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Andrew Spieldenner is executive director of MPact, which builds queer communities, ÿghts HIV and advances human rights.
20 PRIDE IN GLOBAL ACTION As the global political climate heats up, MPact commemorates its 20th anniversary by spicing up its human rights advocacy. BY TIM MURPHY
26 HEALTH IS PRIMARY Two long-term survivors of HIV have transformed their political frustration into a nationwide call to action. BY MARK
3 FROM THE EDITOR
Dancing in the Dark
4 POZ Q&A
Pioneering activist Phill Wilson reflects on founding the Black AIDS Institute and writing his upcoming memoir.
6 POZ PLANET
A symbolic HIV funeral protest • Elton John AIDS Foundation raises $10.6 million at its annual Oscars bash • House of Ruth opens an apartment complex • a new exhibition of AIDS posters • POZ Stories: Mel England • Everyday: moments in the epidemic
10 VOICES
A long-term survivor shares lessons about aging • advancing the study of HIV and brain health
12 SPOTLIGHT AIDSWatch 2026
S. KING
14 NUTRITION & FITNESS
Rhubarb & ginger crumble • time for fitness
15 BASICS
Gay men and HIV
16 CARE & TREATMENT
Budget cuts threaten HIV prevention and treatment • twice-yearly HIV treatment on the horizon • benefits of weight-loss meds • insights on transgender women and HIV
18 RESEARCH NOTES
Longer-acting PrEP • HIV treatment for teens • immunotherapy may delay viral rebound • rise of oral cancer
32 HEROES
Longtime activist Marco Benjamin encourages fellow advocates to take short breaks.
33 HIV PREVENTION DRUG CHART
Antiretroviral options to prevent HIV
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Dancing in the Dark I
WAS 17 YEARS OLD WHEN I ventured into the adult world of New York City. It was 1987, so I had missed the earliest days of AIDS. I was not spared from the following years of the epidemic when hope was hard to find.
It was my first year at New York University. I was born in Spanish Harlem and raised in Queens, but my sheltered upbringing didn’t prepare me for life in Greenwich Village. The vibe was thrilling, but fear of HIV was everywhere. Seeking solace was a shared experience.
Relief took on many forms. Sex, drugs and alcohol were on the menu, of course, but so was art and music as well as activism. For some, all of the above became their everyday. For me, I took more of a cafeteria approach. After all, I was too young for certain spaces and too closeted for others.
Escaping on the dance floor, however, was a virtually universal pastime that I most definitely participated in. Although I tested HIV positive in 1992, I can honestly say that the joy I found surrounded by my fellow queers in the clubs, bars and elsewhere during those days was lifesaving.
As the founder of the Black AIDS Institute (BAI), Phill became a nationally recognized advocate. Go to page 4 to read about his thoughts on the unfinished business of closing the HIV racial gap and his memoir.
When Phill decided to move on from BAI, he had already spent decades in the fight against the virus. A few years ago, Marco faced a similar situation. As a result, Marco stepped away from HIV advocacy but after a while decided to return. Go to page 32 to read about his current efforts as a health activist.
It is this bliss that MPact is tapping into today, particularly for men who have sex with men (MSM). Founded in 2006 as the Global Forum on MSM and HIV, MPact is commemorating its 20th anniversary this year. To mark the occasion, the group has launched a new logo depicting a disco ball, which conveys the joy of being ourselves.
Andrew Spieldenner, PhD, a long-term survivor and an advocate, is MPact’s executive director and our cover subject. In addition to his credentials as a researcher, living with HIV gives him an edge when it comes to fulfilling MPact’s mission to uplift LGBTQ folks through sex-positive messaging. Go to page 20 for more about MPact.
In this special Pride issue of POZ, we also explore the work of additional LGBTQ advocates, including Phill Wilson, Marco Benjamin, Cleve Jones and Sean Strub.
In acknowledgment of HIV as part of a larger health care narrative, Cleve and Sean have joined forces to promote a grassroots campaign. Seven Days in June: Health Is Primary is a national call to elevate health as a governing priority. The goal is to focus attention on how funding cuts as well as policy and regulatory changes will devastate local communities. Folks are encouraged to take action during the first week of June, especially at vigils on June 5, to register their objections to such cuts. Go to page 26 to learn more.
Cuts to the Ryan White HIV/AIDS Program could mean thousands of additional HIV cases and declining health for people living with the virus. Go to page 16 to read more about the possible harms such cuts may cause.
ORIOL R. GUTIERREZ JR. EDITOR-IN-CHIEF editor-in-chief@poz.com
PIONEERING ACTIVIST
Phill Wilson, 70, reflects on founding the Black AIDS Institute and writing his upcoming memoir.
IN APRIL, PHILL WILSON—WHO FOUNDED THE INFLUENTIAL BLACK AIDS Institute (BAI) more than a decade after his own mid-1980s HIV diagnosis— turned 70. Still living in his longtime home of Los Angeles, where he’s busy writing his memoir and enjoying a new relationship, he recently spoke with POZ contributor Tim Murphy about losing his first lover to AIDS, becoming a go-to expert on the epidemic in LA and why BAI’s work to close the HIV racial gap was significant but remains unfinished. He also has a fun, new hobby!
Phill, what was going on in your life on the eve of the epidemic in the early 1980s? My partner at the time, Chris Brownlie, and I were building our lives together as young gay men in Chicago. I was working as a marketing analyst at AT&T. I think I would’ve become a business entrepreneur if AIDS hadn’t happened. But I hope I would’ve still responded to the epidemic in some way.
In a previous interview we did, you talked about you and Chris in 1981 both having swollen lymph nodes and reading about this new disease in [the magazine] Blueboy. And then you and Chris moved to LA in 1982 and volunteered on the hotline of the newly started AIDS Project Los Angeles (APLA). When Chris died of AIDS in 1989, you were 32. Has that early loss impacted your life? It totally changed the trajectory of my life. At the point of his death, my entire gay experience was in the context of a decade-long relationship with him. The impact of that period of time in my life has been my North Star up until today.
What did you do after his death until you founded BAI in 1999?
I was involved in the Black Gay and Lesbian Leadership Forum—an organization I founded. Shortly after, Mayor Tom Bradley asked me to become the AIDS coordinator for LA, writing all the city’s AIDS programs.
Then I worked for APLA until 1996, the year the [new lifesaving drug] cocktails came out. I got really sick from AIDS that year—at one point, they said I had a day to live. But then, I went on the cocktail and started to recover. By 1998, I felt like I needed to get back to work. So I looked around.
Between 1996 and 1998, a lot had changed [in terms of people getting better with the new meds]. But there wasn’t a lot of movement to address AIDS in Black communities.
What did that disparity look like?
In the white gay community, it was like when it goes from black and white to Technicolor in The Wizard of Oz . But Black men were still in the Wicked Witch’s castle being chased by monkeys. There was no Black mobilization,
Left: Phill Wilson in San Francisco, 1991; above: Wilson (right) with his late partner Chris Brownlie
which was needed regardless of gender or sexual orientation.
Did your work intersect with the late, great Archbishop Carl Bean, who not only sang the gay disco classic “I Was Born This Way” but also started the Black LGBTQ Unity Fellowship Church in LA in 1982 and the Minority AIDS Project (MAP) in 1985?
Absolutely. In 1986, [political activist] Lyndon LaRouche had an initiative on the ballot in California to quarantine people living with HIV in, basically, concentration camps. I got into the effort to counter that and reached out to Black communities, where I encountered Archbishop Bean in the early years of Unity Fellowship, where I was a congregant, and the Minority AIDS Project. After we defeated the LaRouche initiative, he asked if I’d become the executive director of MAP, which I was for a short period of time.
What was Bean like?
Anyone who ever met him was struck by his charisma. He came out of a very traditional Black Christian evangelical experience and had a remarkable ability to help people understand that they deserved to be cared for.
You started BAI in 1999 and stepped down in 2019, even though BAI still exists. How would you summarize those 20 years?
Our goal and our mission was to create a Black AIDS movement, meaning our slogan, which was “AIDS in America is a Black disease.” We were able to get Black institutions and leaders to take ownership of the epidemic and acknowledge it was all of our problem. Another of our slogans was “Our People, Our Problem, Our Solution.” We moved HIV/AIDS from the periphery to a central issue in Black culture.
What about closing the racial gap on getting tested and treated and having access to the best prevention? According to the Centers for Disease Control and Prevention—which many people who follow evidence-based science now mistrust due to right-wing inter-
ference—Black folks still make up 38% of new HIV diagnoses in the U.S. despite being only about 13% of the population. The tragedy is, I don’t think we closed it. We improved access and outcomes in Black communities. But there remains a huge gap. White gay men were at the front line of HIV becoming a manageable chronic disease, whereas in Black communities, we are still at the point of educating people about the science of HIV/AIDS, which is a lot of what we did at BAI. We made progress but started so far behind. Also, once HIV became manageable among white gay men, the world turned its attention away.
These are very scary times. Dangerous. The world as we know it—whether we’re talking about LGBTQ, HIV/AIDS or any number of things—faces an existential threat. But all the communities I’m a part of—Black, LGBTQ, HIV/ AIDS—have faced challenges of this magnitude before. We can prevail, but it will depend on how engaged we are in responding to this threat.
What’s something that is giving you joy these days?
I’m involved in gay square dancing. Karl, my partner going on two years now, was involved in it when we met, so I would go to those events with him and
Phill Wilson
“We can prevail, but it will depend on how engaged we are in responding to this threat.”
With distance now from BAI, what are your feelings about your time there?
I’m very proud that we did work that nobody had done before. We focused attention in new ways and engaged folks who’d not been engaged. We created delegations of Black media, thought leaders and elected officials to attend the national AIDS conference. We were able to move traditional Black institutions from a place of blame and shame to one of responsibility and accountability. All of the national Black institutions—NAACP, the Urban League, etc.—had AIDS strategies and national AIDS committees. We were able to get Black media to cover HIV/ AIDS. I’m proud of all that and of our ability to reduce the stigma of HIV/ AIDS in Black communities. But now with the assaults [on HIV funding] happening, it feels like that progress is being erased.
How do you feel about this moment we’re in right now?
decided that I would take lessons. It’s great camaraderie. People who do square dancing skew older, and it’s good exercise.
Is drag involved?
Sometimes! There are events that are drag-related, like leather square dancing and nude square dancing. All sorts of square dancing. Sometimes the women dance the male part, and the men dance the female part. And sometimes both the men and women wear those petticoat dresses.
Would you be open to doing the nude square dancing?
Probably not! I’m a Midwestern boy, hence a little too conservative for a lot of hanging out naked. Q
This interview was excerpted from the original, which was published on The Caftan Chronicles, Murphy’s Substack featuring long-form interviews with famous or notable older gay men.
A SYMBOLIC HIV FUNERAL PROTEST
The event included pallbearers and living obituaries.
Long-term HIV survivors, health advocates, community health providers and faith leaders gathered in Washington, DC, on March 16 to hold a symbolic funeral protest and celebration-of-life service to sound the alarm over the growing instability in HIV prevention and care funding across the United States and the impact on America’s national health care infrastructure.
Organized by the Save HIV Funding Campaign and held at the Renaissance Arlington Capital View Hotel (host hotel for this year’s AIDSWatch conference), the demonstration used the imagery of a memorial service to warn that decades of progress in the fight against HIV could be reversed if critical prevention and treatment programs continue to face funding threats and policy instability.
Top, center: Carmarion Anderson; inset: Jeremiah Johnson
Participants included the Reverend Elder Carmarion D. Anderson, minister for congregational leadership, United Church of Christ National Ministries; Jeremiah Johnson, cofounder of the Save HIV Funding Campaign and executive director of PrEP4All, who acted as “funeral director” for the day; and Maxx Boykin, campaign manager for the Save HIV Funding Campaign.
Speakers and living obituary readers included Kamaria Laffrey, co–executive director, SERO Project, in Florida; Barb Cardell, program director, Positive Women’s Network–USA, in Colorado; Aubrianna Escalera Naranjo, COO and president, Poder Unides Inc., in Georgia; Vincent Crisostomo, director of aging services, San Francisco AIDS Foundation, in California;
Paul Aguilar, author and activist, in California; and Malcolm Reid, cochair, U.S. People Living with HIV Caucus, and founder and CEO, Unity Arc Advocacy Group, in Georgia.
Speakers emphasized that the systems supporting HIV prevention, treatment and care were built with bipartisan support over decades. They warned that weakening these programs not only puts vulnerable communities at risk but also dismantles a public health model pioneered by the HIV response that has guided how the United States responds to large-scale health emergencies.
Jeremiah Johnson shared remarks, saying in part: “We’re going to make sure that our policymakers hear us loud and clear: Do we invest in life, or do we invest in death? Do we invest in care, or do we invest in bombs? We have to save our care, save our prevention, save our research, save our housing. And we have to do it not just for those of us in America, but we have to do it globally.”
The gathering brought together advocates, community members and people directly impacted by HIV policy decisions. Participants highlighted concerns about recent funding instability affecting programs that provide prevention services, treatment access and medication assistance for people living with HIV.
Reading a living obituary of himself, Malcolm Reid said: “Malcolm’s death was not inevitable. It was planned. It was engineered. Treatment worked when it was uninterrupted. Viral suppression was not a miracle. It was access plus consistency plus trust. When the system broke that trust, when it replaced clarity with confusion, it did not merely create inconvenience. It created funerals.”
The celebration-of-life program included remarks from advocates, community leaders and public health voices, along with readings and a musical/ gospel element honoring the generations of activists, caregivers and providers who built the modern HIV response infrastructure.
Advocates warned that weakening federal HIV programs could reverse decades of progress made in reducing new HIV cases and expanding treatment access. —Save HIV Funding Campaign
2026 HIV OSCAR PARTY GETS “MESSY”
The annual fundraiser brought in $10.6 million.
The 34th Annual Elton John AIDS Foundation (EJAF) Academy Awards Viewing Party brought together Hollywood’s biggest stars and advocates at West Hollywood Park on March 15, raising $10.6 million toward ending AIDS.
The evening featured a raw and unfiltered performance by double-platinum-selling British artist and BRIT and Grammy Award winner Lola Young. Performing songs from her third studio album, I’m Only F**king Myself, including “d£aler” and “SPIDERS,” she brought her signature grit and honesty to the stage and had the crowd singing every word of her breakthrough hit, “Messy.”
“My generation didn’t live through the height of the AIDS epidemic, but that means we have a responsibility to speak up for the millions of people still pushing to live freely, especially LGBTQ+ communities, who led the way from the start,” said Young. “It means so much to me to be part of a night that celebrates authenticity and
Top, clockwise from le˜: Neil Patrick Harris, David Furnish, David Burtka, Elton John; bottom: Lola Young
supports a cause that really matters.”
In addition to introducing Young to the stage, Elton John cohosted the benefit alongside David Furnish, Neil Patrick Harris and David Burtka, continuing a tradition that has made the EJAF’s viewing party an impactful event during Oscars weekend.
“The Academy Awards Viewing Party reflects why we started this foundation 34 years ago: to honor the friends we lost and advocate for the people still vulnerable. Every year, we come together, and every year, artists like Lola Young make the night unforgettable. In a moment full of incredible British talent, Lola stood out. She’s bold, brilliant and completely herself. West Hollywood, thank you for showing up and helping us keep pushing to end AIDS,” said John. Additional attendees included Adam Lambert, Bernie Taupin, Billie Jean King, Brandi Carlile, Chris Colfer, Colton Haynes, David Geffen, Dua Lipa, Eric McCormack, Fran Drescher, Jane Seymour, Jason Ritter, JC Chasez, Kate Beckinsale, Laverne Cox, Melissa McCarthy, Orville Peck, Patricia Arquette, RuPaul, Tiffany Haddish, Tina Knowles, Donatella Versace, Zoe Saldaña and others.
This year had the first-ever After Party Benefit Committee, which kept the festivities going late into the night. —EJAF
HOUSE OF RUTH OPENS APARTMENT
The 40 units support people affected by HIV.
In its largest project to date, the nonprofit House of Ruth opened a three-story, 40-unit housing complex dubbed the Red Key Landing for people affected by HIV in Louisville, Kentucky, reports WDRB.com. A ribbon-cutting ceremony was held March 12 with city officials and guests.
House of Ruth has provided housing and support for people affected by HIV since its founding in 1992.
The complex cost $10.2 million, according to WDRB, which noted that many of the funds were allocated from the American Rescue Plan following the COVID-19 pandemic.
“It’s safe, quality, affordable, frankly beautiful housing that most have never known,” said House of Ruth executive director Lisa Sutton. “Despite this great work, we still have a housing waiting list for our supportive and affordable housing.”
HouseofRuth.net offers a history and snapshot of the organization and the community it serves. Founded by eight long-time friends, four of whom were Sisters of Charity of Nazareth, House of Ruth incorporated in 1992. The name House of Ruth is a reference to the biblical Book of Ruth and symbolizes love and mercy for all people.
The number of families and individuals seeking services has consistently grown. In its first year, House of Ruth served eight families. In 2020, House of Ruth served over 600 individuals.
Today, House of Ruth owns 17 scatteredsite housing units for individuals and families affected by HIV and AIDS and partners with Louisville Metro Government to provide rental subsidies for another 25 households that rent from community landlords. —Trent Straube
Records of Optimism
Hope defines a new exhibition of AIDS posters.
WHAT IS AN AIDS POSTER? Over the years, they have been used to share lifesaving information, spread activist messages and promote events.
For historian Ian Bradley-Perrin, PhD, an AIDS poster is something more: “a record of optimism,” a way of tracking the story of hope, effort and community amid an ongoing crisis.
Bradley-Perrin shares this view as curator of Love & Fury: New York’s Fight Against AIDS, an exhibition at New York City’s Poster House, an institution that board president Valerie Crosswhite describes as “dedicated to showing the global history of posters” while maintaining “a deep commitment to our local audience.” The 40-plus posters in Love & Fury honor both goals. Drawn from the worlds of public health, protest and advertising, these posters were displayed on the city’s streets and subways and in its civic spaces from the earliest days of the epidemic through the early 2000s and had a worldwide impact.
As visitors enter the exhibit, they are met by a poster promoting the New St. Marks Baths, a legendary bathhouse that closed during the moral panic of the early AIDS years. Dated 1979, it depicts a fit man riding a fantastical beast, reflecting the sexual exuberance of a specific moment while casting melancholy for an audience that knows what comes next.
This dichotomy flows throughout Love & Fury. Across from the hunk on the sci-fi dinosaur hangs a jaunty Keith Haring illustration of a penis warning about condom use, part of a section on safer sex. Nearby, visitors can get close to posters made by some of the earliest people knowingly living with AIDS, activists who pooled their knowledge and dwindling time on earth to share prevention messages and in doing so saved lives.
For Bradley-Perrin, optimism is inseparable from context. A poster, he says, “forces you to think about the person who designs the poster” and the audience it was made for. Among the most famous works in the exhibition, the Silence=Death poster captures this idea. Created in 1986 by a group of gay men who felt isolated in a world being reshaped by AIDS, it now serves as an inverse of the St. Marks Baths poster: Born of desperation, it endures decades later as the symbol of AIDS activist power.
One unexpected thread of optimism in Love & Fury is the role of New York’s fashion industry, explored through scholar Natalie Nudell’s book In American Fashion, which tracks how, devastated by loss, designers and store owners used their platforms—including posters—to raise money and awareness. The largest work in the show captures this: a wall-sized Benetton ad in which the word AIDS appears among a cascade of vibrant faces.
AIDS posters are not only about the past. Trevor Ladner, director of education programs at One Institute, uses them to connect generations, sharing AIDS posters on social media, in curricula and via programming to bridge history and the present. For young people, he argues, they reveal “the labor and creativity that went into organizing before the advent of widespread digital communication.”
Bradley-Perrin agrees. Yet now that the exhibition is open, he is learning what posters alone cannot communicate: what came next. At events and tours, visitors share the impact these images had on them, filling in the human story behind the artists’ intent. For an ongoing crisis, that may be exactly the right way to look at them. —Theodore Kerr
From top: posters by Boris Vallejo, Keith Haring, Enno Poersch and Oliviero Toscani
FEARLESS COMPASSION
Mel England reflects on actress Sally Kirkland’s legacy and her advocacy for people living with HIV.
TWENTY YEARS AGO, I ARRIVED IN Los Angeles and met Sally Kirkland at the Hollywood premiere of Adam & Steve, written and directed by my friend Craig Chester. She was so kind and looked in my eyes like I was the only person on earth. I left thinking I’d probably never see her again.
In 2008, I was diagnosed with cancer. Ten years earlier, I’d almost died of AIDS-related causes, so my new diagnosis came as a shock. I was just getting my life and career back.
I told Craig, “If I survive, I’m going to make that movie I wrote!” After six months of chemotherapy and radiation, I was cancer-free! I called Craig and told him the good news, and he said, “So now you’re making your movie, right?” I wondered who could play my mother, and he said, “Call Sally Kirkland!” I left a script for her to read. She called the next day and said, “I love your script. I’ll do it!” It was the beginning of my nearly 20-year relationship with the acting legend. Sadly, we never ended up making that movie, but I made another film in which Sally plays my mom. Here We Are is currently in postproduction and will be out next year.
I was one of the lucky people who got to know and work with Sally. She took me to Academy screenings and parties. So many stories! I discovered that when
Sally loved you, she supported you. And she did so with all her heart.
After my cancer scare, I worked on a solo off-Broadway show about surviving AIDS and cancer. Some people in the business warned me it might be a mistake to come out publicly as an AIDS survivor as it wasn’t something that was done. I asked Sally what she thought. She told me, “Be fearless.”
A few months ago, after Sally passed, Coty Galloway and I were closing down her apartment. We were going through her vast library of books about show business, spirituality and healing, and that’s when I learned more about what Sally had done for people living with HIV and AIDS. In the early days of the epidemic, way before the cocktail, we all clung to books by Louise Hay, Marianne Williamson, books on healing people holistically with nutrition.
When I opened up those books in Sally’s library, I saw that she had made notes and underlined passages to share as she ministered to people with AIDS who were dying.
Back when doctors were wearing hazmat suits, she’d sign a release so she didn’t have to because she wanted to hold people, hug them, love them.
Sally was on the front line of the epidemic. She was there: raising money for amfAR and AIDS Project Los Angeles,
June
HIV LONG-TERM SURVIVORS AWARENESS DAY
along with Elizabeth Taylor and Madonna. She was fearless.
Along with the books, I found a copy of A&U: America’s AIDS Magazine with Sally on the cover. Inside, was an interview with the headline “Saint Sally,” which was about her advocacy work for people with AIDS. I looked at the date on the cover. It was the December/January 1997 issue. I started getting chills right there in Sally’s apartment. That was the same time I was in the hospital thinking I was going to die of AIDS.
And that’s when I knew Sally was still right here with me. She had been there all along, cheering me on from my deathbed, then cheering me on to be fearless, to be a revolutionary for love.
And that’s what Sally is saying to all of us right now. “Be fearless. Be a revolutionary for love.”
Thank you, dear Sally. I love you.
Read other POZ Stories or share your own at poz.com/stories.
THE REAL WORLD: SAN FRANCISCO premieres on MTV. The cast includes Pedro Zamora, a Latino activist from Miami living with HIV. (1994) EVERYDAY
poz.com/aidsiseveryday
CASHING OUT premieres at the Provincetown International Film Festival. The documentary short focuses on the viatical settlement industry, in which people living with AIDS sold their life insurance policies to investors for immediate cash to cover medical costs and living expenses, and the investors would profit when the policyholders died. (2024)
5 13 27
NATIONAL HIV TESTING DAY
Zamora and The Real World cast
These dates represent milestones in the HIV epidemic. Visit
to learn more about the history of HIV and AIDS. BY JENNIFER MORTON
Mel England and Sally Kirkland in 2014
THE LONG HAUL
In a blog post titled “Aging With HIV: Notes From the Long Haul,” former New York state Senator Tom Duane shares the lessons he has learned as a long-term survivor of HIV. Below is an edited excerpt.
ITURNED 71. SOME PEOPLE MAKE A sour face when they nd out I’m an Aquarian, and I really can’t understand why. We’re the most fun, passionate, caring beings, all with a little quirkiness thrown in. What’s not to love?
I’m not sure I ever thought about getting to this age. Youth has a way of keeping those thoughts at bay. My HIV diagnosis was also a big factor when it came to thinking about the future.
As optimistic as I’ve always been, I didn’t plan on becoming a long-term HIV survivor. Nobody did. When I was diagnosed in the ’80s, the phrase “long term” wasn’t even on the table. The future was a dark, vague concept, lled with the very real possibility that I wouldn’t be around to see it.
And yet, here I am. Older. Still positive. Still standing. Just like Elton John! (Well, he doesn’t have HIV, but you know what I mean.)
Surviving HIV long enough to age with it is both a privilege and a strange, unadvertised challenge. Medicine did its part, brilliantly—and continues to, thankfully. Life, as usual, got complicated anyway.
For a long time, the goal was simple: Stay alive. Make it to the next year. Then the next. When e ective antiretroviral therapy arrived, survival shi ed from long-shot miracle to genuine expectation. And now, according to the Centers for Disease Control and Prevention, people
with HIV who are diagnosed early and remain on treatment can expect near-normal life expectancy.
That sentence looks neat on paper. Living it is messier.
Aging with HIV means I carry my history in my body. Years of older medications. Chronic in ammation. Trauma that never made it into my medical chart. Many long-term survivors experience higher rates of cardiovascular disease, bone loss, kidney disease and cognitive changes compared with HIV-negative peers, even when the virus is well controlled. Not to mention the fun stu that comes with aging in general: high blood pressure, liver disease, cancer risks, etcetera.
Turns out, survival has consequences.
A lot of people I started this journey with didn’t make it. I carry those friends with me in my heart. That devastating kind of loss doesn’t politely fade with time. It compounds.
Getting older already thins your social circle. Aging with HIV can hollow it out. Some long-term survivors face isolation due to stigma, fractured families or decades spent in survival mode instead of relationship-building. Studies consistently show higher rates of depression, social isolation and drug and alcohol misuse among older adults living with HIV.
For me, it’s an awkward grief. I’m grateful to be alive and angry about
it in the same breath.
It reminds me of the longstanding rally cry from our community: “All I want is a cure and my friends back.” I rst heard that phrase decades ago, and it hits me with renewed ache today. There are so many people I miss. And why was I among the lucky ones to survive?
Heaven knows, I’ve earned the right to complain about pill organizers, insurance paperwork and doctors who are younger than my diagnosis. I have to laugh at the absurdity of surviving a global crisis (more than one!) only to have arguments with a pharmacy app.
There is no medal for stoicism. There is, however, a beautiful freedom in saying, “This is hard” without apologizing— and a strength in moving forward despite it being hard.
Aging looks like adaptation. Radical acceptance. Advocacy, always. Choosing rest without calling it weakness. Asking better questions. Building community where none existed before.
It looks like surviving long enough to rede ne what survival means.
If you’re aging with HIV, you are not a medical anomaly or a cautionary tale. You are evidence. Of science. Of resilience. Of the deeply human ability to keep going, even when the road map keeps changing.
You weren’t supposed to be here. Me neither. And yet, here we are. Getting older and doing it in style. Q
COGNITIVE CONDITIONS
In a blog post titled “Innovations at the Intersections of HIV and Brain Health,” amfAR, The Foundation for AIDS Research, shared a conversation about possible answers found in scientific advances. Below is an edited excerpt.
PEOPLE WITH HIV ARE LIVING longer than ever before, but longevity brings new questions. One area drawing growing attention is brain health. How does HIV that has been treated long term a˜ect cognitive aging?
To explore this question, Andrea Gramatica, PhD, an immunologist and vice president of research at amfAR, and Kelsey Hopland, PhD, a neuroscientist and new program o°cer of research at amfAR, discuss what scientists understand—and what remains unknown— about HIV and neurodegeneration.
Gramatica: Clinicians who work with people living with HIV have long observed memory di°culties, slower processing speed or problems with attention. The challenge is understanding what’s driving those symptoms. Are they related to HIV itself? Are they part of normal aging? Or could they re˛ect early stages of neurodegenerative disease? Those are di˜erent possibilities, both biologically and clinically.
Hopland: And the complexity is that HIV interacts with the immune system in ways that can persist even when the virus is well controlled by therapy.
Gramatica: Historically, the main neurological condition associated with HIV has been HIV-associated neurocognitive disorder, or HAND. In the early years of the epidemic, before e˜ective treatment was available, severe forms of
cognitive impairment were unfortunately common. Today, thanks to treatment, the severe forms are much rarer. But milder cognitive symptoms still occur.
Hopland: What’s changed now is that the population with HIV is aging. Researchers are asking whether some individuals might also develop more typical neurodegenerative diseases, such as Alzheimer’s. If that’s happening, do those diseases look the same biologically in people with HIV as they do in the general population?
Gramatica: From the immunology perspective, one of the key drivers may be chronic immune activation. Even when antiretroviral therapy suppresses the virus e˜ectively, the immune system can remain in a state of low-level activation. Chronic in˛ammation has been implicated in many age-related diseases, including neurodegenerative conditions.
Hopland: That’s where the neuroscience perspective intersects. In˛ammation is increasingly recognized as an important contributor to diseases like Alzheimer’s. So one hypothesis is that the immune environment created by long-term HIV infection might in˛uence how neurodegenerative processes develop in the brain.
Gramatica: Another possibility involves viral persistence. HIV reservoirs remain in the body even during e˜ective treatment, including in immune cells that exist within and interact with the
brain. Understanding how those reservoirs might in˛uence brain biology over decades is an active area of research.
Hopland: One of the biggest limitations is data. We don’t yet have large, harmonized datasets designed to study HIV and neurodegeneration together. Many existing studies were designed to answer di˜erent questions. That means researchers o˝en work with fragmented datasets collected using di˜erent clinical measures, cognitive tests or biological samples. It’s di°cult to compare.
Gramatica: There are several areas where innovation could make a major di˜erence. One is the creation of longitudinal cohorts—following people with HIV over time to understand how cognitive and biological changes evolve. Another is integrating multiple types of data: clinical assessments, neuroimaging, biomarkers and molecular data. With modern approaches, especially machine learning, we can identify patterns across those complex datasets. But building the infrastructure to support that kind of research requires coordination and collaboration.
Hopland: That’s why there is growing interest in developing a coordinated initiative focused on HIV and neurodegeneration. Organizations like amfAR are well positioned to help bring together the necessary partners across disciplines to explore this kind of e˜ort. Q
AIDSWATCH 2026
Billed as “the largest constituent-driven HIV federal advocacy event in the country,” AIDSWatch has since 1993 annually convened hundreds of HIV advocates, leaders and allies in Washington, DC, to share their stories with members of Congress and advocate for policies and funding to end the HIV epidemic. Organized by AIDS United, the U.S. People Living with HIV Caucus (USPLHIV) and the Center for Health Law and Policy Innovation at Harvard Law School, this year’s event took place from March 16 through 18; the theme was “Defending Progress, Demanding Justice.”
Topics on this year’s agenda included mitigating the impact of federal funding cuts on vulnerable communities and supporting HIV prevention efforts and increased access to pre-exposure prophylaxis (PrEP) to prevent HIV. As usual, AIDSWatch also educated participants on priority issues via workshops. For the first time, two of this year’s workshops were conducted entirely in Spanish. This historic milestone served as evidence that despite the Trump administration’s disdain for diversity, equity and inclusion, the HIV and AIDS community believes unity is a source of strength. Meanwhile across the Potomac River, infectious disease science was the focus of the concurrent SYNChronicity 2026 conference on HIV, HCV, STIs, drug user health and LGBTQ health held at the Renaissance Arlington Capital View Hotel in Virginia.
Reflecting on AIDSWatch, AIDS United president and CEO Carl Baloney Jr. stated: “AIDSWatch 2026 was a powerful demonstration of collective advocacy at a pivotal moment for the HIV movement. Our advocates came to Washington not just to observe but to demand that their voices be heard. They made it unequivocally clear that progress in the fight against HIV does not happen by accident; it requires sustained political will and unwavering commitment to justice.”
1. Real Housewives stars NeNe Leakes, Marysol Patton, Phaedra Parks, Melissa Gorga , Erika Jayne, Luann de Lesseps and Candiace Dillard Bassett joined Tristan Schukraft , CEO of online PrEP provider MISTR, to advocate for expanded access to PrEP. 2. Venita Ray, chair of USPLHIV, accepted an AIDSWatch Lifetime Achievement Award, saying, “I am beyond grateful for being seen, for being shown, for being here.”
3. A robust contingent representing LGBTQ health care provider Callen-Lorde shouted for change.
4. Representative Nancy Pelosi, a longtime HIV advocate, also received a Lifetime Achievement award in recognition of her outspokenness about the AIDS crisis since her first day as a congresswoman in 1987.
5. Yonathan Matheus , who fled his native Venezuela after his advocacy for trans sex workers made him a target of violent criminals, continues to stand up for vulnerable people in the U.S. as CEO of América Diversa.
6. Callen-Lorde’s new chief medical officer, Demetre Daskalakis, MD, MPH, hosted the Let’s TalkPrEP Show, a lighthearted but educational live talk show at SYNC 2026 featuring guests like RuPaul’s Drag Race contestant Mandy Mango, RN,an HIV advocate and nurse from Philadelphia.
7. Advocates from Orlando’s Aguilar Salud met with Representative Darren Soto of Florida. 8. Alecia Tramel-McIntyre, CEO and founder of Positive People Network, responded to Florida Governor DeSantis’s temporary restoration of the state’s AIDS Drug Assistance Program: “We need consistent medication to live and thrive.” 9. HIV and cancer advocate Daniel Garza , director of anal cancer, HIV and HPV advocacy for the cancer nonprofit Cheeky Charity, posed with NMAC CEO Harold Phillips.
& FITNESS
RHUBARB & GINGER CRUMBLE
These sweet and tart flavors make a tasty combination.
RHUBARB AND GINGER ARE MEANT TO GO TOGETHER. The tart rhubarb filling in this dessert is complemented by bites of candied ginger and a sweet, crunchy crumble topping. We tend to go easy on the sugar in our sweets, but since rhubarb is a tart fruit, add as much maple syrup as needed to sweeten the dish to your taste.
SERVINGS: 6 / INGREDIENTS: 10 / PREP: 20 MINUTES
INGREDIENTS
Filling:
1 pound rhubarb, cleaned and cut into 1-inch pieces
¼ cup maple syrup, or to taste
½ cup candied ginger, chopped
DIRECTIONS
1. Preheat the oven to 400°F.
Crumble:
2 cups rolled oats
1⁄3 cup whole wheat pastry flour
Pinch of salt
¼ cup sliced almonds
1 teaspoon ground ginger
¼ cup vegetable oil or melted butter
1⁄3 cup maple syrup
2. In a soufflé or shallow baking dish, make the filling by tossing together the rhubarb, maple syrup and candied ginger.
3. To make the crumble, stir together the oats, flour, salt, almonds and ground ginger in a medium bowl. Stir in maple syrup and oil or melted butter until the oats are completely coated.
4. Pile the crumble on top of the rhubarb. Bake until the crumble is golden and the rhubarb mixture is bubbling up on the sides, about 40 to 50 minutes.
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LACK OF TIME
Common barriers, such as lack of time, may keep you from being physically active. Learn how to overcome obstacles and make physical activity part of your day.
• Monitor your daily activities for a week. Identify at least five 30-minute time slots you could use for physical activity.
• Add physical activity to your daily routine. For example, walk or ride your bike to work or to go shopping, walk the dog or take the stairs instead of the elevator.
• Organize school activities around physical activity.
• Choose activities, such as walking, jogging or stair climbing, that you can do in the time you have available— even if it’s just for a few minutes.
• Use facilities and programs at your workplace if possible.
• Schedule walking meetings when you can.
• During phone calls, try to stand, stretch or move and walk.
Adapted from: Physical Activity Basics, CDC.gov
BY LIZ HIGHLEYMAN
GAY MEN AND HIV
Men who have sex with men make up the majority of people living with HIV in the U.S.
IN 1981, AIDS WAS FIRST IDENTIFIED in a small group of gay men in Los Angeles. Since then, men who have sex with men have borne the brunt of the national epidemic, accounting for a majority of the estimated 1.2 million people living with HIV in the United States. This epidemiological category includes gay, bisexual, same-genderloving and two-spirit men as well as those who have male sex partners but identify as heterosexual or straight.
In 2023, two thirds of the 39,000 people newly diagnosed with HIV were gay and bi men, according to the Centers for Disease Control and Prevention (CDC). This di˜ers from the global picture, as women and girls accounted for just over half of all people living with HIV and 45% of those newly diagnosed with HIV worldwide in 2024.
HIV incidence (new cases) among gay and bi men in the United States has declined in recent years, but the risk varies considerably by race/ethnicity and geography. In 2023, Black men accounted for the largest proportion of new diagnoses among men who have sex with men ages 13 to 24 (47%), but Latino men made up the largest proportion of those older than 24 (40%).
While cities such as New York, Los Angeles and San Francisco were early AIDS epicenters, the epidemic has increasingly shi°ed to the South, now home to half of newly diagnosed men who have sex with men.
Most gay and bi men know about pre-exposure prophylaxis (PrEP), which reduces the risk of HIV acquisition via sex by around 99% if used consistently. Along with using condoms and not sharing drug injection equipment, PrEP is a highly e˜ective tool for preventing HIV. However, PrEP uptake has been substantially lower among Black and Latino men compared with their white peers.
Four PrEP options are approved for cisgender male adults and adolescents who have sex with men: two daily pills, Truvada (tenofovir disoproxil fumarate/ emtricitabine) and Descovy (tenofovir alafenamide/emtricitabine), and two long-acting injectables, Apretude (cabotegravir) and Yeztugo (lenacapavir). Truvada may also be taken “on demand” before and a°er sex. Clinical trials have shown that all these options are safe and e˜ective for this population.
With good care and prompt treatment, people with HIV can live long, healthy lives. Overall, gay and bi men have higher rates of HIV testing, prompt entry into care, use of antiretroviral therapy and viral suppression compared with other groups. In 2023, 84% of men who have sex with men were linked to HIV medical care within one month a°er diagnosis, and 73% achieved an undetectable viral load within six months, according to the CDC. Disparities have decreased in recent years, but Black men and those living in the South are still less likely to receive appropriate care.
HIV testing is important because people who know they are positive can start antiretroviral treatment, which both halts disease progression and prevents HIV transmission because people with an undetectable viral load
do not transmit the virus via sex.
Since gay and bi men had the heaviest burden of HIV during the early years of the epidemic, many are long-term survivors. Nationwide, more than half of people living with HIV are ages 50 or older, and around 15% are ages 65 or older. People aging with HIV face some special challenges, including comorbidities and isolation.
Compared with their HIV-negative peers, HIV-positive people are at greater risk for other health conditions, such as heart, kidney and liver disease. To lower your risk, eat a healthy diet, get enough exercise, curb unhealthy habits, such as smoking or drinking too much, and see your health care providers regularly. It’s important to discuss not only your HIV treatment but also your overall health, sexual health and concerns about aging. Q
BUDGET CUTS THREATEN HIV PREVENTION AND TREATMENT
Cuts to the Ryan White HIV/AIDS Program could mean thousands of additional HIV cases and declining health for people living with the virus. The program provides federal funding for primary care, antiretroviral treatment and support services for low-income people with HIV and is the main source of funds for state AIDS Drug Assistance Programs (ADAPs). Over half of people living with HIV in the United States received Ryan White services in 2024. Budget cuts have already led some states to curtail HIV services and limit eligibility, and advocates fear waiting lists could return. A recent report from the National Association of State and Territorial AIDS Directors indicates that over 20 states have implemented or are considering ADAP cost-containment measures. Most notably, Florida lowered its ADAP income eligibility threshold, eliminated health insurance premium assistance and removed Biktarvy—the most widely used rst-line antiretroviral regimen—from its formulary. The state
legislature allocated $31 million in emergency bridge funding in March, but this is only a partial x.
“Our communities deserve stable, complete access to care, treatment and coverage they need to live healthy lives,” says Carl Baloney Jr., president and CEO of AIDS United.
Over 90% of people who receive HIV medical care through the Ryan White Program have achieved viral suppression, which not only preserves their health but also prevents new infections, as those with an undetectable viral load do not transmit HIV via sex.
In a recent analysis, Melissa Schnure, PhD, of Johns Hopkins University School of Medicine, and colleagues used mathematical modeling to estimate the increase in new HIV infections if Ryan White services are ended permanently or interrupted until the end of the Trump administration.
If Ryan White services were to cease in 2026, the model projected an additional 117,431 new infections over the
next ve years, a 73% increase. Eight states could see new cases more than double. A temporary interruption of 2.5 years would result in 68,264 additional infections, a 43% rise.
“Projected increases in HIV infections due to disruptions of Ryan White services threaten the progress made in curtailing the U.S. HIV epidemic,” the researchers concluded.
Twice-Yearly HIV Treatment on the Horizon
Three experimental antiretrovirals could be come components of future long-acting HIV treatment regimens, according to research presented at the Conference on Retroviruses and Opportunistic Infections.
ViiV Healthcare’s VH-499 could be the second approved HIV capsid inhibitor a er lenacapavir. ViiV’s VH-184 is a novel integrase inhibitor with a high barrier to resistance, while GS-3242 is a next-generation integrase inhibitor from Gilead Sciences. Oral versions of all three drugs demonstrated potent antiviral activity and good safety pro les in early small studies, setting the stage for the rst trials of long-acting injectable formulations.
In a Phase I study of injectable VH-499, 65 HIV-negative adults were randomly assigned to receive a single subcutaneous injection in the abdomen or intramuscular injection in the buttocks using various doses or a placebo. Nearly 90% had at least one injection site reaction (ISR), but these were mostly mild and temporary. People who received subcutaneous injections reported more ISRs, including nodules, than those who got intramuscular shots. The pharmacokinetic pro le supports twice-yearly dosing.
The VH-184 Phase I study enrolled 76 HIV-negative adults. They received a single sub cutaneous or intramuscular injection of various doses of two formulations of VH-184 or a placebo. Again, most participants had at least one ISR, usually mild and brief. Formulation B was both better tolerated and lasted longer than Formulation A, and it is expected to maintain an e ective drug concentration if given every four to six months.
A Phase I study of injectable GS-3242 enrolled 34 HIV-negative adults. They received various doses or a placebo administered as a single intramuscular injection in the thigh. Nearly 90% of those who received the highest dose experienced ISRs. The half-life ranged from 50 to 76 days, supporting a dosing interval of at least four months; additional cohorts are evaluating a six-month interval.
Phase II clinical trials of these pipeline drugs are expected to start this year. Ultimately, VH-499 and VH-184 could be combined with experimental ultra-long-acting formulations of cabotegravir or ViiV’s broadly neutralizing antibody lotivibart in a twice-yearly regimen. GS-3242 could be partnered with lenacapavir or Gilead’s investigational antibodies teropavimab and zinlirvimab.
WEIGHT-LOSS MEDS BOOST LIVER, HEART AND GUT HEALTH
Popular GLP-1 weight-loss medications work well for people living with HIV, and they may have multiple beneÿts beyond obesity and diabetes, according to studies presented at this year’s Conference on Retroviruses and Opportunistic Infections. The meeting even included a plenary talk titled “GLP-1 Agonists: Are They a Cure for Everything?”
Weight gain and metabolic abnormalities are a growing concern for people with HIV as they age. Glucagon-like peptide-1 (GLP-1) receptor agonists, including semaglutide (Ozempic or Wegovy), mimic a natural hormone that suppresses appetite. Tirzepatide (Mounjaro or Zepbound) targets both GLP-1 and another gut hormone called GIP.
One study assessed the link between semaglutide and liver ÿbrosis. Based on a study of HIV-negative people, Wegovy was approved last year to treat metabolic dysfunction-associated steatohepatitis, or fatty liver disease. Over time, the buildup of fat in the liver can lead to ÿbrosis, cirrhosis and liver cancer. In this analysis of 1,850 people with HIV, semaglutide was associated with reduced ÿbrosis scores, with the greatest improvement seen in those with the worst ÿbrosis at baseline.
Another study looked at cardiovascular health in a randomized trial of semaglutide that enrolled 108 HIVpositive people with lipohypertrophy, or abdominal fat accumulation. Although the researchers saw “no discernible e˝ects” on markers of subclinical vascular disease, they did observe improvements in overall cardiometabolic health and cardiovascular disease risk.
A third small study showed that the older GLP-1 agonist liraglutide (Victoza or Saxenda) led to decreases in various blood biomarkers of in˙ammation and favorable changes in gut tissue. Finally, a fourth study found that HIV-positive people who used semaglutide reduced their cigarette smoking by 26%.
Yet much remains to be learned about long-term use of GLP-1 agonists and related drugs among people with HIV, and they will only be a game changer if they are accessible and a˝ordable worldwide.
“With the exception of antiretroviral therapy, I can’t think of another class of medications where there has been so much buzz,” said Todd Brown, MD, PhD, of Johns Hopkins Medicine, during his plenary talk. “This class of medications has really transformed the way that we treat multiple diseases, and we really are just at the beginning of this transformation.”
New Insights on Transgender Women and HIV
A new analysis adds to the evidence that transgender women in the United States have higher HIV rates than the general population. The nationwide cohort study revealed racial disparities in HIV diagnoses and identiÿed health inequities that put trans women at risk.
In 2019, the Centers for Disease Control and Prevention reported that 2% of new HIV diagnoses were among transgender people. Of the 671 trans people diagnosed that year, 625 were trans women; nearly half were Black and a third were Latina. But more recent data are limited, and research has been curtailed.
Sari Reisner, ScD, of the University of Michigan Ann Arbor, and colleagues looked at HIV rates among trans women in the United States and Puerto Rico. They enrolled 2,504 participants between March 2023 and December 2024 and followed them for two years. HIV status was determined at baseline and rechecked semiannually.
Nearly one in ÿve were ages 18 to 24. Most (78%) were white, 12% were Black, 5% were Asian and 16% were Latina. A third reported living in poverty, 10% reported sex work, 9% reported recently being unhoused and nearly half relied on public insurance, such as Medicaid, or were uninsured; 16% were considered eligible for preexposure prophylaxis (PrEP), and 18% had used PrEP in the past six months, mostly daily pills.
In total, 39 trans women were diagnosed with HIV, including 25 who tested positive for the ÿrst time at the start of the study and 14 who acquired HIV during follow-up. The overall incidence rate was 3.95 cases per 1,000 person-years, but Black trans women had a 7.4-fold higher risk than white women. HIV incidence was shaped by structural vulnerabilities, including poverty, unstable housing, sex work and lack of insurance.
Targeted services for gender-diverse people have helped close such gaps, but recent political shi°s put this progress in jeopardy. The Trump administration’s focus on eliminating so-called gender ideology has led to changes in how trans people are counted, removal of data by federal health agencies and cuts to research and services for this population.
“Trans women need tailored interventions that are gendera˛rming, that are safe, particularly in the current moment in time,” and “continued genderinclusive research is vital,” says Reisner.
BY
Longer-Acting PrEP PREVENTION
A once-yearly injectable and a once-monthly pill—both now in late-stage trials— could be game changers for HIV prevention. Twice-yearly lenacapavir (Yeztugo) PrEP administered every six months was highly e˛ective in two large trials, but longerlasting versions might o˛er protection for a full year. Using a population pharmacokinetic model to guide dose selection, researchers at Gilead Sciences projected that a 3,000 mg dose of an intramuscular formulation would yield a 52-week trough concentration exceeding the 26-week trough level of the approved twice-yearly subcutaneous formulation. Once-yearly Ienacapavir PrEP is now being tested in the Phase III PURPOSE 365 trial. Similarly, Merck researchers used pharmacokinetic modeling to select a dose for MK-8527, its nucleoside reverse transcriptase translocation inhibitor PrEP candidate. An 11 mg oral dose reached a protective concentration within one hour, provided coverage for a month and had a seven-day dosing window. The Phase III EXPrESSIVE-10 and EXPrESSIVE-11 trials are now recruiting participants.
TREATMENT
Treatment for Teens
Cabenuva (injectable cabotegravir plus rilpivirine)— the longest-acting complete antiretroviral regimen—can be a good HIV treatment option for teens, who o˜en struggle with adherence. The Phase I/II MOCHA trial enrolled 144 adolescents ages 12 to 17 in the United States and four other countries. The median age was 15 years, and most acquired HIV via mother-to-child transmission. At study entry, they were on standard daily oral antiretroviral therapy with an undetectable viral load. They switched to cabotegravir and rilpivirine pills for four weeks before starting injections every other month. Most participants (94%) maintained viral suppression at 96 weeks. Eleven teens had at least one viral blip, but none had conÿrmed virological failure. A pharmacokinetic analysis showed that cabotegravir and rilpivirine levels were comparable to those seen in adults. Cabenuva was safe and generally well tolerated; the most common side e˛ect was mild to moderate injection site reactions. Almost all study participants said they preferred the long-acting injections over daily pills.
CURE
Immunotherapy
A pair of immune-modulating drugs may delay—but not prevent—viral rebound a˜er stopping antiretroviral treatment. Researchers are exploring many approaches to keep HIV in remission, known as a functional cure. One is anti-PD-1 immune checkpoint inhibitors, which are widely used for cancer immunotherapy and might also reinvigorate exhausted T cells to ÿght HIV. A Phase II trial tested the PD-1 checkpoint inhibitor budigalimab plus trosunilimab, an antibody that binds to a di˛erent receptor. The study enrolled 142 adults on antiretroviral therapy with an undetectable viral load; they stopped their antiretrovirals at the start of the trial. At 24 weeks, 24% of people assigned to budigalimab plus low-dose trosunilimab maintained a viral load below 1,000 versus 5% in the placebo group. Viral control decreased with further follow-up, however, and the median peak viral load and the time to viral rebound did not di˛er signiÿcantly between the active treatment and placebo groups. What’s more, side e˛ects were common and sometimes serious, casting doubt on this approach.
CONCERNS
Oral Cancer
Oropharyngeal cancer, a˛ecting the back of the mouth and the throat, has been rising in people with and without HIV in recent decades. It is o˜en caused by human papillomavirus (HPV), a common sexually transmitted infection. A recent analysis looked at incidence and risk factors among 135,359 HIV-positive people in North America. A total of 254 were diagnosed with oropharyngeal cancer between 2000 and 2021, with the incidence rate more than tripling over time. People ages 50 to 59 had the highest incidence rate, while incidence was negligible among those under 40. Men were about three times more likely to be diagnosed than women, and heterosexual men had a higher incidence than gay and bisexual men. People with oral cancer had a lower nadir (lowest-ever) CD4 T-cell count and were more likely to smoke, drink heavily and inject drugs. Given their age, most participants were ineligible when the HPV vaccine was ÿrst recommended for adolescents and young adults; future studies will show whether oral cancer declines in younger cohorts with higher vaccination rates.
Andrew Spieldenner is executive director of MPact.
JIMMY GALT
AS THE GLOBAL POLITICAL CLIMATE HEATS UP, MPACT COMMEMORATES ITS 20TH ANNIVERSARY BY SPICING UP ITS HUMAN RIGHTS ADVOCACY.
BY TIM MURPHY
THE DAY BEFORE WORLD AIDS DAY 2025, SOMETHING SEXY and powerful happened the Tijuana si the United States–Mexico border, which has become highly restricted the U.S. side amid the Trump administration’s crackdown on immigrants.
Abou tw doze ga me livin wit HIV bot Mexica an American cam togethe wearin T-shirt declarin “Sidoso”—Mexica slan fo “AIDS-y. Th ter i usuall use pejorativel bu i increasingl bein reclaime b HIV-positiv Mexican a ter o pride signalin openness abou one’ status An then a phon camera recorded them th me kisse on another no littl peck o the chee b u l ong w et s lopp k isses.
Th event th thi annua Worl AID Da Besoton Sidos (“AIDS- Kiss-In”) wa organize b th Mexican group iviendo ositivo “Living ositively”) nd Pact Global a internationa grou supportin ga an bisexual men’ healt an huma right tha mark it 20t anniversar thi year Th kiss-i wa on o severa global event an campaign tha MPac funds help organiz or otherwis support t disseminat sex-positiv messages
and promote resources for men who have sex with men (MSM) around the world.
MPact is doing this even as many countries crack down harder on sexual minorities, such as gay men. That’s partly because, since the Trump administration has largely turned its back on global aid—especially to stigmatized communities—many nations no longer feel as though the United States, with its allimportant purse strings, is frowning on them for anti-LGBTQ displays.
A new logo marks the group’s 20th anniversary.
World Health Organization (WHO). Early on, the group, which changed its name to MPact in 2018, decided to fund gay and bi male grassroots groups in various countries.
In such an atmosphere, MPact is more determined than ever to help communities of gay men push back on criminalization and stigma with a message of pride and an agenda of grassroots, for-us-by-us organizing that’s not reliant on governments.
That’s where the kiss-ins come in. The 2024 event, in Guadalajara, and the first one, in Mexico City in 2023, drew about 70 men, according to Andrew Spieldenner, PhD, a 54-year-old HIV-positive communications professor at California State University, San Marcos, who has been MPact’s executive director since 2021. Last year’s kiss-in was held in Tijuana, he says, “to highlight queer migrants and the people being trapped by the wall” at the border, for which the Trump administration has turbocharged further construction.
“I cried at the Guadalajara kiss-in,” Spieldenner says. “People made a point of talking to the media—people who aren’t used to holding that space, standing up and saying, ‘I deserve to be here.’”
And did he partake of the smooching? “Of course,” he says. “I kissed five guys!”
MPACT WAS FOUNDED IN 2006 BY A GROUP OF GAY
and bi male activists who felt that the first full decade of the global HIV response, then being powered by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), which was launched in 2003 to treat and prevent HIV worldwide, was overlooking MSM, who made up a disproportionate number of people worldwide living with or at risk for the virus.
“If you looked at the countries that had national HIV plans by that point, none of them were prioritizing gay and bi men,” says Spieldenner, adding that such plans were also not addressing other marginalized high-risk groups, including injection-drug users, sex workers and transgender women.
Spieldenner notes that many such countries would rather acknowledge drug users before recognizing gay and bi men. Or, he says, countries would minimize the scope of the epidemic among gay and bi men. “In 2010, Kenya reported that they’d reached every gay man with an HIV test—because they’d reached 200 gay men.”
MPact began as the Global Forum on MSM and HIV, advocating for that population in front of UNAIDS, the U.S. Agency for International Development (USAID) and the
George Ayala, PsyD, MPact’s first executive director—a New York City native who’d worked for groups including the Hispanic AIDS Forum—was friends with Robert Carr, a respected gay Trinidadian/Jamaican activist, in whose name a fund made up of government and foundation money was started for this purpose. Carr died in 2011, before the fund was actually launched. At that point, says Spieldenner, “MPact becomes the center of a lot of regional networks, an incubator of sorts.” Traditionally, he says, MPact—with funding from groups like the Carr Fund, the Dutch Aidsfonds and the Elton John AIDS Foundation as well as pharmaceutical money—has given out at least $1 million annually. A few years ago, he says, the group disbursed $2 million.
Once the more LGBTQ-friendly Obama administration took office, global advocates such as MPact were able to get PEPFAR to incorporate pre-exposure prophylaxis (PrEP, an HIV prevention regimen first approved in the United States in 2012) into its portfolio and the WHO to promote PrEP. MPact awarded grants that helped fund activities and initiatives in several countries to promote PrEP among gay and bi networks.
The Trump administration has since restricted PrEP for everyone in PEPFAR recipient countries, except for pregnant or breastfeeding women. Spieldenner says MPact and other groups are trying to carve out exceptions to that edict where they can, country by country.
MPact also supported groups in various countries to harvest and publish their own research because, says Spieldenner, “the core of MPact is about community ownership of our own data, advocacy and services.”
These days, as several countries, including Senegal, Uganda and Kenya, step up persecution and criminalization of LGBTQ people while the Trump administration turns a blind eye, MPact’s recipient groups have their work cut out for them. Last year, when the Trump administration all but decimated USAID, whose functions meshed with PEPFAR’s, it meant the elimination in several countries of special clinics where LGBTQ people and other marginalized groups could seek care and avoid the negative treatment they faced at basic government clinics.
Now, says Spieldenner, people have no choice but to go to the basic clinics.
SPIELDENNER, WHO PREVIOUSLY WAS THE VOLUNteer chair of the U.S. People Living With HIV Caucus, succeeded Ayala as MPact’s head in 2021, after an open call for the job. “I think they picked me because I’m openly living with HIV, because I had the researcher chops and because I
was already a visible advocate who’s worked with UNAIDS and had connections,” he says.
He leads Mpact along with senior director for strategic initiatives and communications Alex Garner, administrator and contracts coordinator Tony Nguyen, Mexico City–based community mobilization manager Axel Bautista and communications/social media associate Jesús Suárez.
Spieldenner says that since he’s taken the helm, MPact has beefed up its social media presence, because “I want us to be just three clicks away from anyone in the world who wants to do organizing.” The group’s online followers have ballooned from 1,200 to 25,000 and its digital engagement points from a few hundred thousand to a million.
The group has also worked to make all its online imagery more sex positive, organizing fun photo shoots in locales worldwide with a broad variety of real-life gay and bi men posing shirtless and/or embracing or making out with one another. “We’ve done shots with throuples, trans men, different generations, different body types,” he says. “We’re showing sexy, fun and different kinds of intimacy.”
Thanks to this expanded online presence, MPact now gets direct messages on social media from gay men worldwide up to six times a week. “If it’s HIV stuff, we connect them to support in their own country, and if it’s a cry for help because they’re being persecuted, we connect them to LGBTQ asylum groups, like Rainbow Railroad.”
With a current budget of $2 million from sources including the Carr Fund; the Global Fund to Fight AIDS, Tuberculosis and Malaria; UNAIDS; and HIV pharma companies Gilead Sciences and ViiV Healthcare, MPact in recent years has funded 21 groups in Latin America and the Caribbean to address LGBTQ rights emergencies, including natural disasters, such as hurricanes, which can leave queer people without safe shelter.
In Argentina, for example, MPact is funding groups that provide migrant LGBTQ populations with mental health services to address the trauma of displacement and isolation as well as core medical services. According to Spieldenner, when a group of 120 gay and trans migrants arrived in Argentina, medical intakes revealed that half of them had a sexually transmitted infection they hadn’t previously known about. Groups in that country also use MPact money to hire interpreters for the large number of Russian LGBTQ migrants and other newcomers. Under Putin, Russia has cracked down on queer people and organizing.
Spieldenner is a long-term survivor and an advocate.
MPact also helps groups in various countries relocate queer people after they’ve been harassed by police, the media and the community. Recently, says Spieldenner, MPact helped a wellknown, heavily persecuted gay activist from a West African country, whose name and home country Spieldenner withheld for safety reasons, get to Canada by helping to secure him an invitation to speak at an event in Toronto. He’d been in hiding in his home country ever since his apartment was vandalized after he’d done an HIV prevention workshop. A note left behind by the vandals threatened that he’d soon be murdered.
“I felt a tremendous surge of feeling once we were able to safely get him out,” says Spieldenner.
MPACT’S EFFORTS
TO
BECOME
MORE digitally known, easily reached and just plain sexy have not escaped notice. “MPact under Andy’s leadership has become more visibly sex positive, with a bolder message for an era where backlash to gay men’s inclusion has been so intense,” says Laurel Sprague, a longtime advocate living with HIV and the research director of the UCLA School of Law’s the Williams Institute, a sexual orientation and gender identity research center.
She says that MPact’s booths at conferences “have sex-positive videos that focus on pleasure, well-being and sexual health rather than on science, and I think in this moment, it’s helpful to have this centering of the lived experience of gay men, especially those living with HIV, and their right to have a full, happy, healthy life.”
Sprague describes the support MPact gives to “national and local networks of gay men in countries that often are quite hostile to gay men and use HIV as a cudgel to harm them even further” as invaluable.
Acep Saepudin, a gay influencer living with HIV in Indonesia, where homosexuality is highly frowned upon, albeit not outright illegal, was invited by MPact to join its social media team at the 2022 International AIDS Conference (IAC) in Montreal. That same year, MPact engaged him in what he says was his first photo shoot, in Bangkok, alongside local models.
“MPact has always helped me feel confident about myself, including my body,” he tells POZ. In 2024, at the IAC in Munich, Saepudin was involved in MPact’s spicy Outlaws Wanted event, which featured Latin American OnlyFans porn stars Pablo Bravo and Danny Azcona and gay Mexican singer Christian Chávez. Saepudin will be involved in MPact projects again this July at the IAC in Rio de Janeiro.
Saepudin says that, overall, working with MPact “has given me a safe and meaningful space to continue creating” social media content that in his home country educates about HIV and advocates for the rights of queer people living with or at risk for the virus.
He needs the moral support too. “Speaking about these topics in Indonesia is extremely challenging. My Instagram account has been banned seven times due to mass reporting [of the content] by local users,” because, he says, “it’s perceived as a threat to morality and social order.”
“WE’RE SHOWING SEXY, FUN AND DIFFERENT KINDS OF INTIMACY.”
—ANDREW SPIELDENNER
Stills from MPact’s “Right To” campaign
In São Paolo, Alberto Pereira da Silva, a television personality who has done performance art related to his being gay and HIV positive, worked with MPact in 2024 to convene a group of Brazilians living with the virus. He’s also been working with the group to create social content on HIV topics, including taking oral versus injectable medication. He says that MPact’s support for HIV efforts in Brazil—where both treatment and PrEP are universally free, even if stigma sometimes holds people back from accessing them— has been crucial.
“Most HIV campaigns in Brazil talk only about the meds and the science but don’t focus on pleasure,” da Silva says. “MPact promotes being proud of being queer and the idea that you can be both sexual and safe.”
That’s just what Spieldenner wants to hear about how he and his team have repackaged MPact in recent years, especially as the group plans events to celebrate its 20th anniversary at the IAC in Rio, including an awards ceremony and a special meetup for Black Brazilians living with HIV.
Yes, he acknowledges, MPact and groups like it are doing their work in a far more hostile atmosphere, both in the United States and many other countries, than perhaps they were just a few years ago. “We see how fragile these systems [of support for LGBTQ and/or HIV-positive people] are and how easily they can be taken away,” he says. “Which is why it’s important for organizations like MPact to step forward, because people need to see, hear and know that we’re still advocating.”
But, he adds, don’t forget the joy. “I love our community. And as a queer person living with HIV, I believe that we deserve the best, we deserve connection and we deserve sex.” Q
TWO LONG-TERM SURVIVORS OF HIV HAVE TRANSFORMED THEIR POLITICAL FRUSTRATION INTO A NATIONWIDE CALL TO ACTION.
BY MARK S. KING
CLEVE JONES HAD HAD ENOUGH.
After watching the tumultuous first year of the second Trump administration with incredulity and disgust, the long-term survivor of HIV and iconic AIDS figure was dumbstruck when, in late 2025, the administration announced that it would not observe World AIDS Day, marked each December 1. It was the first time the event was ignored by any White House since the first annual commemoration in 1988.
“We were just beginning to understand how many hundreds of thousands of people were going to die due to the cuts to USAID,” says Jones, referring to the U.S. Agency for International Development, a global humanitarian program that included foreign aid to treat and prevent HIV. “And then World AIDS Day is coming, and we get this petty, stupid response from the White House. It really got under my skin. It didn’t inflict the sort of quantifiable damage that budget cuts are doing to our world and our country, but it just underscored the cruelty of this administration.”
The World AIDS Day insult was particularly stunning to Jones, who has devoted his life to raising public awareness of the plight of those living with HIV and the high death toll of the pandemic. In 1985, he was already thinking about how to honor those lost to AIDS when he conceived the AIDS Memorial Quilt during a candlelight vigil in San Francisco honoring his slain mentor Harvey Milk. The AIDS Quilt, as it became known, would go on to literally cover the National Mall at an event in Washington, DC, and to be regularly displayed across the country.
Channeling his fury, Jones did what he has always done: He started to organize. And soon, a big idea emerged.
The first person Jones called was his friend Sean Strub, a fellow long-term survivor and activist and the founder of POZ magazine.
“I had been wrestling with what to do,” Strub says. “You can only sign so many checks or show up for rallies. I felt like we needed something big that could transcend party lines. This can’t be simply a ‘Trump is awful’ message but more of a constructive vision.”
Strub had been feeling a shared sense of frustration over how to meaningfully respond to the continued damage inflicted on public health programs—not to mention the dismantling of the legacy of progress that he and Jones, along with so many other advocates, had created for future generations.
“I’m always happy to hear from Cleve,” Strub explains. “The World AIDS Day thing was like, How much worse can they get? There are budget cuts we haven’t even begun to feel the impact of, and this was before ADAP [AIDS Drug Assistance Program] funding in Florida was cut [see page 16 for more]. This is existential. We want everyone to be healthy, not to disadvantage segments of society. Everyone should agree on that.”
A certain grim milestone also loomed ahead on the calendar. Looking toward it, a plan took shape. The first report about what would become known as AIDS was published 45 years ago, on June 5, 1981. In the report, which ran in the Morbidity and Mortality Weekly Report (MMWR), a Centers for Disease Control and Prevention periodical, lead author Michael Gottlieb, MD, detailed strange symptoms, including crashing immune systems, among five young gay male patients. The date is widely viewed as the official start of the AIDS pandemic.
“I read that MMWR report,” Jones remembers. “Within five years, everyone I knew was dead or dying. Those of us who lived through that era have a responsibility to step up. I’m old, and I’m tired, but I’m going to fight like hell to make sure the same mistakes are not repeated. The failures killed the people I loved the most. I’m still angry about it.”
“An estimated 45 million people will have died in the 45 years we have dealt with HIV and AIDS,” Jones adds.
Jones and Strub knew that June 2026 would be significant in another critical way. It’s the month during which the most primary elections will be held for the upcoming 2026 midterms. One way to make a tangible difference this election cycle, the pair realized, would be to motivate voters to focus on their pocketbooks and their access to health care and medications.
Jones and Strub immediately began work on a document—at once a manifesto and a sign-on vehicle for others to join the effort. They reached out. They made more calls. No one said no. They got feedback on their document from diverse perspectives.
The result is Seven Days in June: Health Is Primary, a decentralized, grassroots campaign laser-focused on the issues of
From top: Cleve Jones, Sean Strub, Cecilia Chung, Tyler TerMeer
affordability and health care, dual issues that have galvanized special elections during the last year and served as linchpins for successful campaigns across the political spectrum. (See the “Seven Days in June” sidebar on page 30 to read the document in full.)
Among the list of ideas the document includes—such as demanding clear commitments from candidates and participation in town halls, demonstrations and social media campaigns from June 1 to 7—is a request for people to gather at sunset on Friday, June 5, for a candlelight vigil “to honor those already lost and the millions more who will certainly die if funding is not restored.”
In strategizing with others, including civil rights leader Nadine Smith of Color Of Change and Cecilia Chung of the Transgender Law Center, Jones and Strub understood early on that the campaign should be broad-based, weaving in health and affordability concerns that personally impact a wide swath of the electorate.
“Both Cecilia and Nadine emphasized that Health Is Primary couldn’t just be about HIV, even with cuts to PEPFAR [the President’s Emergency Plan for AIDS Relief] and USAID,” says Jones. “With recent advances with treatment as prevention [also called Undetectable Equals Untransmittable, or U=U], we were on the brink of victory. Instead, we are on the precipice of another wave of illness and death. So it’s about HIV, but this situation illustrates a much larger problem nationally and globally.”
“When we consider 45 million deaths,” Chung adds, “we cannot forget how the United States has stopped providing global resources, like USAID. What we are fighting for is not just the survival of the community in the United States but also globally. We have that responsibility. This campaign is perfect timing for a new call for action that includes global aid, research and treatment options for everyone.”
The advocacy effort has grown legs quickly. “Health Is Primary is becoming something enormous,” Strub observes, “with no single organization behind it, totally decentralized, with no money being raised for it. Just good old-fashioned organizing, getting broad input into the document and
“THIS IS EXISTENTIAL. WE WANT EVERYONE TO BE HEALTHY, NOT TO DISADVANTAGE SEGMENTS OF SOCIETY.”
—SEAN STRUB
working our networks and our networks’ networks. I’m more exhilarated than I have been in a long time.”
Though cooked up by two long-term survivors of HIV, the broadness of the campaign is essential to its success, both Jones and Strub emphasize. “When the major deep cuts to Medicaid kick in after the elections this fall,” Strub warns, “local communities and health care systems will be devastated.”
Passed by Congress last year, Trump’s “Big Beautiful Bill,” which masks ugly budget realities, intentionally delayed cuts to Medicaid and other social safety net programs until after the midterms this year. The cynical political strategy hasn’t been overlooked by Jones and Strub.
“I’ve spoken to people on the San Francisco Board of Supervisors who simply don’t know what kind of money they will have to work with,” Jones says, listing the many ways the cuts will affect average Americans. “Yes, HIV and AIDS programs will be affected. And Black mothers are more likely to die in childbirth, 17 veterans commit suicide every day, Veteran Administration (VA) hospitals are being defunded, clinics are closing, whooping cough is rising, childhood cancer research is slowing and women in this country often have to drive hundreds of miles to see an obstetrician. Not to mention health insurance premiums are going up.”
“I’M OLD, AND I’M TIRED, BUT I’M GOING TO FIGHT LIKE HELL TO MAKE SURE THE SAME MISTAKES ARE NOT REPEATED.”
—CLEVE JONES
One aspect of Health Is Primary that particularly excites Jones is the involvement of organized labor, another cause to which Jones has devoted much of his life. He believes passionately that unions are essential to the conversation about health care and affordability.
“My connection with unions goes back to Harvey Milk, who created the first significant alliance with labor unions and the LGBTQ community through the Coors beer boycott of the 1970s,” Jones explains. “I have a half-century history of working with labor, and for the past 20 years, I have been on the staff of UNITE HERE, representing workers in the United States and Canada with affiliates around North America.”
“The American middle class exists because of the labor movement lifting
Seven Days in June
A NATIONAL CALL TO ELEVATE HEALTH AS A GOVERNING PRIORITY
The health of Americans is on the ballot in 2026. Medical research, a˜ordable access to health care and treatment and strong public health systems are fundamental to our quality of life, economic stability, workforce strength and national security. Health is not a niche issue. It touches every person, family, employer, community and local economy. When health systems are underfunded or destabilized, people suffer, families are driven into bankruptcy, communities lose services and the nation becomes less prepared for the next crisis. Gutting global health infrastructure exacerbates political instability and threatens U.S. security interests. This weakens our nation’s global influence and does nothing to reduce the federal deficit.
Budget cuts to Medicaid, the Centers for Disease Control
When UNITE HERE political director Susan Valentine reached out to Jones to say she wanted to help, it became the first union to sign on to Health Is Primary. And then it was as if a dam burst. Other unions began immediate talks to join, including the Service Employees International Union (SEIU), the largest in the country, and National Nurses United. The organizational bandwidth of these unions will help ensure the exposure and success of Health Is Primary.
“We want this to be broad enough and local enough that an American Legion Hall is comfortable hosting a town hall on what is happening at the VA,” Strub says.
“We need to find out how these policies will impact service providers and agencies, hospitals, prisons, the Indian health agencies, all across the board. We were intentional about not calling for a national march on Washington. We want attention on the local level, where these cuts will be
By the Seven Days in June Campaign
and Prevention and the National Institutes of Health are threats to the health of all Americans. Many cuts passed by Congress last year will not go into e˜ect until a°er this fall’s election, when they will cause severe local economic damage, the loss of over a million jobs, billions in reduced tax revenues and lost state GDP.
Seven Days in June: Health Is Primary is a decentralized, grassroots-driven campaign to focus local media attention on how funding cuts, as well as policy and regulatory changes, will devastate local communities. From June 1 to 7, thousands of local organizations and activists will demand candidates for federal and local office in 2026 to clearly articulate how they will:
• Improve a˜ordability and access to care and treatment;
• Sustain and strengthen biomedical research;
• Protect and modernize domestic and global public health infrastructure;
• Provide stability for seniors, veterans, rural communities, people with disabilities, working families and others reliant on accessible, a˜ordable health care.
Local groups and advocates will organize town halls, panel discussions, candidate forums, demonstrations, marches, rallies, vigils, interfaith services, social media campaigns and other tactics as appropriate for their organizations and communities.
Our goal is to establish a civic expectation that health must be treated as a core governing responsibility, regardless of ideology or party. Working together, we can build a healthier nation.
WHY THIS MOMENT MATTERS
Across the country, chronic diseases are a˜ecting more Americans and account for the majority of U.S. health spending. Preventable conditions are too o°en detected late, compounding
felt and where the organizing must take place to influence the November election.”
At press time, organizations that had joined the Health Is Primary effort include NMAC and the San Francisco AIDS Foundation (SFAF), whose executive director, Tyler TerMeer, PhD, has some experience wrangling with the current administration.
“I keep coming back to this thought that help should never be up for debate,” TerMeer says. “SFAF received letters from the government saying that because we were providing services to trans folks and grounded in diversity, equity and inclusion, that we needed to stop that and wash that language from our website.” So SFAF filed a lawsuit against the Trump administration that is ongoing. “We filed our suit because our values weren’t up for sale and our mission wasn’t up for negotiation. That’s what’s resonating with me now.”
“When Cleve came to me,” TerMeer continues, “it felt like it was coming from the same place as in the early days of the movement, the same urgency, the same moral clarity, the refusal to accept that preventable suffering is OK.”
“The HIV movement has taught us so much about values,” TerMeer adds. “We have to fight for each other, and we have to show up for each other. We don’t have to accept a system designed to treat people as disposable. Health Is Primary is about asking the country to remember that.”
“The question isn’t whether we know how to save lives,” TerMeer says. “The question is if we have the courage to do it.” Q
Go to SevenDaysInJune.org for more information.
costs and su˜ering. Preventable disease outbreaks have reemerged as vaccination rates have declined.
Strained public health workforces and disease surveillance systems are already near a breaking point. Reductions in biomedical research funding slow innovation and threaten future advances in prevention and treatment. Community hospitals and safety-net providers face mounting ÿnancial pressure.
Chaotic and inconsistent health investment carries real consequences. Short-term politics should not undermine long-term health security.
Sponsors of this initiative include:
• Organizations, leaders and advocates focused on heart
JUNE 1-7
disease, cancer, diabetes, HIV and AIDS and other chronic or life-threatening conditions;
• Human rights and civil rights leaders;
• Public health o˛cials, health care workers and medical professionals;
• Biomedical research institutions, academics and scientists;
• Labor and workforce leaders;
• Faith communities and faithbased service providers;
• Senior, veteran and disability advocates and organizations;
• Hospital and health system leaders;
• Business and civic organizations. Health is not ideological. Health is primary.
HERE’S WHAT YOU CAN DO:
• Endorse the Seven Days in June: Health Is Primary campaign;
• Organize or cosponsor town hall meetings with health department o˛cials, agency heads, service providers and
elected o˛cials to examine the impact of health cuts on your local communities;
• Demand clear and speciÿc commitments from those running for o˛ce to protect and strengthen America’s health systems through candidate forums, questionnaires and published scorecards;
• Participate in rallies, demonstrations, AIDS Memorial Quilt displays, social media campaigns as appro priate for your organizations and communities;
• Celebrate your local health care heroes, the hard-working people whose skill and compassion are the backbone of America’s health care system;
• Reaffirm the centrality of compassion, empathy and service as core values of every faith tradition through interfaith solidarity;
• Gather at sunset on Friday, June 5, for a candlelight vigil to honor those already lost and the millions more who will certainly die if funding is not restored.
HEROES
Longevity in the Fight
A˜er taking some critical time away from ÿghting HIV, Marco Benjamin last year became the director of public health at the Joseph H. Neal Health Collaborative in Columbia, South Carolina.
A˜er living with HIV for 20 years, much of that time as an AIDS activist, Benjamin was at a crossroads. Decades of HIV activism had le˜ him feeling burned out.
“I kind of thought I retired from HIV, so I spent some time on the beach in Puerto Rico,” says Benjamin, whose island roots run deep. “Then the Neal family called and explained it was time for me to come back to activism. They needed my help to run the organization as it needed to be done.”
Joseph H. Neal was a legendary South Carolina state lawmaker who died in 2017. He spearheaded the removal of the Confederate ˛ag from the statehouse. He also had a decades-long track record ÿghting HIV. In 1993, he sponsored the bill to make HIV testing private and conÿdential in South Carolina. “A˜er his death, the family opened up a nonproÿt in his name, primarily to address HIV and rural health,” Benjamin says.
According to Benjamin, roughly 20,000 South Carolina residents are living with HIV, including 5,000 who are not in care. So what’s it like in a state that didn’t expand Medicaid and doesn’t fund HIV prevention tools like condoms or needle exchange?
“We are in a twilight zone here,” says Benjamin, a New York native, referring to South Carolina’s conservative leanings. “Some would say if you can’t beat them, you join them, right? So we made MAGA-style red caps. The hat doesn’t say, ‘Make America Great Again.’ It says, ‘Make Sex Safe Again.’”
Benjamin also uses South Carolina’s high diabetes rates as a point of entry for his health advocacy.
“We’re not leading with HIV; we’re leading with diabetes or hepatitis C,” Benjamin explains. “And while you’re here to test your blood sugar, can I test you for HIV as well? In the past few months, we’ve identiÿed about 20 people with hepatitis C and got them on treatment.”
Benjamin notes a growing cohort of heterosexual patients engaging in their sexual health for the ÿrst time “because something’s itching, burning and/or dripping.”
And that highlights one of Benjamin’s current headaches: a nationwide shortage of Bicillin, a frontline treatment for syphilis. So, like many sexual health professionals before him, he’s forced to improvise.
“You can use doxycycline [to treat syphilis], but you have to take it for a month,” Benjamin says. “And when you’re on doxycycline, you cannot expose your skin to the sun. We’re in South Carolina. Hello, when is it not sunny here?”
Being forced to act on the ˛y all the time to navigate such headwinds is “exhausting.” That’s why Benjamin preaches the beneÿts of a short sabbatical for HIV activists looking to foster longevity in the ÿght.
“The war on HIV has not been won,” Benjamin explains. “And so I got a little break, and now I’m back, better than ever, stronger than ever, mentally better prepared. And more importantly, I’m in a place where I am needed, in a state where people need my help.” Q
Marco Benjamin is a long-term survivor and advocate.
HEALTH, LIFE & HIV
This quick-reference chart compares antiretroviral options for the prevention of HIV, including adult dosing information. Visit poz.com/drugchart-prevention for more info.
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Pre-Exposure Prophylaxis (PrEP)
PrEP is antiretroviral medication taken by a person who is HIV negative to reduce the risk of contracting HIV. The Food and Drug Administration has approved the following four regimens for PrEP:
TRUVADA
(tenofovir disoproxil fumarate + emtricitabine)
One tablet once a day. For some people, taking PrEP “on demand” before and a er sex may be an option. Each tablet contains 300 mg tenofovir disoproxil fumarate (TDF) + 200 mg emtricitabine.
Approved for HIV-negative men, women and transgender individuals at risk for HIV. Generic version available.
DESCOVY (tenofovir alafenamide + emtricitabine)
One tablet once a day. Each tablet contains 25 mg tenofovir alafenamide (TAF) + 200 mg emtricitabine.
Not approved for those at risk for HIV acquisition via vaginal sex.
Post-Exposure Prophylaxis (PEP)
APRETUDE (cabotegravir)
Apretude is initiated with two 600 mg injections in the buttocks given one month apart for the rst two months, a er which injections are given every two months. Alternatively, oral cabotegravir (Vocabria) may be taken for four weeks before the injections.
Approved for HIV-negative men, women and transgender individuals at risk for HIV.
YEZTUGO (lenacapavir)
Yeztugo is initiated with two 463.5 mg subcutaneous injections and two 300 mg tablets on day 1 and two 300 mg tablets on day 2, a er which two injections are given every six months.
Approved for adults and adolescents weighing at least 77 pounds at risk for sexually acquired HIV.
PEP involves taking a short course of antiretroviral drugs, usually for a month, after a high-risk exposure to HIV. For maximum effectiveness, PEP should be started immediately—and no more than 72 hours—after possible exposure. The Centers for Disease Control and Prevention (CDC) recommends the following preferred HIV PEP regimens:
One tablet once a day. Each tablet contains 50 mg of dolutegravir.
DESCOVY
(tenofovir alafenamide + emtricitabine)
One tablet once a day. Each tablet contains 25 mg tenofovir alafenamide + 200 mg emtricitabine.
One tablet once a day. Each tablet contains 300 mg tenofovir disoproxil fumarate + 200 mg emtricitabine. OR
VIREAD + EPIVIR
tenofovir disoproxil fumarate + lamivudine
One tablet of each drug once a day. Generic versions are available.
Alternative PEP regimens can be found online in
The impact of this work truly reaches far beyond HIV—it’s shaping the future of biomedical science.
DR. FRANCESCO SIMONETTI amfAR Research Grantee
: ADVANCING SCIENTIFIC DISCOVERY
amfAR IS DEDICATED to advancing scientific discovery to improve global health, with a primary and enduring commitment to finding a cure for HIV.
amfAR SUPPORTS deliberate and strategic research into virology, immunology, and AI-enabled science, which will shorten the pathway to a cure by learning from the most relevant areas of biomedical science and cycling those discoveries back to advance HIV cure research.
OUR RECIPROCAL APPROACH ensures that everyone potentially benefits—people in need of therapies for cancer and autoimmune diseases, for example, as well as the over 40 million people living with HIV.
