton Jones is the Texas House Minority Whip and CEO of the Southern Black Policy and Advocacy Network. Kelley Robinson is president of the Human Rights Campaign.

DEMANDING ACTION

In a blog post titled “Bearing Witness, Standing in Solidarity,” José Zuniga, PhD, MPH, president and CEO of the International Association of Providers of AIDS Care, spotlighted trans people with HIV. Below is an edited excerpt.

AT THE U.S. FAST-TRACK Cities 2025 Summit in September in New Orleans, I experienced a moment that pierced through the formality of policy discussions about the U.S. HIV response. It came in a private conversation with a transgender Latina woman who lives in the Southern United States. Her voice shaking under the weight of lived experience, she described what it has meant to be a trans person in the United States since the Trump administration intensiﬁed its assault on the transgender community. Mid-sentence, she broke down in tears.

I will not share her name here out of an abundance of caution for her safety in a climate where visibility can be as dangerous as it is empowering for trans and other highly stigmatized communities. But her tears spoke volumes. They reflected the pain of a community already subjected to pervasive stigma, now forced to endure heightened hostility, policy rollbacks and cultural attacks designed to strip away dignity, rights and even access to health care. The dehumanizing tactics being used to erase their existence violate human decency, not to mention human rights. What we witnessed was a stark reminder that stigma is not an isolated phenomenon; it is amplified and codified

by policies and rhetoric that embolden discrimination. For trans people, especially trans women of color, stigma intersects with systemic racism, sexism and economic marginalization. This convergence of forces transforms everyday life into a constant negotiation of safety, dignity and survival.

The Trump administration’s efforts to roll back protections for transgender people in health care, education, employment and public life created a ripple effect far beyond policy. It validated prejudice. It emboldened those who would misgender, exclude or erase transgender individuals. And it deepened the isolation that many already feel navigating a world where simply existing can trigger violence. The resulting atmosphere of fear reverberates through families, workplaces and communities, eroding social cohesion and trust.

For trans people with HIV, these forces converge with life-threatening consequences. Discrimination in health care settings discourages engagement in care. Stigma compounds the mental health burden of HIV. In such an environment, the structural determinants of health weigh more heavily than any single medical intervention.

The summit is, at its heart, about accelerating progress against HIV. But the tears we saw reminded us that viral

suppression and prevention cannot be achieved in a vacuum. The HIV response cannot succeed if entire communities are under siege. Equity, therefore, is not a peripheral concern but the very foundation upon which effective public health strategies must rest.

Trans women, particularly Black and Latina trans women, are disproportionately affected by HIV in the United States. According to Centers for Disease Control and Prevention data, about 40% of trans women tested in seven major U.S. cities were living with HIV. These numbers reﬂect not biology but inequity: barriers to employment, housing instability, lack of gendera rming care and routine encounters with stigma in clinics and communities alike. Each of these barriers is a policy failure that demands urgent redress.

When governments enact policies that strip away rights, they exacerbate these inequities. They widen the gap between those who have access to prevention and care and those who are pushed further into the shadows. The tears we witnessed were, in many ways, an indictment of these policies—not abstractly, but as lived consequences.

Moments like this one demand reﬂection, but more importantly, they demand action. Q

USCHA 2025

Held from September 4 through 7 in Washington, DC, this year’s United States Conference on HIV/AIDS (USCHA) marked the 29th such annual gathering organized by NMAC (formerly the National Minority AIDS Council), whose executive director of 36 years, Paul Kawata, this year passed the torch to incoming CEO Harold Phillips, a former director of the Office of National AIDS Policy who is living with HIV.

This year’s theme, “Aging with HIV,” honored people growing old with the virus by examining their challenges and acknowledging their lived experiences. The program highlighted those who had HIV before the advent of effective treatment in the mid-1990s, those who benefited from such treatment, and “dandelions” (those born with HIV). Plenary speakers included Anthony Fauci, MD, the former longtime director of the National Institute of Allergy and Infectious Diseases, NBA Hall of Famer Earvin “Magic” Johnson, Representative Maxine Waters (D–Calif.) and activist Jeanne White-Ginder, Ryan White’s mother.

Proposed cuts to HIV funding and Medicaid and the potential end to subsidies for those covered by insurance through the Affordable Care Act imbued the conference with a sense of urgency. On September 3, to coincide with USCHA, the “Save HIV Funding” campaign organized the Protect the HIV Community rally outside the Capitol. Speakers included Representative Mark Pocan (D–Wisc.), cochair of the Congressional LGBT Equality Caucus, actor-singer Javier Muñoz and reality TV star Peppermint. Despite these potential looming setbacks, USCHA celebrated progress made in the fight against HIV with such plenaries as “Survival and Legacy,” “Sisterhood & Survival: Our Lifelong Legacy of Power and Perseverance” and “Timeline of Innovation: Moments that Changed HIV.”

1. U.S. Representative Maxine Waters addresses attendees at the Protect the HIV Community rally outside the Capitol protesting federal funding cuts to HIV prevention and care services. 2. Left to right: AIDS Alabama’s director of prevention Trevis Smith , CEO Kathier Hiers and board member Carmarion D. Anderson-Harvey pose with Magic Johnson , who shared his personal journey and gave a plenary speech on aging with HIV, leadership and building a lasting legacy. 3. Advocate with the “Save HIV Funding” campaign displayed quilt panels to highlight the potential loss of lifesaving medication, health care and other support.

4. At the Capitol rally, POZ contributing writer and creator of the musical series Merce Charles Sanchez cozies up to Broadway actor and singer Javier Muñoz (In the Heights, Hamilton). 5. Positive Women’s Network–USA co–executive director Marnina Miller delivers a presentation titled “More Than One Truth: A Gender Justice Call to Action.” 6. Plenary speaker Jeff Berry, cofounder and executive director of The Reunion Project, an alliance of long-term survivors, poses with fellow long-term survivor and POZ contributing writer Mark S. King . 7. POZ is in the house—and at the booth! Staffers share valuable information via health posters, drug charts and magazines. Back row: president and COO Ian Andersen and vice president Diane Andersen; front row: managing editor Jennifer Morton , science editor Liz Highleyman and editor-in-chief Oriol Guiterrez 8. NMAC CEO Harold Phillips poses with AIDS activist, writer and USCHA plenary speaker Rae Lewis-Thornton.

HIV AND YOUR LIVER

Lifestyle changes and precautions can help keep your liver in good working order.

MANY PEOPLE LIVING WITH HIV have conditions that affect the liver, including hepatitis B or C, fatty liver disease or alcohol-related liver disease. Over time, these can cause serious complications, such as cirrhosis and liver cancer. Fortunately, you can take steps to protect your liver and prevent disease progression.

The liver processes almost everything you eat, drink, breathe and absorb through the skin. It provides energy from food, stores nutrients, produces blood proteins, processes many drugs and acts as a ﬁlter to remove harmful toxins and waste products. A healthy liver is essential to a healthy life.

HIV can infect liver cells directly, and the virus can cause chronic inﬂammation that harms organs throughout the body. Some medications can cause liver damage, but modern antiretrovirals are generally well tolerated and do not cause serious hepatotoxicity (liver damage) like some older drugs.

The most common causes of chronic liver disease are viral hepatitis, fatty liver disease and heavy alcohol consumption.

Hepatitis B virus (HBV) and hepatitis C virus (HCV) are blood-borne infections with the same transmission routes as HIV, including shared drug injection equipment, sex and from mothers to babies. People who have one or both of these viruses in addition to HIV— known as coinfection—tend to develop more serious complications.

Most people who acquire HBV as adults clear the virus naturally and develop lifelong immunity, but about 10% will develop chronic infection. In some cases, chronic HBV is inactive and does not cause problems, but it can reactivate if immune function declines. Hepatitis B can be treated with antiviral medications, but they seldom lead to a cure. Some HIV drugs, including tenofovir, are active against both HIV and HBV, and people with coinfection should include these in their antiretroviral regimen. Fortunately, hepatitis B can be prevented with a safe and effective vaccine.

In contrast, around 75% of people with hepatitis C will develop chronic infection. While there is no vaccine for HCV, it can be treated with well-tolerated

direct-acting antiviral regimens, such as Epclusa and Mavyret. More than 95% of people who complete a twoor three-month course of treatment will be cured. Hepatitis C does not confer immunity, however, and people can acquire the virus again.

Now that hepatitis B can be prevented and hepatitis C can be easily cured, fatty liver disease is a growing cause of advanced liver disease worldwide. Metabolic dysfunction-associated steatotic liver disease (MASLD) and its more severe form, metabolic dysfunction-associated steatohepatitis (MASH), are o en associated with obesity and diabetes. There are now two approved MASH medications— resmetirom (Rezdiffra) and semaglutide (Wegovy)—but management largely relies on lifestyle changes such as weight loss, diet and exercise.

Regardless of the cause, symptoms of liver problems may include fatigue, loss of appetite, nausea and upper abdominal pain. Some people develop jaundice (yellowing of the skin and eyes). Increased levels of liver enzymes in the blood, including ALT and AST, can be an early sign of trouble. Many people with early liver disease have no symptoms

or mild symptoms that can be mistaken for the ﬂu. But over years or decades, it can lead to progressive liver ﬁbrosis (scarring), cirrhosis, hepatocellular carcinoma (the most common type of liver cancer), liver failure and the need for a liver transplant. Late-stage symptoms may include swelling, abdominal bloating, internal bleeding and cognitive impairment.

People with HIV can take steps to protect their liver. These include starting and staying on antiretroviral treatment, eating a balanced diet, maintaining a healthy weight, managing such metabolic problems as diabetes, getting enough exercise, limiting use of alcohol and recreational drugs and avoiding environmental toxins.

Guidelines recommend that all people with HIV should be screened for hepatitis B and C and should be vaccinated against hepatitis A and B. Periodic liver function tests, especially a er starting new meds, are used to monitor liver health. People with cirrhosis should receive regular monitoring for liver cancer. See your doctor if you develop signs of liver problems, and make sure to tell them about all drugs, herbs and supplements you are taking. Q

BY LIZ HIGHLEYMAN

PrEP Implant PREVENTION

A biodegradable implant for pre-exposure prophylaxis (PrEP) could offer protection for several months and “potentially revolutionize” HIV prevention. One benefit of implants is that they are removable. When using Apretude for PrEP, residual cabotegravir can remain in the body for a year or more a er the last injection, known as a “long tail.” If a person acquires HIV a er stopping Apretude, the virus can develop resistance to cabotegravir. Researchers evaluated an ultra-longacting subcutaneous cabotegravir/barium sulfate (CAB/BaSO4) implant capable of maintaining therapeutic drug concentrations for up to 390 days. Barium sulfate is a contrast agent that can be visualized in the body using X-rays. The implant was well-tolerated and caused minimal inflammation in mice. A er removing the implant, cabotegravir plasma levels fell below the inhibitory concentration within 24 hours and below the limit of quantification within 14 days. Wholebody X-ray imaging showed that the implants remained visible for up to 268 days with no noticeable migration.

TREATMENT

Maturation Inhibitor

A novel HIV maturation inhibitor dubbed HRF-10071 showed good activity in a small Phase II study. Modern antiretrovirals are usually effective, but people with extensive drug resistance can have trouble maintaining viral suppression. Maturation inhibitors work in a different way, blocking the release of proteins that make up HIV’s capsid structure and leading to the production of noninfectious immature virus.

Researchers in India tested the drug in 30 previously untreated people with HIV who were randomly assigned to receive one of four doses or a placebo once daily for 14 days. (Antiretrovirals used alone do not maintain viral suppression, but they are typically tested for a brief monotherapy period to determine antiviral activity.) HRF-10071 reduced HIV RNA levels by up to -1.84 log. The drug was well tolerated with no treatmentrelated adverse events. Hetero Labs will now test HRF-10071 in combination with other antiretrovirals. While this trial used oncedaily oral dosing, data from preclinical studies suggest it has potential for longacting therapy.

Sex Differences CURE Frailty and Falls CONCERNS

The HIV viral reservoir in males and females differs in ways that may enable women to control the virus better than men. Antiretrovirals can keep HIV replication suppressed, but the virus inserts its genetic blueprints, or provirus, into the DNA of cells, establishing a longlasting reservoir that makes a cure nearly impossible. Building on evidence that women are more likely to be natural elite controllers or maintain posttreatment control a er stopping antiretrovirals, researchers compared viral reservoir characteristics and immune responses in 35 men and 30 postmenopausal women on antiretroviral therapy. Analyzing more than 4,000 HIV genomes, they saw sex-speciﬁc differences in viral reservoir cell structure and composition. While the overall frequency of proviral genomes did not differ, women were more likely to have intact proviruses inserted in transcriptionally silent parts of their chromosomes where they could not reactivate. What’s more, women had more effective innate immune responses, speciﬁcally natural killer cells with enhanced functionality.

Older people with HIV who take multiple medications are more likely to develop frailty and are at higher risk for falls. Characterized by fatigue and weakness, frailty can lead to poor health outcomes, disability and death. Fall-related mortality among older adults has been climbing sharply, and many experts attribute the increase to rising use of medications that cause drowsiness, dizziness or poor coordination. Older people living with HIV o en take multiple meds to manage comorbidities, known as polypharmacy. Canadian researchers looked at drug prescribing and its association with frailty and falls among 440 HIV-positive people ages 65 and older; 16% were classiﬁed as frail, 63% were considered “prefrail” and 21% had experienced a fall within the past six months. More than half (54%) used ﬁve or more drugs besides antiretrovirals, while 15% used 10 or more. People with polypharmacy, those who used inappropriate medications and those who took anticholinergic drugs or sedatives were two to three times more likely to experience frailty and falls.

CDC Recommends Twice-Yearly PrEP

In June, the Food and Drug Administration approved twiceyearly lenacapavir injections—brand name Yeztugo—for HIV pre-exposure prophylaxis (PrEP). The Centers for Disease Control and Prevention (CDC) has now added a recommendation for lenacapavir PrEP, published in the September 18 edition of Morbidity and Mortality Weekly Report.

Lenacapavir, Gilead Sciences’ ﬁrst-in-class HIV capsid inhibitor, dramatically reduced the risk of HIV acquisition in two large Phase III trials. PURPOSE 1 showed that the twiceyearly injections were 100% effective for young cisgender women in Africa, while PURPOSE 2 found that lenacapavir PrEP reduced the risk of HIV acquisition by 96% among gay and bisexual men and gender-diverse people in the United States and six other countries.

broader insurance coverage. Cheap generic versions of the daily PrEP pill Truvada (tenofovir disoproxil fumarate/ emtricitabine) are widely available, and some insurers may ask people to try the less expensive option ﬁrst.

Health o cials, clinicians and advocates are hopeful that lenacapavir could ﬁnally help turn the tide of the HIV epidemic, but long-acting PrEP can only fulﬁll its potential if it is available to those who need it most. The drug’s high cost—$28,218 per year in the United States—is a barrier to access, but the CDC recommendation could encourage

The day the CDC released its recommendation, advocates urged CVS Health to reverse its decision to hold off on covering lenacapavir PrEP. And some have gone further. “America needs a federally funded National PrEP Program that ﬁlls in the gaps in access for un- and underinsured populations and builds a pathway toward access to innovations in PrEP for everyone,” says PrEP4All’s Jeremiah Johnson.

HIV GUIDELINES ADD CHAPTER ON HEART AND METABOLIC HEALTH

In September, the Department of Health and Human Services released the latest update to its Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents With HIV. Among the changes is a new chapter on cardiovascular and metabolic complications in people living with HIV, with sections on inﬂammation, statin therapy and weight gain.

As effective antiretroviral treatment has enabled people with HIV to live longer, they are prone to a host of age-related comorbidities, including heart disease, diabetes, kidney and liver disease, cancer and cognitive impairment. All of these are linked to persistent immune activation and chronic inﬂammation, which occurs even among people with viral suppression.

The guidelines now recommend statin therapy for HIV-positive people ages 40 to 75 with low to moderate cardiovascular risk scores, based on ﬁndings from the REPRIEVE trial. The large study showed that people in this group who took a daily statin lowered their risk for heart attacks, strokes and other major cardiovascular events by 35%.

Weight gain is also a growing concern for people living with HIV. Studies of the association between antiretroviral therapy and weight changes have yielded mixed results, and the guidelines state that people should not delay or interrupt antiretroviral treatment or switch drugs in an effort to control their weight. Providers should include weight monitoring and counseling as part of comprehensive care for people with HIV. Lifestyle modiﬁcation, including healthy eating and exercise, “remains the starting point and gold standard weight management intervention,” according to the guidelines authors. The section touches on GLP-1 agonists—popular weight-loss meds like semaglutide (Ozempic or Wegovy) and tirzepatide (Mounjaro or Zepbound)— but notes that there have been few studies of their use by people with HIV.

HIV Funding Cuts Could Spur More Cases

As Congress continues to debate the federal budget for 2026—including proposals to reduce funding for domestic HIV services— researchers have been assessing the consequences of the cuts in terms of new HIV cases, medical costs and lives lost. Funding for the Centers for Disease Control and Prevention (CDC) HIV prevention efforts, the Ending the HIV Epidemic initiative and the Ryan White HIV/AIDS Program are all at risk.

An analysis published earlier this year estimated that defunding the CDC’s HIV prevention work from 2025 to 2030 could lead to more than 213,000 additional HIV cases, over $52 billion in lifetime medical expenses and more than 10,600 extra deaths.

Another analysis looked at the consequences of reduced pre-exposure prophylaxis (PrEP) use. The researchers estimated that if PrEP coverage declines by just 3% annually,

more than 8,600 HIV cases would not be prevented over a decade, resulting in lifetime medical costs of $3.6 billion. Policies that increase out-of-pocket PrEP costs “risk reversing progress toward ending the HIV epidemic,” the study authors wrote.

A third analysis projected what would happen if Ryan White funding is cut. The program pays for antiretroviral therapy for low-income people, which suppresses the virus and prevents onward transmission. Using mathematical modeling, the researchers predicted that ending Ryan White services could lead to over 75,000 extra HIV cases across 31 highburden cities over the next

ﬁve years—a 49% increase. “The most powerful form of prevention is making sure we treat people with HIV effectively,” says senior study author Todd Fojo, MD, of the Johns Hopkins University School of Medicine.

STI NUMBERS DOWN, WITH ONE EXCEPTION

Three major sexually transmitted infections (STIs)—chlamydia, gonorrhea and syphilis—decreased by a combined 8.5% last year, according to provisional data from the Centers for Disease Control and Prevention. Despite the decline, more than 2.2 million cases were reported in 2024. The report comes at a time when STI, sexual health and women’s health services are facing steep funding cuts, and advocates fear recent progress could be lost.

Chlamydia cases fell by 8.0% last year, to just over 1.5 million cases, the second consecutive annual decline. Gonorrhea cases fell by 9.6%, the third straight drop. Primary and secondary syphilis—the most infectious stages— declined by 21.7%, while late-stage or unknown-duration syphilis decreased by just 1.5%.

STIs have been on the upswing in recent decades, with a 13% overall increase from 2015 to 2024. The latest data suggest that the epidemic may be turning a corner. The adoption of doxyPEP—taking a dose of the antibiotic doxycycline a er sex to prevent bacterial STIs—may be playing a role.

But the report also contains some concerning news. Congenital syphilis among newborns, acquired during pregnancy or delivery, rose by 1.6%, reaching 3,941 cases. This was the 12th annual increase in a row, though it was much lower than the double-digit jumps seen in some prior years as cases skyrocketed by nearly 700% over the past decade.

The latest data offer hope, “but we have far more work to do,” says Elizabeth Finley, of the National Coalition of STD Directors. “We call on the Trump administration to make sure states and cities can win this ﬁght by giving them the resources, information, effective workforce and modernized systems they need to protect every American, and particularly our most vulnerable infants.”

HONORING THOSE WHO USE THEIR VOICE TO ADVOCATE FOR THE HIV COMMUNITY

BY JENNIFER MORTON

IN THE EARLY DAYS OF THE AIDS EPIDEMIC, SILENCE WAS deafening and denial was deadly, but a few bold voices emerged to cut through the fear. This year’s POZ Icons—Earvin “Magic” Johnson, Larry Kramer, Rae Lewis-Thornton, Elizabeth Taylor and Pedro Zamora —all had the courage to speak out about HIV and got the world to pay attention. They opened their hearts and our eyes on behalf of every person silenced and erased by a disease many in the world tried to ignore.

Magic Johnson shocked the world in 1991 by announcing he was living with HIV, shatteringstigmaandcallingforcompassion instead of fear and misinformation. Larry Kramer, furious and unflinching, sparked a movement and galvanized AIDS activists into action. Rae Lewis-Thornton bravely graced the cover of Essence magazine, helping to change the conversation about Black women and HIV. Elizabeth Taylor, with her conviction and star power, leveraged Hollywood’s spotlight to push for HIV resources and advance research. Pedro Zamora

showed the world that living openly with HIV could be a powerful act of education, proving that visibility and vulnerability can change hearts and minds.

To honor them is not just to remember what they faced but also to carry forward their legacy: that truth-telling and courage can change the world. Today, we draw from the power of their voices to confront the current attacks on the progress made in the fight against HIV and to fiercely advocate for those living with or at risk for the virus. These are the icons we need.

Johnson in 2025

EARVIN “MAGIC” JOHNSON

By Harold Phillips, MRP

On November 7, 1991, NBA star Earvin “Magic” Johnson stunned the world when he announced that he was HIV positive. At the time, HIV was widely misunderstood and stigmatized, often seen as a death sentence and wrongly associated only with certain communities. Johnson’s courage to speak publicly—at the height of his basketball career—shattered stereotypes and changed the global conversation around HIV.

An Advocate for Care and Compassion

Since that historic press conference, Magic Johnson has become one of the most visible and impactful advocates for HIV awareness, prevention and treatment. His openness helped normalize HIV testing and inspired millions to seek care. He used his platform to educate the public, especially communities of color, about the importance of safe sex, regular testing and the power of early treatment. More than three decades later, Johnson continues to lead by example.

At the 2025 United States Conference on HIV/AIDS in September, after it was announced that I was NMAC’s CEO-elect, I had the privilege—especially as a person also living with HIV—to introduce Magic Johnson to our community. He delivered a powerful keynote address on aging, surviving and thriving with HIV. His message was clear: Living with HIV is not just possible—it’s also a testament to strength, discipline and community support. He honored those who came before him, acknowledged the challenges of aging with HIV and called for renewed investment in care and dignity for long-term survivors.

Johnson’s journey is more than a personal triumph—it’s a public legacy. He transformed fear into hope, stigma into strength and silence into advocacy. Today, he stands not only as a sports legend but also as a beacon for millions living with HIV. His life reminds us that with compassion, access to care and unwavering resolve, we can all thrive.

And that’s the real magic.

Harold Phillips, MRP, is the CEO of NMAC, a national HIV organization that aims to end the HIV epidemic among the communities most impacted in the United States.

KEY MOMENTS

1991

Magic announces that he is living with HIV and retires from the NBA.

He establishes the Magic Johnson AIDS Foundation to combat HIV through awareness, education and prevention programs.

2006

Magic launches the “I Stand With Magic” campaign to promote testing, treatment and education among African Americans.

Magic appears on The Oprah Winfrey Show to discuss the rising rate of HIV among Black women.

2012

Magic and the AIDS Healthcare Foundation announce plans to open HIV clinics in three cities.

2025

Magic gives a speech at the United States Conference on HIV/AIDS in Washington, DC.

1992 Magic is appointed to the National Commission on AIDS but leaves eight months later, stating the Bush administration had “dropped the ball” on AIDS.

Magic competes as part of the United States “Dream Team” in the Barcelona 1992 Summer Olympics, inspiring people living with HIV.

Magic discusses HIV and AIDS with kids in a Nickelodeon special titled A Conversation with Magic. Magic publishes his autobiography, My Life, in which he reﬂects on his journey on and off the court.

2022 They Call Me Magic, a documentary that chronicles his life, airs on Apple TV+.

Magic

LARRY KRAMER

By Peter Staley

I was just a kid when I walked into my ﬁrst meeting of ACT UP (AIDS Coalition to Unleash Power) in 1987. It was just weeks after Larry Kramer’s legendary speech at the Lesbian and Gay Community Center in New York City, which had led to the founding of ACT UP. I didn’t even know who he was—but I would soon learn. That year, Larry’s life became part of the steep learning curve I desperately climbed.

An Activist Who Sparked

a Movement

ACT UP members were mostly young and angry; Larry called us “my kids.” After meetings, we’d gather at Woody’s—dissecting strategy, debating our future, trading gossip and soaking up his ﬁre. Those moments were the happiest I’ve ever seen him. He was surrounded by the kind of community he had long dreamed of—energized, radical and ﬁercely committed.

Larry became a father ﬁgure to many of us, asking about our lives and setting us up on dates. He genuinely cared about our struggles and fears.

ACT UP was born six years into a deadly silence. America and its president ignored AIDS as the virus slaughtered a community they despised. Larry told us to ﬁght back. And we did. By 1990, the National Institute of Health’s AIDS budget hit $1 billion. It was the AIDS activist movement that caused that shift, and Larry was its spark.

Our relationship was stormy. He accused me of destroying ACT UP when TAG [Treatment Action Group] split off in 1992 and for not being angry enough in the years since; I accused him of being sex negative and out of touch (his early opposition to PrEP [pre-exposure prophylaxis] was symbolic of this). But we shared too much to ever fully turn away from one another. Under the anger lived profound mutual respect.

Larry was ﬂawed—but he was also fearless. He was our community’s greatest advocate. He constantly told straight America that his gay brothers and sisters were the most beautiful people on earth. He pushed back against the hate directed at us like no other. Larry loved gay people and spent his entire life ﬁghting for us.

Those ACT UP meetings gave me the only hope I could ﬁnd back then. Larry Kramer founded a movement, and I’m alive because of that. Millions more can say the same. All of his faults fade away in the wake of our thanks.

Peter Staley is an AIDS and LGBTQ rights activist who cofounded the Treatment Action Group and PrEP4All.

Larry Kramer in 2007

KEY MOMENTS

1957

Larry graduates from Yale with a bachelor’s degree in English.

1978

Larry publishes Faggots, a satirical portrayal of gay men and their relationships in New York in the 1970s.

1985

Larry’s play, The Normal Heart, which depicts the early years of the AIDS epidemic, premieres at The Public Theater.

1988

1969

Larry earns an Academy Award nomination for the screenplay adaptation of Women in Love.

1981

Larry cofounds Gay Men’s Health Crisis (GMHC), one of the ﬁrst organizations dedicated to AIDS services and awareness.

1987 Larry learns he has HIV.

2013

Larry marries architect David Webster in a ceremony in the intensive care unit of NYU Langone Medical Center while recovering from abdominal surgery.

2020

Larry dies of pneumonia at age 84.

Larry gives a speech focused on using political action to ﬁght AIDS, which leads to the formation of the advocacy group ACT UP.

2001

Larry undergoes a liver transplant a er ﬁghting for the right to receive one as a person living with HIV.

2015

Larry publishes The American People: Volume 1 The second volume is published in 2020.

RAE LEWIS-THORNTON

By Olivia Ford

A Pioneering Diva Living

With AIDS

Whether she’s holding your gaze from a photo or commanding a stage facing a rapt audience of thousands, the word that comes to mind when beholding Rae Lewis-Thornton is poised. With her silver hair impeccably coiffed, this renowned speaker and gifted writer is always dressed to the nines, just as she was on the December 1994 cover of Essence magazine where she proclaimed to all the world, and speciﬁcally to Black women, “I’m young, I’m educated, I’m drug-free, and I’m dying of AIDS.” She was 32 and had already been silently living with her HIV diagnosis for nine years as she worked for historic Democratic campaigns and amassed a roster of inﬂuential associates, building a career as a political strategist from which her health eventually forced her to retire.

That Essence piece made Lewis-Thornton a household name, leading to decades of media appearances, speaking engagements and awards, and helped establish her as an enduring voice and brand grounded in faith, affirming of sexuality and focused on leaning into pleasure to cope with crushing circumstances. In her long-running blog, Diva Living With AIDS (which was syndicated on TheBody .com during the 2010s when I was an editor there), she described her struggles with the effects of advanced HIV on her body, finances and mental health with unflinching candor, just as she reveled in descriptions of how a hot bath, a delicious cup of tea, a fresh outfit or spending time on an activity she loved could be a balm. Openly discussing the physical, emotional and sexual abuse she survived as a child—experiences a staggering proportion of women living with HIV share— Lewis-Thornton was an early voice framing HIV as a condition not simply of individual behavior but of trauma, years before that stark reality was validated by study findings. An ordained minister, pioneer in social media advocacy and accomplished author of three books and numerous articles sharing personal narratives as well as subject-matter expertise on menopause, the impact of childhood trauma and more—not to mention tea connoisseur, jewelry designer and loving mom to several generations of toy poodles—Lewis-Thornton continues to make a thriving garden of the life she once assumed would end before she reached 50. At every step, she has demonstrated through her work and example that becoming our full selves is a journey— and what a gift to witness hers.

Olivia Ford is the executive director of The Well Project, which prioritizes the advancement of women in all aspects of HIV prevention, treatment and cure research and policy.

1987

Rae learns she is living with HIV a er donating blood at a blood drive. She believes she acquired HIV in 1983.

1992

Rae is diagnosed with AIDS, which drives her to begin publicly sharing her story.

1995

Rae wins a Chicago/ Midwest Emmy Award for an eight-part television series titled Living With AIDS.

2000

Rae becomes ordained as a licensed Baptist minister.

2010

Rae launches the blog Diva Living With AIDS, which discusses the realities of living with the virus.

1988

Rae serves as the national youth director for the Reverend Jesse Jackson’s presidential campaign.

1994

Rae appears on the cover of Essence magazine and announces she is living with AIDS.

1996

“Rae’s Story” is an episode of Ted Koppel’s Nightline.

2006

Rae obtains a master of divinity degree from McCormick Theological Seminary.

2015

Rae takes part in “Doing It,” a testing campaign from the Centers for Disease Control and Prevention.

2022 KEY MOMENTS

Rae releases her memoir, Unprotected

Rae LewisThornton in 2022

ELIZABETH TAYLOR

By Robert Suttle

A Legacy of Justice and Courage

Elizabeth Taylor, who founded The Elizabeth Taylor AIDS Foundation (ETAF) in 1991, was one of the ﬁrst globally recognized advocates to stand with people living with HIV and AIDS during a time when silence and stigma prevailed. She refused to let misguided fear dictate the response to the epidemic and instead called for compassion, courage and action. By framing HIV as a human rights issue, she shifted the focus of the global conversation and demanded that the world recognize the dignity of those most affected.

Her advocacy, however, went beyond speaking out. At a time when few dared to address HIV publicly, she established ETAF to ensure that care and resources reached those who needed them most. The foundation remains a vital force, funding lifesaving services, supporting vulnerable communities and confronting HIV-related stigma and discrimination. Long before celebrity advocacy was common, Taylor risked her reputation to raise awareness, inﬂuence policy and ﬁght for justice. She understood that ending the epidemic required not only effective medication but also the dismantling of inequity and fear.

That legacy is more than history—it continues to shape lives like mine. Years after an HIV criminalization prosecution changed my life, I now serve as chair of ETAF’s Council of Justice Leaders. In this role, I work with other survivors of criminalization to promote the values she championed: amplifying the voices of people living with HIV, dismantling unjust laws and promoting policies grounded in science and compassion. In 2024, I had the privilege of presenting the Elizabeth Taylor Human Rights Award, which reminded me of the enduring and powerful inﬂuence she continues to have in the ﬁeld.

Taylor’s unwavering advocacy continues through the efforts of many leaders, advocates and organizations inspired by her example. She demonstrated that courage and compassion can change hearts, inﬂuence laws and open doors that were once closed. Her spirit inspires our ﬁght for justice, reminding us that the journey to ending the HIV epidemic, which includes decriminalizing HIV, must be grounded in human rights.

Robert Suttle is a New York City–based advocacy consultant and movement leader in the global HIV community with expertise in decriminalization, human rights and the intersection between equity and social justice.

KEY MOMENTS

1985

Elizabeth organizes the ﬁrst celebrity AIDS beneﬁt, which raises $1.3 million for AIDS Project Los Angeles.

Elizabeth and Rock Hudson’s doctor, Michael Gottlieb, partner with Mathilde Krim, PhD, to establish the American Foundation for AIDS Research (amfAR).

1991

Elizabeth establishes ETAF to support direct services for people living with HIV and AIDS.

2000

Elizabeth is named a Dame Commander of the Order of the British Empire by Queen Elizabeth for her acting work and for her role in the ﬁght against AIDS.

2011

Elizabeth dies at age 79. Her jewelry is auctioned by Christie’s and raises nearly $116 million for ETAF.

1986

Elizabeth testiﬁes before the Senate on behalf of the Ryan White CARE Act to push for increased funding for AIDS emergency care.

1987

Elizabeth becomes the ﬁrst patron for the AIDS Crisis Trust in London.

1996

Elizabeth appears in four prime-time CBS sitcoms (The Nanny, Can’t Hurry Love, Murphy Brown and High Society) in a single night and donates her earnings to ETAF.

2001

Elizabeth is awarded the Presidential Citizens Medal by President Bill Clinton for her humanitarian work and her HIV and AIDS advocacy.

Elizabeth Taylor in 1992

PEDRO ZAMORA

By John Cunningham

At 17, Pedro Zamora learned he was living with HIV. Rather than let the diagnosis define him, he chose to dedicate his life to raising awareness about HIV and AIDS and the broader health and social injustices affecting those impacted.

This dedication took him all the way to Congress, where he spoke fervently about the need for greater government efforts to promote HIV and AIDS awareness. “There is not one second of my day that I am not aware that I am HIV positive. I don’t want to forget that I have AIDS, and I don’t want you to forget that I have AIDS. You have to understand AIDS is part of my life. It’s my reality. It’s who I am,” he said in congressional testimony.

Pedro Zamora in 1994

An

AIDS Educator Who Won Our Hearts

Pedro took his activism to mainstream pop culture via television, where he captivated the nation with his openness, compassion, vitality and charisma when he appeared on MTV’s reality TV show The Real World: San Francisco and spoke openly about his sexuality, status and activism. Throughout his time on The Real World, Pedro highlighted his relationship with Sean Sasser, another man of color living with HIV, and, in another historical first, the two pledged their love in a commitment ceremony on the show, nearly 20 years before such marriages became legal.

Pedro’s incredible life and work were tragically cut short when he died of an AIDSrelated illness in 1994, the morning after the final episode of The Real World aired.

Pedro’s legacy lives on through those he inspired and through the efforts of those fighting to ensure that his story is never forgotten. In memory of his inspirational efforts and with major funding from Gilead Sciences, the National AIDS Memorial established the Pedro Zamora Young Leaders Scholarship. The scholarship spotlights and supports young leaders who carry the torch of activists like Pedro and speak out against health and social injustices in their communities—in ways inspired by their own passions, insights, originality and conviction. Today, this program supports young people doing the same work to bring about positive change that Pedro did. Q

John Cunningham is the CEO of the National AIDS Memorial, which ensures that the story of AIDS and the AIDS movement is never forgotten. The organization uplifts today’s health and social justice issues to help the nation heal, remember, thrive and continue to work for a just and equitable future.

KEY MOMENTS

1989

Pedro learns he has HIV a er attempting to donate blood during his junior year of high school.

1991

Pedro gains attention as an HIV educator when a frontpage article about his work is published in The Wall Street Journal. He gains more attention a er interviews with Phil Donahue, Oprah Winfrey and Geraldo Rivera.

1993

Pedro testiﬁes before Congress and advocates for comprehensive and explicit HIV educational programs for youth.

Pedro attends the 1993 Lesbian and Gay March on Washington and meets fellow AIDS educator Sean Sasser, who later becomes his partner.

1990

Pedro joins Body Positive, a Miami-based HIV resource center and begins to raise awareness about HIV in his community.

1992

Pedro is appointed to Florida’s Red Ribbon Pannel on AIDS, which makes education and prevention recommendations to the state legislature.

1994

Pedro joins the cast of the third season of MTV’s The Real World: San Francisco. He educates his housemates and millions of viewers about HIV and AIDS. He appears on the August/ September cover of POZ.

Pedro dies of AIDS-related complications at age 22.

AIDS UNITED ADVOCACY

Looking to the Future

CARL BALONEY JR. ENTERS THE SPOTLIGHT AS CEO AND PRESIDENT OF AIDS UNITED.

BY ALICIA GREEN • PHOTOGRAPHY BY LIZ ROLL

IN JULY, AFTER 10 YEARS AT AIDS UNITED, CARL BALONEY JR. stepped into a new and very important role. He succeeded Jesse Milan Jr. as president and CEO of the HIV organization, becoming the second Black gay man to hold the post.

“What brought me to this work was knowing that I am the population that is most at risk for HIV and AIDS,” says 41-year-old Baloney, who is HIV negative and lives in Washington, DC. “It’s heartwarming to be in this position.”

Baloney ﬁrst joined AIDS United in 2015 as director of government affairs. Previously, he was the group’s vice president for public affairs and chief policy ofﬁcer. His job included leading strategic communication, public policy and advocacy efforts.

“From the policy perspective, we made sure to maintain strong relationships with policymakers on Capitol Hill and in the White House,” he says. “So that when there was an opportunity to engage on either a positive action or to push back against a negative action, we would be heard.”

BALONEY PLAYED AN IMPORTANT ROLE IN doubling the size of AIDS United’s Public Policy Council (PPC). The council now has over 60 member organizations. The council’s mission is to bring together HIV-focused groups from across the United States to advocate for people

living with or vulnerable to HIV.

He also doubled the reach and capacity of AIDSWatch— the largest constituent-driven HIV federal advocacy event in the country.

“I didn’t double those events for numbers,” Baloney says. “I doubled it for impact and representation—better geographic, racial, ethnic, linguistic and gender identity representation.” Because, as Baloney notes, policymakers should ensure that everyone is included and heard.

As he looks to the future, Baloney wants to use both PPC and AIDSWatch to bring about important changes. He hopes to thread the needle for communities between federal and local advocacy and policy action.

“Now more than ever, local power is critical to positive change,” he says. “It’s certainly been critical to the negative changes that we’ve been experiencing.”

AIDS UNITED HAD ANNOUNCED THAT BALONEY would succeed Milan upon Milan’s retirement on July 1.

Baloney first joined AIDS United in 2015.

“Jesse and I upped how often we met,” Baloney says. “I started meeting with our ﬁnance team and board more regularly and communicating more directly with the staff.”

Baloney also took the lead on some speaking engagements and meetings.

“It was really quite seamless,” he says. “I was really fortunate to have the trust of the board and to frankly have buy-in from the staff, who didn’t actually quite know what was going on yet but trusted me in those spaces.”

Six months into his position, Baloney faces the challenge of leading an HIV organization at a time when people living with HIV in the United States are afraid of rising stigma, a loss of access to affordable medication and cuts to essential HIV funding. But he remains undeterred.

“Our movement was built for this moment,” he says. “We’ve found ourselves in dire and devastating times before, and we were able to not only persevere but eventually really build something.”

It all starts with people living with HIV and those at risk being unashamed and unafraid to share their stories, Baloney explains.

“I believe, at my core, that the vast majority of policymakers come to DC to positively impact their communities, and they need to hear the stories of impact,” he says. “They need to know that you depend on Medicaid and SNAP [Supplemental Nutrition Assistance Program, also known as food stamps].”

AS A MILLENNIAL, BALONEY MIGHT just be the right person to inspire AIDS United’s staff at this difﬁcult time.

“NOW MORE THAN EVER, LOCAL POWER IS CRITICAL TO POSITIVE CHANGE.”

“Millennials sit at an interesting intersection,” he says. “We have some of the pragmatism of the older generations and then a little bit of the urgency of the generations beneath us. I think we’re a healthy mix open to different perspectives.”

“My generation is ready for this,” Baloney says. “We’ve built the requisite skills and invested in education and knowledge. It’s really critical that we have the opportunity to bring our voice to bear in these conversations and to utilize the lessons that we’ve learned from our mentors who came before us.”

Baloney hopes he can serve as an example to other young Black men no matter their ﬁeld. He thinks fondly of the Black male peers and mentors who poured into him over the course of his career. It’s what he wants to do for others.

“I’m incredibly proud to be in a position to ﬁght for what I believe in and hopefully bring others up with me,” he says. “There is enough room for all of us.”

DESPITE ALL THE WORK THAT MUST BE DONE, Baloney knows that advocates need a break.

“When you care, that can be really difﬁcult, but you have to step back and realize this is a marathon, not a sprint,” he says. “I think people need to work together on stepping up and stepping back. Like, Hey, I’m going to do this for a while, and then I’m going to step back and take care of myself, and you step forward and continue that ﬁght.”

Burnout is real in work like this. That’s why AIDS United staffers have unlimited vacation leave and are recommended to at least take a whole week off.

Baloney has a built-in off switch that lets him step away. He’s also a father to 5-year-old twins. “Parenting is hard, but not thinking about work because they want to go to the pool or the playground helps,” he says.

Baloney urges advocates never to lose sight of hope.

“The moment when things look their most bleak, those are also times when cultivating hope is most important,” he says. “I really would encourage advocates to celebrate their wins, no matter how small or seemingly ﬂeeting.” Q

AIDS UNITED ADVOCACY

The Fight Continues

JESSE MILAN JR. REFLECTS ON HIS TIME AT AIDS UNITED AND WHAT LIES AHEAD.

BY ALICIA GREEN • PHOTOGRAPHY BY LIZ ROLL

IN 2016, JESSE MILAN JR. MADE HISTORY BY BECOMING THE

ﬁrst Black gay man to lead AIDS United. After nine years at the helm and over 40 years of HIV advocacy, Milan retired in July, the same month he turned 69.

“I realized that in 2025 I would be 40 years from 1985, when my late partner was diagnosed with AIDS and died,” says Milan, who lives in Ellicott City, Maryland. “And there was some nice symmetry about a 40year commitment that literally started in my own home.”

WHEN MILAN REFLECTS

on his tenure at AIDS United, he sees the many accomplishments the organization has achieved.

“We created a road map for ending the epidemic that was the basis for what President Trump did in creating the Ending the HIV Epidemic initiative,” he says. “We created new initiatives, like the Southern HIV Impact Fund, which has given away nearly $16 million to organizations in the South.”

He also highlights AIDS United’s work within the harm reduction and transgender communities via the Harm Reduction Futures Fund and the Transgender Leadership Initiative.

“I’m proud that I was able to be the steward for creating those [initiatives],” he says. “We kept AIDS United’s mission alive and, I believe, our reputation intact.”

IN FEBRUARY, AIDS

United announced Milan’s retirement and named his successor, Carl Baloney Jr. A succession plan had been in place since 2023 thanks to Milan, who brought the idea to the board.

“I needed it to be an organic decision that was part of our business structure,”

Milan has over 40 years of HIV advocacy experience.

he says. “It wasn’t just about me. It needed to be owned by the organization.”

The succession plan was ﬁnalized and approved last year. It addressed three issues: what to do if the CEO had to depart due to an emergency, what to do in case of a planned departure and what to do if the CEO recommended a successor ahead of a planned departure.

Milan’s departure was planned, and he wanted Baloney to succeed him. He believed it was time for the next generation to take over.

“It’s a model that I hope every CEO thinks about, especially as they’re hitting their own personal milestones with their organizations or their life,” he says. “This movement is not just about us. It’s about the organizations and the institutions that we lead.”

WHEN THE NEWS WAS

announced publicly, Milan didn’t know what the response would be.

“It had been a ﬂood of appreciation, love and gratitude that had just washed over me,” he says. “I felt that I had made the right decision. I had a shocking and surprising sense of calm because the years of worry about how and when I would do this had now ended.”

Milan spent the months leading up to his departure working closely with Baloney to ensure a smooth transition while working tirelessly to repeal Maryland’s outdated HIV crime law. In May, the state’s governor signed a bill into law that decriminalized HIV.

thing I needed to do. I was ready to leave,” he says.

MILAN HAS SINCE BEEN LIVING LIFE LIKE A retired person should. He’s taken up new activities, like line dancing, and has generally been having fun.

“In my ﬁrst month, I took three trips,” he says. “One by plane, one by train and one by car. I went and saw three matinees—two at the movies and one on Broadway. And I gave three dinner parties.”

And in September, he celebrated 37 years of marriage to his husband.

“THIS MOVEMENT IS NOT JUST ABOUT US. IT’S ABOUT THE ORGANIZATIONS AND THE INSTITUTIONS THAT WE LEAD. I FELT THAT I HAD DONE EVERYTHING I NEEDED TO DO. I WAS READY TO LEAVE.”

“I got to be there for the governor’s signing,” Milan says. “I shook his hand and told him how much I appreciated that he was signing this law. And he looked directly at me, grabbed my hand and thanked me. That was beautiful.”

Milan also started making plans for the people who meant the most to him, particularly those at AIDS United.

At a farewell dinner prior to his last board meeting, he sang “What I Did for Love” from the musical A Chorus Line “It’s about leaving your colleagues,” he says. “I have loved this organization and this community, and I know I have received love back from them.”

At his ﬁnal staff meeting, Milan personally thanked every staffer and said his goodbyes. “I felt that I had done every-

But retirement doesn’t mean Milan is no longer involved in HIV causes. He sits on four boards, including the American Board of Internal Medicine, and various committees and is a member of the advisory council of U.S. Business Action to End HIV.

“It is important to me that I still have a role in this epidemic,” he says, “I’m a person living with HIV. It is my life that this epidemic is about, and I’m not ready to completely leave it.”

In September, he spoke on a panel at the United States Conference on HIV/AIDS in Washington, DC, that addressed the funding gap in service delivery for Black organizations. Then, he gave the keynote at the HIV/AIDS Caracon Symposium 2025 in Cincinnati in October.

MILAN KNOWS THE FIGHT

ahead won’t be easy. But he encourages advocates to remember why they joined this ﬁght in the ﬁrst place.

“Whatever drove you to this movement has probably not changed,” he says. “Your commitment to do something for someone else is really beautiful. If you haven’t heard someone say thank you, I want you to hear it from me.”

Although today’s HIV advocates face different kinds of challenges, Milan emphasizes that the ﬁght for people living with HIV has been hard since the beginning of the epidemic.

“You’re not the ﬁrst, and, hopefully, you won’t be the last who makes the commitment to do this work,” he says. “Those in the past are grateful that you are doing it today, and those in the future will look back and be grateful that you’ve done it today too.” Q

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BY JAY LASSITER

Martina Clark is a longtime HIV advocate and a long-term survivor.

My Unexpected Life

Martina Clark ﬁrst learned she was HIV positive in 1992. Since then, she’s been changing the face of HIV in America and beyond.

“The initial diagnosis happened over the phone, which, of course, was a no-no,” Clark explains from her home in Brooklyn. “I was by myself, house-sitting in San Francisco, and I just felt like my whole life was erased, and I had to start over—and not in a good way.”

Clark quickly experienced the lack of treatment and support options for women living with HIV.

“I wanted to be the voice to speak for women wherever I could,” Clark tells POZ. “There was very much a gap that women’s needs weren’t being represented as much as men’s, particularly in this country.”

Her desire to advance the concerns of women living with the virus propelled Clark’s rise as an activist. Indeed, in 1995, she made history as the ﬁrst North American representative to the UNAIDS Programme Coordinating Board and the ﬁrst openly HIV-positive UNAIDS staffer.

“I was the link between UNAIDS and every nongovernmental organization (NGO) working on AIDS in the world,” she explains. “It was a daunting task. I felt completely overwhelmed, but I tried to set things up so that the NGOs felt truly welcome to approach us and that they had a partner in UNAIDS.”

According to Clark, most women still live in societies where a woman’s worth is determined by her ability to bear children. That was especially true in 1992, when Clark was diagnosed.

“We didn’t have the knowledge we have now,” Clark says. “It was assumed that any baby born to a mother with HIV would automatically have HIV. So society treated us like we were murderers if we dared to have a child. It was a very disturbing and unfair experience to go through because I was 28 years old. I had assumed I would eventually get married and have kids. But it was made clear to me by medical providers that having kids was not what I should do.”

That’s why, she explains, she felt like “damaged goods” a er her diagnosis, a sentiment Clark explores in her 2021 memoir, My Unexpected Life: An International Memoir of Two Pandemics, HIV and COVID-19.

“There are interventions that can prevent the transmission from mother to child that are very inexpensive and that people can utilize easily if they have access to good health care,” Clark adds. “I hope that women who test positive today will realize that they have very different options than we did back in the ’80s and ’90s, when we didn’t know yet that you could have a baby safely.”

Thanks in large part to Clark’s decades of advocacy, HIV-positive women can dream bigger and live long, healthy lives; for many women, that includes having healthy children.

“That was one of the things that kept me going,” Clark says. “Even if I only had ﬁve years to live, I hoped that whatever I could do at least would help somebody else down the line. I can never reverse this diagnosis, but at least, I can contribute to something that makes it easier for somebody else and hopefully raises visibility so that more women in the future don’t feel alone and isolated like I did.” Q

BILL WADMAN

HEADSPACE

People living with HIV are more likely to experience anxiety and depression compared with the general population. Taking care of your mental health is just as important as taking care of your physical health. Let POZ know about your mental health needs, struggles and support systems by completing our conﬁdential survey. And be sure to seek help when you need it.

1 How long have you been living with HIV?

T30 years or more TLess than 10 years

T20–29 years TI’m not living with HIV.

T 10–19 years

2 How would you rate your overall mental health?

TExcellent TFair

TGood TPoor

3 Have you ever been diagnosed with a mental health condition? (Check all that apply.)

TAnxiety TDepression

TBipolar disorder TPTSD

TOther (Please specify.): ___________________

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4 Are you currently receiving any mental health treatment or support?

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5 In the past month, how often have you felt overwhelmed, anxious or depressed?

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TSometimes TRarely

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7 How easy is it for you to access mental health care when you need it?

TVery easy TVery difficult

TSomewhat easy TI haven’t tried.

TSomewhat difficult

8 Which barriers do you face in accessing mental health care? (Check all that apply.)

TCost TScheduling issues

TLack of providers TStigma/fear

TLong wait times TTransportation issues

TOther (Please specify.): ___________________

TI haven’t faced any barriers.

9 Do you feel supported by your community (family, friends, neighbors)?

TYes TNo

10 Do you feel that there are adequate mental health support services in your community for people living with HIV?

TYes TNo

11 What year were you born?__ __ __ __

12 What is your gender?

TMale TTransgender

TFemale TOther

13 What is your sexual orientation?

TStraight TBisexual

TGay/lesbian TOther

14 What is your ethnicity? (Check all that apply.)

TAmerican Indian or Alaska Native

TArab or Middle Eastern

TAsian

TBlack or African American

THispanic or Latino

TNative Hawaiian or other Pacific Islander

TWhite

TOther (Please specify.): ___________________

15 What is your current level of education?

TSome high school TSome college

THigh school graduate TBachelor’s degree or higher

16 What is your annual household income?

TLess than $15,000 T$50,000–$74,999

T$15,000–$34,999 T$75,000–$99,999

T$35,000–$49,999 T$100,000 or more

17 What is your ZIP code?

Scan this QR code with your smartphone to take this survey at poz.com/survey. Or email a photo of your completed survey to website@poz.com.

Starting + Staying

By starting HIV treatment as soon as possible after diagnosis and staying on treatment as prescribed, you can help control your HIV viral load, which can help you live a longer and healthier life.

Today’s HIV treatments can ﬁt into your schedule, and some can even be started right away. So be sure to talk to your healthcare provider about what’s right for you.

And remember, you are not alone. There are many people to help support you, alongside your healthcare provider.

Work together with your healthcare provider to ﬁnd an HIV treatment option that is right for you and start your treatment journey today.

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