POZ October/November 2023

Guatemalan Goddess

Spotlight on drag and HIV

Queen

IMPORTANT FACTS FOR BIKTARVY®

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

MOST IMPORTANT INFORMATION ABOUT BIKTARVY

BIKTARVY may cause serious side e ects, including:

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

ABOUT BIKTARVY

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

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

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

` dofetilide

` rifampin

` any other medicines to treat HIV-1

BEFORE TAKING BIKTARVY

Tell your healthcare provider if you:

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

` Have any other health problems.

` Are pregnant or plan to become pregnant. It is not known if BIKTARVY can harm your unborn baby. Tell your healthcare provider if you become pregnant while taking BIKTARVY.

` Are breastfeeding (nursing) or plan to breastfeed. Do not breastfeed. HIV-1 can be passed to the baby in breast milk.

Tell your healthcare provider about all the medicines you take:

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

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

POSSIBLE SIDE EFFECTS OF BIKTARVY

BIKTARVY may cause serious side e ects, including:

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

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

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

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

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

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

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

HOW TO TAKE BIKTARVY

Take BIKTARVY 1 time each day with or without food.

GET MORE INFORMATION

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

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

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

BIKTARVY, the BIKTARVY Logo, GILEAD, the GILEAD Logo, and KEEP BEING YOU are trademarks of Gilead Sciences, Inc., or its related companies. © 2023 Gilead Sciences, Inc. All rights reserved. US-BVYC-0250 04/23

#1 PRESCRIBED HIV TREATMENT*

No matter where life takes you,

ELIAS SWITCHED TO BIKTARVY

Because HIV doesn’t change who you are.

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

Ask your healthcare provider if BIKTARVY is right for you.

Person featured takes BIKTARVY and is compensated by Gilead.

Please see Important Facts about BIKTARVY, including important warnings, on the previous page and at BIKTARVY.com.

EXCLUSIVELY ON POZ.COM

POZ BLOGS

Our roster of bloggers spans the diversity of the HIV community. Go to poz.com/blogs to read varying points of view from people living with the virus as well as from HIV-negative advocates. Join the conversation in the comments section. Visit the blogs to find hope and inspiration from others.

POZ OPINIONS

Advocates, researchers, politicians, thought leaders and folks just like you all have ideas worth sharing. Go to poz.com/ opinions to read about topics such as living with HIV, improving care and treatment, increasing prevention efforts and fighting for social justice.

#UNDETECTABLE

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

POZ DIGITAL

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

22 QUEEN MOXIE IS READY FOR HER CLOSE-UP

The drag performer spotlights HIV. BY MATHEW RODRIGUEZ

26 THE MODERN ART OF HIV DISCLOSURE Actor and artist David Anzuelo confronts his status. BY CHARLES SANCHEZ

3 FROM THE EDITOR Rhythm Is Gonna Get You

4 POZ Q&A

Charles King, CEO and cofounder of Housing Works, focuses on lessons learned and the future of his HIV advocacy.

6 POZ PLANET

R.I.P. Stephaun Elite Wallace • Jeanne Marrazzo named director of the National Institute of Allergy and Infectious Diseases

• Amida Care at 20 • Everyday: Milestones in the HIV epidemic

8 VOICES

More support for those aging with HIV • pharmacies take action against the virus

12 SPOTLIGHT Highlights from IAS 2023

14 RESEARCH NOTES

PrEP and kids’ bones • drug resistance

• ruxolitinib • COVID-19

16 NUTRITION & FITNESS

Black bean breakfast burrito • don’t skip breakfast and other slim-down tips

17 BASICS

Herpes simplex

18 CARE & TREATMENT

WHO reaffirms treatment is prevention • statin cuts heart risk for people living with HIV • can bnAbs help kids control HIV? • a different kind of stem cell cure

32 HEROES

Yolanda Diaz, a longtime advocate and a long-term survivor, celebrates a lifetime of service to the HIV community.

Getting real with Queen Moxie

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TIMMES, BILL WADMAN

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Rhythm Is Gonna Get You

I‘M A KARAOKE SINGER. That’s not a bad thing as far as I’m concerned. I was a theater kid in high school. I enjoyed singing and acting on a stage, but my lack of memorization skills prohibited me from pursuing them further.

So I sing karaoke. Having the lyrics projected in front of me allows me to focus on singing, which for me is the whole point. It’s one of a few activities, like cycling and long peaceful walks, that I use for coping with the stresses of life. They are very much about being in the moment. There’s no time for worries when you take center stage.

Our cover subject, Queen Moxie, can relate to my coping mechanism—she performs drag. As a drag performer living with HIV, she wants to use drag not only to entertain but also to educate. In particular, Moxie seeks to dispel the stigma surrounding the virus. Go to page 22 to read about her hopes for her journey with drag and HIV.

Moxie’s real name is Kevin Soto. He’s a gay man and uses he/him pronouns but as Moxie uses she/her pronouns, as is common among drag queens. Acknowledging HIV status, as well as sexual orientation and gender identity, shouldn’t be difficult.

And yet it is for many people, especially those with negative views of LGBTQ folks. Nationwide, we are experiencing a backlash against us that feels familiar. Coming out as gay and then as HIV positive was not easy for me to do, so I’m not a stranger to such negativity. What sets this moment in time apart are the specific targets—trans people and gender expression—and the laws being passed to suppress them. It’s a scary time.

It’s in these moments that we need to stand up for ourselves and our communities. Thus, we are thrilled to spotlight Moxie.

A self-described “Guatemalan Goddess,” Moxie is also a proud member of the Latino community. This special issue ded-

icated to Latinos includes other related profiles and content.

David Anzuelo is a queer Latino performer who has enjoyed success onstage as well as in film and television. He’s also been living with HIV for over 20 years. Until recently, Anzuelo had kept his status a secret. In an article promoting his playwriting debut, the reporter included the fact that Anzuelo has HIV, which led to his very public disclosure. Go to page 26 for more about the aftermath.

Yolanda Diaz is a longtime AIDS activist and long-term HIV survivor. As such, she wears many hats. In addition to her day job as a health educator at Iris House, a nonprofit that provides housing and social services to women at risk for HIV, she also volunteers for various HIV-related groups. Go to page 32 to read about her service to the community.

For years, POZ has published an annual quick-reference drug chart comparing HIV treatments. Go to the back of this issue to see our first Spanish-language version. Also, please go to the center of this issue to see our annual edition of POZ en Español.

ORIOL R. GUTIERREZ JR. EDITOR-IN-CHIEF editor-in-chief@poz.com

Want to read more from Oriol? Follow him on Twitter @oriolgutierrez and check out blogs.poz.com/oriol.

FOCUSING ON ADVOCACY

The CEO and cofounder of Housing Works shares his lessons learned and his vision for the future.

CHARLES KING, 68, WAS DIAGNOSED WITH HIV IN 2000. HE IS the CEO and cofounder of New York City’s Housing Works, which launched in 1990 and has grown to serve more than 30,000 low-income or homeless New Yorkers, most living with or affected by HIV and AIDS. Below is an edited excerpt from an interview about his life and work that King gave to longtime POZ contributing writer Tim Murphy for his Substack newsletter, “The Caftan Chronicles,” which features in-depth interviews with older gay men who’ve led, and continue to lead, remarkable lives.

Hi, Charles! First, describe where you live.

Since 2008, in a staff apartment in a 10-unit Housing Works residence in Harlem. I’ve lived in a Housing Works community since 1996—I love interacting with residents in a way that’s not business-focused. I barbecue for everyone on holidays.

In 2018, you turned over your long-held title as Housing Works president to former COO Matthew Bernardo, although you remain CEO. What has that been like?

I’m no longer bogged down in the day-to-day. I can focus on international, federal, state and local advocacy, serving as the external face of Housing Works. I’m in heaven. I wake up every morning joyful to go to work.

What are the agency’s current priorities?

In our health care program, the number of people living with HIV is now no more than a third. Overwhelmingly, we’re seeing people who’ve experienced homelessness, incarceration and mental health and substance use disorders. We’ve also expanded into serving homeless people beyond those with HIV. Currently, we’re operating four hotels for people leaving incarceration as well as a stabilization hotel for homeless people living on the street and a hotel for migrants. We’d like to offer an alternative to the congregate housing [NYC shelter system] model, which is dehumanizing.

You were born in 1955, correct? In Delaware, the sixth of 10 children. When I was 2, my father, a preacher, moved us to Southern Texas. I was Wednesday’s child, full of woe. From when I was 4, my father recognized that I was gay, so he tried to beat the devil out of me. Later, I put myself through Sam Houston State University, then went to Southwest Baptist Theological Seminary before going on in the 1980s to Yale Divinity School and then Yale Law.

How did you become involved with AIDS advocacy?

While in divinity school, I was drafted by the pastor of an all-Black church in New Haven to become assistant pastor. I’d sequestered my gay self, but [at a certain point], I told the pastor, “I’m going to resign, come out as a gay man and do something about AIDS.” But he convinced me to stay through June to start an AIDS ministry, which I did, and in exchange, he gave me the pulpit one Sunday to preach on AIDS—and to come out.

And did you?

I didn’t say, “I’m gay.” I said something like “For those of us who cannot fully be ourselves in the church…”

Clockwise from left: Charles King (center) at a New York City protest; a rally to unionize Housing Works employees; King’s Housing Works residence; King (right) supporting U=U

Let’s get to the NYC part of your story. After law school, I threw myself into [the AIDS activist group] ACT UP. At the time, there was very little city support for homeless people with HIV and AIDS, which I had decided was my calling, so we formed ACT UP’s Housing Committee in 1988. That fall, a city court order had been won saying that homeless people with AIDS had to be moved out of city group shelters into private rooms in SROs [single-room occupancy low-budget hotels].

In summer 1989 in ACT UP, we formed Anger Into Direction Action, or AIDA, and I went to Majority Action, the committee of people of color in ACT UP, and we asked that ACT UP fund AIDA. This big, tall Black guy asked, “What’s this white guy doing [here]?” That was Keith Cylar.

And you and Keith ended up as both Housing Works cofounders and directors and as lovers until his death in 2004. How would you characterize that relationship?

Tumultuous. We were passionately in love. And meanwhile, I became conscious of his cocaine addiction. His use could be a point of conflict between us, but I was also proud that Housing Works had a CEO who openly acknowledged that he had a substance use disorder. For a while, we stopped living together, but then we moved back in. By our last final years together, we were amazingly compatible and more deeply in love than ever.

Keith had been HIV positive? Yes, but he didn’t transmit it to me— another sex partner did. I had not told anyone about my status since my 2000 diagnosis because here I was, the head of an AIDS organization, and how could I get HIV knowing all I knew? But after Keith died, I felt it was important that the staff know. So I started with a dinner with the HIV-positive staff and told them. And that created wild emotions, including people being angry at me.

Why?

They expected better of me. But in subsequent disclosures to staff, I was met

with warm embraces and support. Again, I felt it was important to be open about it. I wanted to let people know that Housing Works was still being led by someone who had HIV.

A few years ago, when some staffers were pushing for unionization, you got a very public media rap for appearing to oppose it, partly because you refused to sign an agreement that would bar Housing Works from interfering in union organizing.

I’ve always supported unions, but I wasn’t going to give RWDSU [the Retail, Wholesale and Department Store Union, which the staff voted to join] carte blanche. I thought they needed to earn staff votes. So there was an election and unionization won. And now, we have a very good relationship with the union.

out fell the clods. The foreman asked, “What the fuck is this?” I clammed up, and it was blamed on the Mexicans, and next thing you know, immigration shows up and deports the whole crew back to Mexico. And I have lived pained by that to this day.

What does that story mean in the context of Housing Works?

There’s a reason why a third of our board is not chosen by me. [They are Housing Works clients.] We’ve worked hard to maintain diverse leadership. There is very little of just me saying, “This is what we’re going to do.” I always think about things in terms of helping the people we serve. Like the new Housing Works cannabis dispensary. We’re going to make good money off it, but I wanted to open it to [help] people

How you were portrayed during the union fight ties a bit into my next question: What’s been your selfimage in the past several years of heightened discourse around white male privilege?

I’ve lived most of my life very conscious of my whiteness. The first time I was consumed with guilt as a child was realizing that I had used my whiteness in a way that hurt a group of Mexicans. I was 8 or 9. My father would rent out his sons as a team to pick cotton. We were the only white team, and we’d work with crews brought over from Mexico. You were paid by the pound, and often, we would put clods in our sacks to make them heavier. So I did that, and once,

who’ve been harmed by cannabis and other drug criminalization. So all our profits from cannabis are going to be used to help people who’ve been criminalized related to drugs. We’re emphasizing hiring people who’ve been harmed by drug laws.

What do you want the rest of your life to be about?

If I could be a part of eliminating the congregate NYC shelter system, that would give me great fulfillment. My other goal is to continue engaging individuals to help them transform their lives. I can think of no greater reward than watching people come into the fullest version of who they can be. Q

“I’m in heaven. I wake up every morning joyful to go to work.”

Charles King on the cover of POZ December 2008

R.I.P. STEPHAUN ELITE WALLACE

The late HIV epidemiologist founded the House of Marc Jacobs.

Stephaun Elite Wallace, PhD, an epidemiologist and social justice and HIV advocate who was also a legend of the house ballroom scene, died Saturday, August 5, 2023. He was 45. A cause of death was not disclosed.

The director of external relations for Fred Hutchinson Cancer Center’s HIV Vaccine Trials Network (HVTN) in Seattle, Wallace was also a staff scientist at Fred Hutch, a clinical assistant professor at the University of Washington and an affiliate professor at Yale, according to a statement from HVTN.

Colleagues and friends noted his passing, posting condolences and remembrances on social media.

During the COVID pandemic, Wallace worked to address health disparities, promote vaccinations and improve health and science understanding in the Black community. His efforts, including those with the COVID-19 Prevention Network, earned him praise from Bill Gates, who interviewed Wallace for the book How to Prevent the Next Pandemic.

“For many people, science is still very much a mystery; it still feels like there’s a veil over this process,” Wallace says in the video Bill Gates’s Heroes in the Field: Dr. Stephaun Wallace “Part of my role is to take this veil off.… Often, I encounter myths and misinformation about COVID-19. The distrust in science and medicine is rooted in day-to-day-experience with systems that routinely show them that their lives don’t matter. Everyday experiences of racism and xenophobia contribute to people’s hesitancy and skepticism.”

Wallace grew up in Los Angeles during the ’80s and ’90s and is revered as a legendary father in the ballroom community, notes a memorial to him on InCloudForever.com.

He was preceded in death by his

parents, according to the site’s biography, and he “leaves behind a brother, Jeremiah, a sister, Krystal, and a large and extended chosen family with children from many houses, including The House of Elite, which he reopened in 2004, The House of Blahnik, and The House of Marc Jacobs that he founded in 2021.” —Trent Straube

Jeanne Marrazzo Named NIAID Director

She has helped develop biomedical interventions to

Jeanne M. Marrazzo, MD, has been named as director of the National Institute of Allergy and Infectious Diseases (NIAID) at the National Institutes of Health (NIH). She is currently the director of the Division of Infectious Diseases at the University of Alabama at Birmingham. She is expected to begin her role as NIAID director this fall, replacing Anthony S. Fauci, MD, who stepped down as NIAID director in 2022.

As NIAID director, Marrazzo will oversee NIAID’s budget of $6.3 billion, which supports research to advance the understanding, diagnosis and treatment of infectious, immunologic and allergic diseases. NIAID supports research at universities and research organizations around the United States and across NIAID’s 21 laboratories, including the Vaccine Research Center on NIH’s main campus in Bethesda, Maryland, and the Rocky Mountains Laboratories in Hamilton, Montana.

NIAID also has a unique mandate to respond to emerging and reemerging public health threats at home and abroad. The NIAID research response to outbreaks of infectious

prevent HIV.

diseases, including HIV, Ebola and COVID-19, has led to new therapies, vaccines, diagnostic tests and other technologies.

Marrazzo’s research in discovery and implementation science has focused on the human microbiome, specifically as it relates to female reproductive tract infections and hormonal contraception; prevention of HIV using biomedical interventions, including pre-exposure prophylaxis and microbicides; and the pathogenesis and management of bacterial vaginosis, sexually transmitted infections in people living with HIV and management of antibiotic-resistant gonorrhea.

She has been a principal investigator on NIH grants continuously since 1997 and has served frequently as a peer reviewer and advisory committee member. Marrazzo also has served as a mentor to trainees at all stages of professional development, including on NIH-funded training grants, and was the recipient of the American Sexually Transmitted Diseases Association’s Distinguished Career Award, the highest recognition of contributions to research and mentoring in the field. —NIH

Jeanne Marrazzo, MD

Stephaun Elite Wallace, PhD

AMIDA CARE AT 20

The health plan specializes in coverage for people living with HIV.

New York City’s largest Medicaid Special Needs health plan, Amida Care, which focuses on comprehensive health coverage for people with HIV, celebrates its 20th anniversary in August.

Founded in 2003 by communitybased HIV and AIDS providers, the nonprofit currently serves more than 9,000 New Yorkers. Amida Care works in partnership with its members and clients, prioritizing their feedback to best address their needs and serve as a bridge between members and providers.

“Two decades ago, no one believed that seven community-based health care organizations with no experience with Medicaid managed care could launch a health plan. But thanks to the vision of our provider founders, we have been able to help thousands of New Yorkers live healthy, fulfilling lives by

EVERYDAY

October

creating an innovative model of care that puts the needs of people impacted by HIV first,” says Doug Wirth, president and CEO of Amida Care, in a news release.

By working with Medicaid—a health insurance plan for low-income and disabled Americans—Amida Care is able to provide communities most impacted by HIV with access to lifesaving care and resources. Amida Care offers primary care, gender-affirming procedures and mental health support services.

What’s more, the health plan covers pre-exposure prophylaxis and postexposure prophylaxis, the pills and long-acting injectables that prevent HIV.

Amida Care was one of the first plans to advocate for gender-affirming care, including hormone therapy and surgeries, as well as hepatitis C testing and treatment, which is now covered

for all Medicaid members.

Two thirds of Amida Care members are living with significant mental health issues, 40% have experienced homelessness at least once since their HIV diagnosis and 90% have a history of substance abuse. Black and Latino members make up 55% and 32% of Amida Care’s current membership, respectively, highlighting the disproportionate impact HIV has on communities of color.

“We have grown and evolved,” Wirth says, “but our commitment to addressing health disparities, ending HIV, breaking down barriers to care for marginalized communities and addressing racism as a public health crisis remains steadfast.” —Laura

Schmidt

9 15

LEROY WHITFIELD, a writer and former senior editor at POZ who chronicled his life with HIV and his choice to forgo antiretroviral treatment, dies of AIDS-related complications at age 36. (2005)

November 7 14

POZ Founder SEAN STRUB is elected mayor of Milford, Pennsylvania. (2017)

RAPPER LIL B releases the track

NATIONAL LATINX AIDS AWARENESS DAY

“I Got AIDS” from his album I’m Gay (I’m Happy) The song urges listeners to get tested for HIV and have safer sex. (2011)

19

Inspired by the Broadway classic Bye Bye Birdie, the digital company Queerty releases ORAQUICK: THE MUSICAL, a video featuring well-known drag queens, influencers and actors who promote sex positivity and at-home HIV testing with Oraquick. (2021)

28

AIDS United names

JESSE MILAN JR.

30-year community advocate and nationally recognized leader and speaker on HIV and AIDS policies and programs, as president and CEO. (2016)

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

STILL UNANSWERED

In an opinion piece titled “Questions Still Unanswered,” advocate and long-term survivor George Kerr III pleads for more support for those aging with HIV. Below is an edited excerpt.

WHEN THE HIV EPIDEMIC began in the 1980s, we knew very little about the disease and the possibilities of living a long life with HIV. The focus was on saving lives and trying to survive. More than 40 years later, people who have been living with HIV are asking new questions: What toll has it taken on my body? How will the countless medications that I’ve taken over the years impact my organs, my memory, my life span?

I know the angst felt by this community of older adults because I have been living with HIV for 28 years, and I used to take up to 27 daily pills—almost every single day. This is a diverse community of older adults too, whose life experiences create different health realities for all. As for myself—a Navy veteran and member of the LGBTQ community—I think about these questions all the time. I have also worked with Washington, DC’s most prominent health service practitioners and advocated for those silenced by the stigma of HIV. Sadly, we don’t yet have answers for what our future holds.

We have seen major advancements in this area. For instance, pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) have proved to be remarkably life-enhancing and even

lifesaving. Today’s HIV regimens are highly effective, meaning young people who start treatment promptly can expect a near-normal life span. But half of all people with HIV are over age 50.

So, while it’s important to focus on preventing HIV transmission, it’s just as important to provide the right care for those living with HIV. This includes stopping HIV from advancing to later stages as well as helping patients get to a place where their viral load is undetectable. There is an overwhelming body of clinical evidence to support Undetectable Equals Untransmittable (U=U). The National Institutes of Health defines this as when a person with HIV adheres to antiretroviral therapy such that the virus is no longer detectable, meaning that the person cannot transmit HIV to others. Emphasizing these approaches within patient care will go a long way in supporting those living and aging with HIV.

The health system that miraculously carried us through the HIV crisis must now focus on the gaps in care for the millions of us aging with HIV—for both our physical and mental health needs. Care for HIV is already a highly complex process, so extending that care to aging patients will not be easy. A literature review from the National Library of Medicine proves this and shows that

older HIV-positive adults who receive antiretroviral therapy do not recover nearly as quickly as younger adults.

Having a relationship with a primary care practitioner (PCP) who knows your full life experience and medical history is crucial. This is also why I’m very encouraged to see programs such as George Washington University’s Two in One: HIV + COVID Screening and Testing Model.

This new program is designed with a combined health and racial equity lens to help PCPs routinize HIV screening and screening for COVID vaccines for all their patients. By training PCPs to use culturally responsive communication, the program promotes honest and frank conversation. Regular, open health screenings can help address the whole person by covering cardiovascular diseases, cognitive impairment, osteoporosis and cancers.

Let us celebrate the historic progress made in fighting HIV while also recognizing the gaps in care that hurt so many of those silently aging with HIV. Ours should not be a silent struggle.

Let us raise our voices and demand a health care system that recognizes the long-term challenges we face and provides the necessary support to ensure a fulfilling and healthy life in our later years. Q

PHARMACIES TAKE ACTION

SINCE THE RELEASE OF THE National HIV/AIDS Strategy (the Strategy), I have been working with federal and community stakeholders to increase the low-threshold availability of pre-exposure prophylaxis (PrEP) and other services throughout communities.

As part of these efforts, I have been working with several partners to expand the role of pharmacists in efforts to end HIV. Pharmacists are important partners in implementing the Strategy.

My o ce, the White House O ce of National AIDS Policy, in conjunction with the U.S. Business Action to End HIV and the Elton John AIDS Foundation, convened leaders from across the pharmacy sector at the American Pharmacists Association headquarters in Washington, DC, to explore opportunities.

The meeting included 40 individuals from major retail pharmacies (Avita Care Solutions, CVS Health, Walgreens and Walmart), community pharmacy representatives, a liated associations, the federal government and experts. The meeting focused on opportunities and challenges and included action planning for joint work to increase services provided in communities by pharmacists and pharmacy technicians.

In June, Walmart, a founding member of the U.S. Business Action to End HIV,

opened 70 specialty HIV pharmacies in Colorado, North Carolina, Texas, Virginia and Florida. By the end of 2023, Walmart will have more than 80 HIV Specialty Pharmacies of the Community in 11 states. These pharmacies, operating within the traditional pharmacy setting, are staffed with a team of HIV-trained pharmacists, technicians and community health workers.

On World AIDS Day 2022, Walmart announced, in conjunction with the Elton John AIDS Foundation, a nationwide training HIV Prevention + Treatment continuing education program available to all Walmart pharmacies and Walmart health team members.

On June 27, National HIV Testing Day, Walgreens teamed up with Greater Than HIV, health departments and community organizations for its annual event providing free HIV testing and counseling at more than 400 locations. Counselors were available to answer questions about HIV prevention and treatment options and provide referrals to PrEP. Since the partnership began in 2011, more than 76,000 free HIV tests have been provided, including over 15,000 self-tests. Additionally, more than 3,000 Walgreens pharmacists have received specialized training.

Also in June, the Human Rights Campaign announced a nationwide

self-testing initiative supported by CVS Health. The initiative, Wellness in Action, will distribute 3,000 self-testing kits to community-based partners focused on reaching those in communities disproportionately impacted by HIV. Community partners working on this initiative include Arianna’s Center (Fort Lauderdale, Florida), TruEvolution (Riverside, California), Abounding Prosperity (Dallas), Thrive SS (Atlanta) and Chicago Black Gay Men’s Caucus (Chicago). Select CVS MinuteClinics in those locations will also work with an individual’s health plan to provide access to additional follow-up services.

The Strategy emphasizes the role of pharmacies in increasing access to a variety of HIV prevention and care services, such as testing, PrEP education and initiation, medication education and adherence counseling, as well as in reengaging patients who have fallen out of care.

The U.S. Business Action to End HIV launched on World AIDS Day last year and has continued to engage corporations in accelerating public-private partnerships to end HIV. I am confident that the actions taken, and the future commitments by these partners and others, will lead us further toward reaching our collective goal to ending HIV in the United States. Q

The following is an edited excerpt of a blog post from HIV.gov titled “Pharmacies Take Action to Address HIV” written by Harold J. Phillips, MRP, director of the White House Office of National AIDS Policy.

IAS 2023

Since 1988, the International AIDS Society (IAS) has convened experts from around the world every other year at its biennial HIV science conferences to accelerate the scientific response to the epidemic and enhance the quality of life of all those living with the virus. Today, IAS comprises a global forum of more than 13,000 members in 170 countries, making it the world’s largest association of HIV professionals.

This year’s IAS Conference on HIV Science (IAS 2023), held over four days in Brisbane, Australia, brought together thousands of scientists, policymakers and activists to address global challenges and showcase scientific advances in HIV prevention, treatment, cure and vaccine research.

To ensure participation by as diverse a group as possible, IAS awarded grants and scholarships to key stakeholders and change makers, including young people (through its Youth Hub). IAS also held the conference virtually.

The Prevention Access Campaign’s (PAC) Undetectable Equals Untransmittable (U=U) message loomed large at the conference (see page 18). Although the concept that people with an undetectable viral load who continue to take their meds do not transmit the virus to their sexual partners has taken root in the United States, that is not the case in many other countries around the world. Spread more broadly, the fact of U=U will go a long way toward stemming global transmission of the virus as well as fighting HIV stigma.

1. At IAS 2023, The World Health Organization (WHO) released a policy brief stating that people with HIV who have an undetectable viral load using any WHO-approved test and continue taking medication as prescribed have “zero risk” of transmitting HIV to their sexual partners, the first time the agency has done so. PAC’s #sayzero campaign encourages people to use clear and celebratory language to help spread the message. 2. Bruce Richman , of PAC, held hands with Kenyan activist and IAS member Doreen Moraa Moracha , who helped develop the Youth Hub. Both activists are proudly undetectable. 3. Many Brisbane landmarks were lit up in support and celebration of IAS 2023.

4. During his remarks at the opening ceremony of IAS 2023, WHO director Tedros Adhanom Ghebreyesus, PhD, warned that overlapping crises such as conflict, migration and climate change have implications for the response to HIV, especially for small, fragile island states. 5. IAS would not have been possible without the hard work of the many volunteers who helped keep things running smoothly. 6. Alegra Wolter, MD, a trans physician from Indonesia (the country’s first!) who specializes in gender, sexual and reproductive health and HIV, delivered some opening remarks. 7. Vamsi Vasireddy, MD, DrPh, (second from left) received a prize for research in long-acting HIV prevention and treatment using client-centered models in Uganda. 8. IAS president Sharon Lewin noted that the past 40 years of HIV research have taught us that progress happens when science, policy and activism come together.

Send your event photos to POZ at website@poz.com or tag us on Facebook, Instagram or Twitter. For a list of community events, visit poz.com/calendar.

PREVENTION

PrEP and Kids’ Bones

Children whose mothers used tenofovir-based pre-exposure prophylaxis (PrEP) during pregnancy did not have reduced bone density or stunted growth compared with unexposed kids, according to study findings presented at the International AIDS Society Conference on HIV Science. Tenofovir disoproxil fumarate (TDF, a component of the Truvada pill) has been linked to bone loss when used for HIV treatment, but there’s a lack of research on children whose mothers took PrEP during pregnancy. Researchers looked at data from an ongoing study of PrEP use during pregnancy in Kenya. As previously reported, an assessment by study nurses found that children exposed to TDF before birth showed no notable differences in growth or neurological development for up to three years. A more in-depth analysis using whole-body DEXA scans found that exposed and unexposed children had similar height and bone mineral density. “Our findings bolstered the safety profile of PrEP use for pregnant women,” the researchers concluded.

Drug Resistance TREATMENT

People who switch to dolutegravir plus lamivudine (Dovato) have a high likelihood of maintaining an undetectable viral load even if they have a history of treatment failure and a common resistance mutation.

The SOLAR-3D trial looked at outcomes among 100 treatment-experienced people on suppressive antiretroviral therapy—mostly three-drug regimens—who switched to dolutegravir/ lamivudine. Half had the M184V/I mutation, which confers resistance to lamivudine and emtricitabine, now or in the past.

At 96 weeks after the switch, only 15 people who once had M184V/I still showed evidence of the mutation in their viral reservoir. At that point, 84% of people who ever had M184V/I and 88% of those who never did maintained an undetectable viral load.

Three people experienced viral blips, but all regained viral suppression without changing their regimen. Switching from three to two drugs could potentially lead to cost savings “in the billions,” said Gary Blick, MD, of Health Care Advocates International.

CURE

Ruxolitinib

An immune-modulating drug may reduce the size of the HIV reservoir and help reverse immune dysfunction. Antiretrovirals can keep HIV replication suppressed, but the virus inserts its genetic blueprint—known as a provirus—into the DNA of human cells and establishes a long-lasting reservoir that makes a cure nearly impossible. A Phase II trial enrolled 60 adults on antiretroviral therapy with viral suppression; 40 added ruxolitinib (Jakafi), an oral JAK 1/2 inhibitor, for five weeks. Ruxolitinib recipients with a high viral reservoir saw a significant decline in proviral DNA in peripheral blood cells, but there was no change in those with a low reservoir. The researchers calculated that 99.99% viral clearance could potentially be achieved in 2.9 years. The drug reduces the life span of cells harboring latent virus and blocks inflammation that allows the reservoir to persist, according to Monica Reece, a PhD student at Emory University. What’s more, ruxolitinib may be helping to maintain remission in a man who appears to be cured after a stem cell transplant (see page 21).

COVID-19 CONCERNS

People with HIV did not see as much of a decrease in COVID-19 mortality as HIV-negative people during the omicron wave. World Health Organization (WHO) researchers looked at the risk of death among 821,331 people hospitalized with COVID during different SARS-CoV-2 variant waves. Before the delta wave, 24% of HIV-positive people and 22% of HIV-negative people died. During the delta period, the mortality rates were 23% and 21%, respectively. But during the omicron period, mortality was twice as high for people with HIV: 20% versus 10%. During the pre-delta and delta periods, HIV-positive people had about a 55% greater risk of death, but during the omicron period, their mortality rate was 142% higher. “While COVID-19 mortality risk declined dramatically during omicron among HIV-negative people, it declined only modestly among people living with HIV, especially those with low CD4 counts,” said the WHO’s Meg Doherty, MD, PhD. The good news is that vaccinated people with HIV had about a 40% lower risk of death than those who were unvaccinated.

I stay undetectable to be an example to others like me.

“When I was first diagnosed, I didn’t know anyone else with HIV whose background was similar to mine. So I decided to become my own role model, and hopefully help other Latinx men living with HIV see they can have a full life too.” — GABRIEL FROM ORLANDO, FLORIDA

BE YOUR OWN ROLE MODEL. START YOUR HIV TREATMENT JOURNEY.

DON’T SKIP BREAKFAST

By Craig Ramsay

BLACK BEAN BREAKFAST BURRITO

A great source of protein

THERE’S SOMETHING SATISFYING and comforting about being able to wrap everything up in a tortilla. This breakfast burrito is a filling meal, and the eggs and black beans are both great sources of protein, which helps you feel fuller longer. To save some time, use store-bought salsa instead of making the pico de gallo. Just make sure it contains minimal ingredients.

INGREDIENTS

Pico de gallo (salsa):

1 plum tomato, seeded and diced

1 tablespoon finely chopped white or red onion

1 tablespoon minced jalapeño, deseeded

1 tablespoon fresh lime juice

1 tablespoon chopped cilantro

Salt, to taste

Burrito:

4 large eggs

Salt and pepper, to taste

Pinch cayenne pepper (optional)

2 teaspoons canola or grape seed oil

1⁄3 cup grated Monterey Jack or cheddar cheese

1 cup black beans, rinsed and drained

2 (9-inch) whole wheat tortillas

½ ripe avocado, peeled, pitted and diced

SERVINGS: 2 / INGREDIENTS: 14 / PREP: 20 MINUTES

DIRECTIONS

1. In a small bowl, mix the diced tomato, onion, jalapeño, lime juice, cilantro, salt and pepper. Set aside.

2. In a medium bowl, whisk the eggs with 1 teaspoon of water, cayenne pepper (if using) and salt and pepper.

3. In a medium nonstick skillet, heat 1 teaspoon of oil over medium heat. Add the eggs and cook, stirring to scramble just until set. Stir in the cheese and cook until it has melted. Remove from heat.

4. Wipe the skillet clean. Heat the remaining 1 teaspoon of oil over medium-high heat and add the drained black beans. Cook just until heated through, about 1 minute. Remove from heat.

5. Wipe the skillet clean again and heat the tortillas just until warmed.

6. Fill the tortillas with the pico de gallo vertically down the center, about an inch away from the edges. Then top with even amounts of beans, scrambled eggs and diced avocado. Fold over the top and the bottom of the tortilla, then fold over the sides, overlapping them. Serve folded side down.

CHEF TIPS

To get your meal on the table quicker, you can substitute a store-bought pico de gallo.

NUTRITION FACTS (per serving)

Calories: 834; fat: 33 g; saturated fat: 10 g; polyunsaturated fat: 8 g; monounsaturated fat: 13 g;

carbohydrates: 93 g; sugar: 6 g; fiber: 21 g; protein: 45 g; sodium: 862 mg

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Here are some slim-down tips: Eat before drinking coffee. Split your lunch into two portions. Cut out carbs in the evening.

Space out your meals every two to three hours.

Eating six small meals a day will increase your metabolic rate and help you burn more calories throughout the day.

Craig Ramsay is a fitness expert, an author and the winner of season 8 of The Amazing Race Canada Follow him on Instagram at @ craigramsayfit

SHINGLES

SHINGLES IS A CONDITION caused by varicella-zoster virus (VZV), which also causes chickenpox. It is characterized by a painful rash, sometimes accompanied by flu-like symptoms. In some cases, it can lead to long-term nerve damage. Like other viruses in the herpes family, VZV causes lifelong infection.

Most people acquire VZV during childhood. Chickenpox was once very common, but its incidence has declined dramatically in the United States since the advent of childhood immunization in 1995. A er recovery, the virus establishes latent infection in nerves and can reactivate later in life to cause shingles (herpes zoster).

According to the Centers for Disease Control and Prevention (CDC), about one in three adults will develop shingles during their lifetime. This typically occurs in older individuals, but people living with HIV—especially those with a low CD4 T-cell count—and other people with weakened immunity are susceptible at any age.

VZV spreads primarily through contact with fluid from chickenpox or shingles sores. Shingles exposure doesn’t directly lead to shingles, but people with an outbreak can transmit the virus to others who have never been infected or vaccinated, and they can develop chickenpox.

People having a shingles outbreak may first develop fever, fatigue, head-

ache or other flu-like symptoms, and they may experience burning, itching or tingling—known as a prodrome— before breaking out in a rash.

While chickenpox is characterized by an itchy rash that can occur anywhere on the body, shingles typically has a more limited distribution, o en appearing on one side of the body or face in a band-like pattern following the path of a nerve. The rash consists of flu-filled blisters that are itchy and painful. In some cases, shingles can also affect the eyes, inner ear, lungs and brain.

Shingles blisters typically heal within a few weeks, but the rash may last longer in people with weakened immunity. Some people develop long-lasting nerve damage known as postherpetic neuralgia, which can lead to chronic pain or numbness.

VACCINATION AND TREATMENT

A vaccine called Varivax prevents initial VZV infection and chickenpox. It is recommended for children under 13 as well as adolescents and adults who have never had chickenpox. A different vaccine, Shingrix, prevents shingles outbreaks in people who already carry the virus. It reduces the risk for shingles outbreaks and postherpetic neuralgia by more than 90%.

The CDC recommends Shingrix for all adults ages 50 and older, including those who have already had shingles or

previously received Varivax or an older shingles vaccine called Zostavax. It is also recommended for younger adults with compromised immunity, including those living with HIV. Shingrix is a twoshot series spaced two to six months apart. The vaccine can cause injection site soreness and flu-like symptoms, but serious side effects are rare.

VZV cannot be cured, but antiviral medications can reduce pain, speed healing and lower the likelihood of recurrent outbreaks and postherpetic neuralgia. Three related nucleoside analog medications—acyclovir (Zovirax), valacyclovir (Valtrex) and famciclovir (Famvir)—are used to treat shingles. Treatment works best when started as soon as possible a er the first symptoms or prodromal signs. These antivirals are generally well tolerated with few side effects.

Beyond antivirals, over-the-counter medications and topical preparations can be used to relieve pain. Some people, especially those with postherpetic neuralgia, may need stronger prescription pain medications. During an outbreak, keep sores clean and dry, as this helps speed up healing and prevent bacterial infection.

Researchers are studying new therapies that might be more effective for shingles and postherpetic neuralgia. Ask your doctor whether a clinical trial might be a good option for you. Q

Vaccination is recommended for people 50 and older and all adults living with HIV.

Shingles (le ); varicella-zoster virus (right)

WHO Reaffirms Treatment Is Prevention

In a move long encouraged by advocates, the World Health Organization (WHO) has reaffirmed that people living with HIV who consistently take antiretroviral treatment and have an undetectable viral load do not transmit the virus during sex, a concept known as Undetectable Equals Untransmittable, or U=U.

According to a WHO policy brief released at the International AIDS Society Conference on HIV Science, people with an undetectable viral load—usually defined as below 50 or 200—who continue to take their medication “have zero risk of transmitting HIV to their sexual partner(s) and minimal risk of transmitting HIV vertically to their children.” People with a suppressed but detectable viral load (under 1,000) have “almost zero or negligible risk” of sexual transmission.

The updated guidance is supported by a systematic review of evidence that found sexual transmission of HIV did not occur when viral load was less than 600 and was very rare when it was below 1,000. There is not enough

evidence about the link between viral load and transmission via shared drug injection equipment.

“The brief is a game changer for equitable scale-up of viral load testing and clear messaging about transmission risk,” says Bruce Richman, executive

director of the Prevention Access Campaign. “When the WHO’s new brief is translated from policy to implementation, millions more people living with HIV will have the assurance that their treatment is working to protect their health and their partners.”

STATIN CUTS HEART RISK FOR PEOPLE LIVING WITH HIV

People with HIV who are at low to moderate risk for cardiovascular events can reduce their risk even further by taking a daily statin medication, according to long-awaited results from the REPRIEVE study.

The international Phase III trial enrolled nearly 7,800 HIV-positive people ages 40 to 75. Their demographics, comorbidities and laboratory values reflected low to moderate cardiovascular risk, so they ordinarily would not have been prescribed a statin. But standard risk scores developed for the general population tend to underestimate the risk for people with HIV, who are about twice as likely to develop cardiovascular disease.

The study participants were randomly assigned to receive oral pitavastatin or a placebo. Statins reduce low-density lipoprotein (LDL) cholesterol and also have anti-inflammatory properties. The drugs have been shown to lower the risk for cardiovascular problems and death in the population at large, but their benefits for people living with HIV were uncertain.

The trial was stopped ahead of schedule in April after an interim analysis showed that pitavastatin reduced the risk for heart attacks, strokes, severe chest pains, heart surgery and cardiovascular death by 35%. The effect was consistent for men and women, across racial/ethnic groups and regardless of CD4 count or base-

line LDL level. Pitavastatin was generally safe and well tolerated, but people who used the drug were more likely than placebo recipients to develop diabetes (about 5% versus 4%, respectively).

“We would highly recommend that guidelines be changed” to include statin therapy for people with HIV, says lead investigator Steven Grinspoon, MD, of Massachusetts General Hospital. “Pitavastatin is effective, prevents major adverse cardiovascular events and

Can bnAbs Help Kids Control HIV?

Broadly neutralizing antibodies (bnAbs) show promise as a treatment for children with HIV, and they may help bring about long-term remission.

Antiretrovirals can keep HIV replication under control during treatment, but the virus inserts its genetic blueprints into the DNA of human cells and establishes a long-lasting reservoir that makes a cure nearly impossible. People with HIV normally produce antibodies, but these usually don’t recognize new viral mutations. However, a small proportion of people make bnAbs that target parts of the virus that don’t change much. Modified versions of these antibodies are being tested for HIV prevention and treatment.

The Tatelo Study evaluated a pair of bnAbs known as VRC01LS and 10-1074 in 28 children ages 2 to 6 in Botswana. They started oral antiretroviral therapy within the first week after birth, continued treatment for at least two years and had an undetectable viral load. They received the bnAbs by intravenous infusion once monthly. The antibody treatment overlapped with antiretrovirals for at least eight weeks, and three children experienced viral rebound during this time.

The remaining 25 children who still had an undetectable viral load then stopped antiretrovirals and continued to receive the two bnAbs alone. Eleven of them (44%) maintained viral suppression for six months, while 14 experienced viral rebound. Children who had a smaller viral reservoir at birth and sustained viral suppression throughout early life were more likely to maintain suppression after stopping antiretrovirals. The antibody treatment was generally safe and well tolerated, and some parents said they preferred monthly infusions rather than giving their children oral meds every day.

A DIFFERENT KIND OF STEM CELL CURE

A man dubbed the Geneva Patient may be the sixth person to be functionally cured of HIV after a stem cell transplant for cancer treatment. But unlike the other five, his donor did not have a rare mutation, known as CCR5-delta32, that prevents the virus from entering cells.

The man, who was diagnosed with HIV in 1990, received chemotherapy and radiation followed by a stem cell transplant to treat aggressive sarcoma in July 2018. He maintained viral suppression until November 2021, when he stopped his antiretrovirals in a closely monitored treatment interruption. Twenty months later, he still has undetectable HIV in his blood, and researchers have been unable to find intact virus in his T cells or bone marrow, according to a report at the International AIDS Society Conference on HIV Science in July.

“We cannot exclude that there is still some virus present, so there may be viral rebound in the future, although we hope this situation of viral remission remains permanent,” says Asier Sáez-Cirión, PhD, of Institut Pasteur in Paris.

Researchers are working to learn why this man was apparently cured after a so-called wild-type stem cell transplant while previous attempts have failed. In 2013, hopes were raised when two men in Boston appeared to be controlling HIV after wild-type stem cell transplants, but they ultimately experienced viral rebound three and eight months after stopping antiretrovirals.

The Geneva Patient developed acute and chronic graft-versushost disease—when donor immune cells attack the recipient’s body— which was treated with various immunosuppressive drugs, including ruxolitinib (see page 14). The fact that he used on-demand pre-exposure prophylaxis (PrEP) on two occasions might also be important.

Stem cell transplants are too risky for people who do not need them to treat life-threatening cancer, but cases like this offer clues that could help scientists develop strategies that lead to a more widely applicable functional cure.

THE DRAG PERFORMER SPOTLIGHTS LIVING WITH HIV TODAY.

BY MATHEW RODRIGUEZ PHOTOGRAPHY BY ARI MICHELSON

During LGBTQ Pride Month this year, she was invited to speak about AIDS activism and the queer community on a panel at the El Capitan Theatre, a historic renovated theater in Hollywood. By the time the crowd turned its attention to Moxie, the final panelist, the queen took a long pause and spoke her truth to the dozens of people gathered there: that she is HIV positive. Afterward, she felt lighter and breathed a sigh of relief. Moxie’s real name is Kevin Soto, and he is 28 years old. Soto is gay and uses he/him pronouns, but as Moxie, Soto uses she/her pronouns, as is common among queens.

“It was a beautiful moment,” Moxie tells POZ. “You don’t know if someone in the room has a family member that is going

through your same situation and having that conversation about it can help them in some way.” After she shared, people approached her in tears, calling her brave and shaking her hand. In a way, it was not unlike the work that she and many other drag queens do onstage. When a queen, especially in the current political climate, straps on her heels, dons her wig and shimmies for a few minutes while channeling the passion of music, she can transmute pain, grief or sadness into something beautiful.

It’s something Moxie, a self-described “Guatemalan Goddess” on her Instagram, has been doing since she was diagnosed in 2015. The news came as a shock. When the health care worker told her the test result, she couldn’t hear a word being spoken. She described what sounded like a long beep that was muting the words coming out of the person’s mouth. After going home and crying all night, then waking up and crying again, she started looking for places to perform.

been living with HIV for eight years, speaking publicly about having the virus is, like a garment fresh out of a sewing machine, something she is trying on for the first time.

Queen Moxie at a Los Angeles beach

“I just wanted to get in drag,” Moxie says. “I just wanted to get up there and perform.” She began asking around about places where she could perform for audience tips. The more such jobs she could book, the less she had to think about her diagnosis. Instead, she could just get lost in the music, making herself happy and radiating joy to others in the room who’d come to escape their own lives for a moment, just as she had—a beautiful cycle.

pastors for parents, Moxie first learned about drag in 2009. While channel surfing one night, she discovered Rupaul’s Drag Race on TV. Her first episode featured one of the reality competition’s first iconic moments: Shannel, a contestant on the show’s first season, loses her tentacle-laden headpiece while lip syncing to Whitney Houston’s “The Greatest Love of All.” Moxie then told her two brothers about the show, and they began to watch together; one of her brothers is her twin, and the other is older. They are both gay.

She watched Drag Race alone until she was old enough to perform herself. On September 26, 2014, she stepped into drag for the first time at a small queer Latinx festival promoting safer sex and HIV testing. She asked her brother, Daniel, who was already inhabiting his drag persona, Sister Bam Bam, as part of the Sisters of Perpetual Indulgence, for help crafting a costume. She ended up performing a medley emphasizing opulence that included Fergie’s “Glamorous” and Nicki Minaj’s “Muny.” And it was all inspired by the outfit, a leotard with a graphic print featuring cash money and dollar signs.

That a look can inform a performance is the driving philosophy behind her drag. Sometimes, when a drag performer is called a “look queen,” it can mean she is serving fierce visuals at the expense of a captivating performance. But for Moxie, a fierce show begins with a stunning look. She sketches an outfit, consults with Sister Bam Bam, who now serves as her costume designer, and then builds a performance around the look, allowing the patterns to dictate the vibe she wants to convey.

Her performance style is inspired by her favorite queen, Raven, the runner-up of both season 2 of Drag Race and All Stars season 1. “She captivates you in the performance, and she doesn’t have to do a dip or a split,” Queen Moxie says. “I love to look my best, and I score my 10s like that. I may do a little shimmy here and there.”

Rather than rely on acrobatics in her performances, Moxie emotes to connect with her audience. “It’s all about the audience,” she says. “I give them a wink or a little nudge.” She often performs slowed-down covers of songs that allow her to move with sensual grace and emphasize her body, rather than

requiring her to fly high into a cartwheel. One of her favorites is a cover of the Spice Girls’ “Say You’ll Be There” by Danish singer MØ, whose down-tempo version allows the singer to emote and drive home the song’s lyrics.

Daniel says that to watch Moxie is to witness a celebration of womanhood, including many of the strong women they saw in their own lives while growing up. “She does that flick of the wrist, the turn of the neck,” he says, noting that every movement in his brother’s show is timed to the words and beats of the songs. In crafting a show, Moxie is meticulous. “There’s an intention behind every move.”

Her emotional performances and looks, Moxie hopes, can someday help her nab a coveted spot on Drag Race. Moxie has auditioned to be on the program three times. Based on the number of times her tapes have been viewed, she believes that her audition reels have gotten better and better. To get

Striking a pose for HIV advocacy

cast, a queen uploads her audition tape to Vimeo, where producers watch it. Her first audition tape, she says, was terrible, and her second was viewed only six times. But, she says, when she auditioned about three years ago, producers viewed her video a couple of dozen times, a sign that they were interested.

“I was so proud of that,” she says. “I thought I was going to get one of the phone interviews, but no, not yet.”

living with HIV. “You don’t know what other people are going through,” she says. “You should share your thoughts and experiences with how you’ve been dealing with it because you can save a life.” And beyond simply wanting to be inspirational, Moxie also wants to be real about the ways that living with HIV and being a queen intersect, even when it comes to the mundane reality of taking her daily medication.

At first, she took her medications at night to avoid a day’s worth of side effects, but she eventually switched to taking her meds in the morning, as mixing her meds with alcohol while out at night wasn’t great for her. Now, she takes one pill once per day with a swig of water the moment she wakes up.

Drag Race is no stranger to HIV. Indeed, HIV has been a part of Drag Race since its earliest days. The show’s very first front runner, Ongina, came out as HIV positive after winning a challenge that involved taking a screen test for a MAC Viva Glam commercial. But no queen living with HIV has made it to the final episode of the show. The closest was Trinity K. Bonet, who came in seventh place on season 6 and in fifth place on All Stars 6

Both Bonet and Ongina have become beloved for their willingness to talk about a topic that is still too often stigmatized in queer circles. Of course, speaking out is often what a drag performer must do. One doesn’t need to look far to find examples of drag artists who have been at the forefront of LGBTQ activism. One of the mothers of the queer rights movement, Marsha P. Johnson, was a trans woman and drag queen, who performed as part of the drag troupe Hot Peaches. And, of course, there are the Sisters of Perpetual Indulgence, of which Bam Bam is a member, who were some of the first people to respond to the AIDS crisis.

While drag queens push for societal change, they can also have a profound effect on us individually. In their performances of exaggerated gender norms, they subvert patriarchy, a system that not only oppresses women and LGBTQ people but is also recognized by the United Nations as a significant factor worsening the global AIDS epidemic. “The world will not be able to defeat AIDS while reinforcing patriarchy,” UNAIDS executive director Winnie Byanyima said in 2022.

Moxie’s drag has helped her wrestle not only with her HIV diagnosis but also with her own feelings about masculinity and machismo, a specific kind of aggressive masculinity emphasized in Latinx communities. “My dad had never really been macho, but I always felt like I had to be for him,” she says. “Putting on drag is like putting on a superhero cape.”

made drag queens a target of America’s right-wing movement, which is often deeply invested in holding up ideas of masculinity and patriarchy.

Currently, drag queens are experiencing a major backlash from Republicans, many of whom liken drag performers to groomers (people who manipulate and desensitize children in order to sexually exploit them).

The backlash is part of a larger push against LGBTQ people, especially trans people, and has resulted in the passage of anti-drag performance laws in Tennessee and Florida (though both laws have been blocked by federal judges).

“I love performing, and I cannot imagine being out in Tennessee and being told, ‘Oh, we’re banning what you love to do,’” she says. “We’re not here to make them queer. We’re here to just put on a good show and make people smile.”

Moxie maintains that Republicans are attempting to ban drag shows and gender-affirming health care to distract from the issues that they fail to act on. “Kids are being killed, and that gets overlooked,” she says. “They’re trying to deflect the biggest situation, which is gun control.”

Despite the pushback against her chosen art form, Moxie sees hope and resilience in her community and says she’ll continue to perform and bring much-needed energy to those who watch her. And, no matter what happens in the future, it’s clear that she’s already had a major impact on those around her. Daniel calls Moxie his “muse” and says his brotherly love has led him to push and improve his own craft and artistry as a queen. Beyond creating her outfits, Daniel was there to help nurture her as a baby queen, including driving her to early gigs. “I was really honored to be able to be that person for my brother and just support him,” he says. “I’m like her biggest fan. I really, truly am.”

Nearly a decade since she launched her career, Moxie is ready to take the next step to an even larger platform, that is, Drag Race. Winning Drag Race , after the show helped her come out as queer and become a queen herself, would be an incredible achievement, she says.

“It would be a stamp of approval for all the work and the dedication I put into this art form that is drag,” she says. “The crown and scepter would represent this whole community of people living with HIV and let them know the fight is not over. If I could achieve this goal, then you can too.” Q

“PUTTING ON DRAG IS LIKE PUTTING ON A SUPERHERO CAPE.”

Long-term survivor David Anzuelo makes his mark in New York City.

ACTOR AND ARTIST DAVID ANZUELO KEPT HIS STATUS A SECRET FOR OVER TWO DECADES.

APROLIFIC ACTOR, DAVID Anzuelo, 57, is well known in the New York City theater scene and has performed in regional theaters across the country.

BY CHARLES SANCHEZ

gay Chicano dude. We talked, and I didn’t know we were on the record yet! I disclosed my status to him, and he put it in the article.”

The queer Latino performer has also enjoyed success in film and on television. If you’re a Law & Order fanatic, you may recognize him from various roles over the years—he’s played everything from a gang member to a priest. He is also a playwright, a director and a musician. On top of all that, UnkleDave’s Fight-House, a theatrical fight and intimacy choreography company Anzuelo founded, has been nominated for three Drama Desk Awards, and his team is in high demand for theater, film and TV productions.

Anzuelo has also been living with HIV for over 20 years, but until recently, he kept his diagnosis from the professional arts community.

In the spring of 2023, his playwriting debut, Día Y Noche (Day and Night), was being performed off Broadway by the LAByrinth Theater Company in Manhattan. “I was doing an interview,” Anzuelo says, “and the interviewer was a

Anzuelo was nervous. Although his family, his husband and those closest to him knew he was living with HIV, many people in his life didn’t know his status. He called the reporter. “I say, ‘Hey, I didn’t know you were going to include that in the article.’ And he says, ‘Well, I think it’s really important.’” The journalist then offered to edit out the detail. At that moment, Anzuelo had a choice to make.

ANZUELO GREW UP IN A MEXICAN-AMERICAN household in El Paso, Texas, with his parents and a younger sister and attended college in New Mexico. “I got a BFA in acting from the College of Santa Fe,” he says. “I moved to New York City in ’89, but I’d been coming here since, like, ’82.” He would visit New York to attend the Primal Theater Institute at The Martha Graham School. “I got interested in physical theater,” Anzuelo says. “My dance teacher in college was a former Graham dancer, and she called them up and

MEGAN SENIOR

said, ‘He’s intermediate level—let him in the summer intensive.’

“I arrived in New York on July 4 [1989], and by July 5, I was auditioning,” he says. “By July 7, I had booked my first paid performing job.” It was for Music Dance USA, a family-friendly music revue that performed at county fairs up and down the East Coast. Anzuelo played Elvis Presley. “Sometimes, we’d open for the Gatlin Brothers or Reba McEntire, but sometimes, we were the headliners, and our opening acts were, like, the racing pigs or the diving donkeys!” It paid $400 per week. “Back then, that was a lot to me,” Anzuelo says.

In 1990, he booked his first TV job. “It was a miniseries, a follow-up to Michael Mann’s The Drug Wars , about the cocaine cartels in Colombia. That won an Emmy, so they made Drug Wars 2.” Although his role was significant and he earned a good salary, he was disappointed when the series came out. “They cut all my scenes,” Anzuelo says, “so I looked like a day player with only one line. That was hard.” He wouldn’t work in TV again for another two years.

Meanwhile, he worked at the art house Film Forum, waited tables on a dinner boat called The Spirit of New Jersey and was a salesperson at Footlight Records, a defunct record store that catered to musical theater lovers. “I worked at the Forum for a good 11 years, on and off. They always took me back when I’d come back from a gig,” Anzuelo says.

In his early 30s, he landed a job as a bootblack, shining boots at the notorious (and also defunct) leather bar The LURE (the acronym stood for “Leather, Underwear, Rubber, Etc.”) in Manhattan’s Meatpacking District. “My first night there, it was awesome!” he says. “They had this band there called Bile, and it was this intense industrial punk band with these huge tom-toms, and the lead singer had a box on his head that lit up from the inside.” Anzuelo says it reminded him of the Frankie Goes to Hollywood music video for “Welcome to the Pleasuredome.” He says, “And I was like, ‘I’m in New York. I’m really in New York now.’ And that was great.”

He also found more work in theater, paying his dues at such New York companies as the Latino INTAR Theatre and the experimental theater club La MaMa. He booked roles in short films, working alongside the likes of drag queen Candy Cane and Rent star Anthony Rapp. He also was cast as the lead in Bill Cain’s rap-infused drama Stand-Up Tragedy at The Apple Tree Theatre in Chicago, for which he won a prestigious Jeff Award.

IN THE FALL OF 2001, ANZUELO RECEIVED SOME surprising news during a routine physical. At the time, he was competing regularly on the international level as a black

belt in martial arts. “I was at the top of my game, in terms of the fighting tour nament circuit. I was regularly bringing home gold medals and trophies,” he says. At the physical, the clinician offered comprehensive testing for sexually transmitted infections, including for HIV. “Then they said, ‘We need to call you back to talk about some things.’”

That’s when Anzuelo was told he was HIV positive. He wondered whether it could be a mistake. “They said, ‘No, we ran the test three times, and your [CD4] cells are below normal,’” he says. Anzuelo was in the best physical shape of his life and felt terrific. “It was a real head trip,” he confides.

A week later, he was working on the soap opera Guiding Light when the terrorist attack on the World Trade Center occurred, devastating the city and the nation. “We were given the option of staying at the studio overnight or going home, so I chose to walk home.” His diagnosis and the events of the day had him in a state of shock. “It was really weird to be working on television and to be a competitive martial artist but feeling like a zombie,” he says. As he headed from the downtown TV studio to his uptown apartment in Washington Heights, he saw fellow New Yorkers covered in ash walking silently. “I thought, They look how I feel, which was dead.”

(BOTTOM RIGHT) MEGAN SENIOR; ALL OTHERS: COURTESY OF DAVID ANZUELO

Anzuelo today (bottom right) and throughout his life in both the performing arts and the martial arts

Despite Anzuelo’s low CD4 count, his doctor didn’t start him on treatment right away. “He told me, ‘If you can hold on and keep your health, there are some new meds coming out that have less adverse side effects,’” Anzuelo says. Meanwhile, he tried several alternative treatments, like acupuncture, herbalism and psychotherapy.

“At the time, I was in a very toxic relationship,” Anzuelo recalls. “He [his partner] told me, ‘Would you just hurry up and die?’ And that actually helped me, because it made me really mad.” Anzuelo decided at that moment not to die and soon after moved to his own apartment.

He also had a toxic doctor. Anzuelo was 35 at the time, yet this medical professional told him he would die at 50 and that the last five years were going to be especially difficult. “Then he called me José. I said, ‘Who do you think you’re talking to? Whose chart are you holding in your hand?’” The doctor had confused Anzuelo with another patient.

“I said, ‘You are no longer my doctor because first of all, you shouldn’t talk to anybody like that, and second, you’re not paying attention to who’s sitting right in front of you and whose chart is in your hand.’” Anzuelo started seeing a new doctor who treated him with respect and kindness.

Anzuelo found additional support at New York’s GMHC (formerly Gay Men’s Health Crisis), where he was assigned a caseworker, and he found a gay therapist to help manage the complicated emotions surrounding an HIV diagnosis as well as the aftermath of 9/11.

Anzuelo decided to disclose his HIV status to his parents and sister. “They were devastated,” he says, “but supportive.” His family invited him to return home, but he chose to remain in the city. “I told them that the care is going to be better here in New York than in El Paso.” He also came out to a few very supportive friends. “And you know that boyfriend who wanted me to hurry up and die? He actually gave me some good advice,” Anzuelo says. “He said, ‘You hardly have any gay friends, and you’re going to need them.’”

Surprisingly, the theater groups that Anzuelo was involved in had mostly straight cisgender members. “It was strange. The circle I was running with—there weren’t very many gay people,” he says. “It was mostly very bro guys, and they couldn’t relate and had no inclination to relate.” Anzuelo says he’s now surrounded by a mix of queer and straight friends, which he describes as “very helpful.”

Anzuelo’s HIV diagnosis also affected him professionally. “Before I went on meds, I was afraid of bleeding,” he says. “One day, during [martial arts] class, we were sparring, and someone hit me in the nose, and I got a nosebleed. I freaked out.” He went and cleaned up the mess with bleach and made excuses to the class.

Anzuelo’s friends also noticed him losing weight. “I’d always

fought at 155, and when I dropped to 140, people noticed and were like, ‘What’s going on?’” He quit fighting soon after.

“It was hard. I thought martial arts was going to be a lifelong thing. My father said something great,” Anzuelo says imitating him, “‘Mijo [my son], they’re not making many pirate movies! You are a professional actor.’ And that made it easier to retire [from martial arts].”

His doctor finally put him on HIV medications, but that first year was rough. “It took a while to adjust to the meds,” Anzuelo says, “and it affected my auditions.” His agents would be told that he was unfocused at professional interviews, that something was wrong. “I didn’t feel safe enough to tell [my agents]. I just told them I’m going through some stuff, blah, blah, blah. I had a lot on my mind.”

Once he started treatment, Anzuelo’s health began to bounce back. “The meds leveled me out pretty quickly,” he says, adding that his viral load was undetectable soon thereafter. As he got older, he started to feel more comfortable disclosing, especially to other gay artists, who weren’t phased by the news. “I still hadn’t disclosed to my representatives or for bigger jobs,” he says.

IT WAS APRIL OF THIS YEAR, ON THE EVE OF HIS playwriting debut, Día Y Noche , that Anzuelo accidentally disclosed his HIV status to the reporter. When the writer offered to pull the disclosure from the published piece, Anzuelo wasn’t sure what to do.

For guidance, he reached out to friends, his mother and, finally, his professional representative. “My rep said, ‘I don’t think it matters that much anymore. Treatment is so good, and there are a lot of people coming out [with HIV]. I think it’s not an issue in any way for you.” His friends were also encouraging and supportive, and his mother said that if disclosing would help others, he should do it.

“And so we did,” Anzuelo says. The article came out, and his fear that the disclosure might be detrimental to his career was quelled. “It didn’t make a ripple,” he says.

Currently, Anzuelo is as busy as ever, working on a variety of projects: acting, writing, a lot of fight and movement direction and intimacy coordination. “I just did a play off Broadway last season called Shared Sentences with Houses on the Moon Theater Company. That was a very good experience. And I presented an excerpt of a new piece called The Boy Called Lobo. I booked the national tour of Girl from the North Country as fight director and the Broadway production of Merrily We Roll Along.” And his HIV status hasn’t been an issue in any way.

Anzuelo continues, “I booked an episode of American Horror Story. But they cut the scene! I still get paid, but I don’t get to be in the episode.” Some things about show business never change. Q

“YOU SHOULDN’T TALK TO ANYBODY LIKE THAT. YOU’RE NOT PAYING ATTENTION.”

BY JAY LASSITER

A Life of Service

Yolanda Diaz wears many hats. A longtime AIDS activist and community organizer from the Bronx, New York, she is a health educator at Iris House, a nonprofit that provides housing and social services to women at risk for HIV.

In addition to her day job, Diaz volunteers at the U.S. People Living with HIV Caucus (aka the HIV Caucus), a nationwide voice for people living with HIV.

Diaz is also a cofounding member of Positive Women’s Network–USA, a group for HIV-positive women that aims to “strengthen the strategic power of all women living with HIV in the United States.”

Given all that, she has some advice for anyone newly diagnosed with HIV. “Get involved, and start helping other people,” says Diaz. “Get with the community, and continue to save lives.”

Her life exemplifies service to community, which Diaz credits with helping her manage her own 34year battle with HIV. She says she has experienced many ups and downs since her HIV diagnosis in 1989.

“I used drugs to get high,” says Diaz. “I was in the penitentiary. I got arrested and did time in Bedford [Hills Correctional Facility]. When I came home in 1996, I decided to change my life around. And I had people there to help me.”

Diaz pays it forward with her laser-sharp focus on at-risk populations. Some of the women she helps are fleeing abusive relationships. Others are exiting prison. And then there are people who inject drugs, an underserved and heavily stigmatized population that relies on harm reduction interventions to avoid diseases like HIV and viral hepatitis.

“The path to an AIDS-free generation will not happen without that harm reduction work,” she says.

Diaz has vowed to keep fighting the persistent stigma around HIV and AIDS. Her goal is to foster a climate in which more people get tested and know their HIV status.

Prospects for managing HIV can vary depending on geography, says Diaz, citing laws in dozens of states that criminalize HIV transmission and thus perpetuate HIV stigma.

“It depends on what state you live in,” Diaz notes. “You do have HIV decriminalization happening now, but these laws are still on full blast in over 30 states. People get criminalized just for having HIV.

“It’s also very important to develop HIV organizations for people 50 and over,” she says, pointing to changes in America’s HIV population.

According to the National Institutes of Health, people 50 and over account for over half of HIV cases in the United States. This aging cohort also includes a growing number of people like Diaz who are well into their fourth decade managing HIV.

“Back in the 1980s, nobody ever thought we would live to be over 50 years old,” Diaz says. “They’d say, ‘Listen, go sell your life insurance— you’re going to freaking die.’ And here we still are. I’m 61 years old and still living, still planning to go on vacations, still going, still moving.” Q

BILL WADMAN

Yolanda Diaz is a longtime AIDS activist and a longterm HIV survivor.

El tratamiento ayuda a prevenir la transmisión del VIH

Si estás viviendo con VIH, un objetivo fundamental es hacer que tu carga viral sea indetectable. Esto significa que hay tan poca cantidad de virus en la sangre que no puede medirse en una prueba de laboratorio. Los estudios actuales demuestran que seguir el tratamiento como te lo recetaron, lograr un nivel indetectable y mantenerlo evita la transmisión del VIH a través del sexo. Esto también se conoce como I = I.

I = I es importante?

I = I significa indetectable = intransmisible. Ayuda a acabar con el estigma de vivir con VIH, aumenta la concientización acerca de que las medicinas actuales pueden ser eficaces y nos recuerda la importancia de seguir el tratamiento como fue recetado. Mantente empoderado para vivir una vida más larga y saludable.

Habla

con tu proveedor de atención médica

Es importante que seas abierto y honesto con tu proveedor de atención médica para encontrar el tratamiento adecuado para ti y tu rutina. Cuando te reúnes con tu proveedor de atención médica, todas las preguntas son válidas.

¿Por qué

Regímenes completos

ATRIPLA * efavirenz + tenofovir disoproxil fumarate + emtricitabine

Una tableta una vez por día. Cada tableta contiene 600 mg efavirenz + 300 mg tenofovir disoproxil fumarate + 200 mg emtricitabine. Tomar con el estómago vacío. La dosis debe tomarse al acostarse para minimizar los mareos, somnolencia y pérdida de concentración.

BIKTARVY

bictegravir + tenofovir alafenamide + emtricitabine

Una tableta una vez por día. Cada tableta contiene 50 mg bictegravir + 25 mg tenofovir alafenamide + 200 mg emtricitabine. Tomar con o sin alimentos.

CABENUVA cabotegravir + rilpivirine

Un régimen inyectable de larga duración administrado como dos inyecciones intramusculares cada cuatro semanas u ocho semanas. Un mes de preparación con Vocabria (cabotegravir) + Edurant (rilpivirine) es opcional. Tomar con alimentos.

COMPLERA

rilpivirine + tenofovir disoproxil fumarate + emtricitabine

Una tableta una vez por día. Cada tableta contiene 25 mg rilpivirine + 300 mg tenofovir disoproxil fumarate + 200 mg emtricitabine. Tomar con una comida.

DELSTRIGO

doravirine + tenofovir disoproxil fumarate + lamivudine

Una tableta una vez por día. Cada tableta contiene 100 mg doravirine + 300 mg tenofovir disoproxil fumarate + 300 mg lamivudine. Tomar con o sin alimentos.

TABLA DE MEDICAMENTOS PARA EL VIH 2023

Esta tabla de consulta rápida compara opciones de antirretrovirales (ARV) para el tratamiento del VIH, incluyendo las dosis para adultos y las restricciones alimenticias. Para más información, visita poz.com/drugchart/espanol.

* LaversióngenéricaestádisponibleenlosEE.UU (Laspíldorasnosemuestranentamañoreal)

CIMDUO tenofovir disoproxil fumarate + lamivudine

Una tableta una vez por día. Cada tableta contiene 300 mg tenofovir disoproxil fumarate + 300 mg lamivudine. Tomar con o sin alimentos.

DESCOVY

tenofovir alafenamide + emtricitabine

Una tableta una vez por día. Cada tableta contiene 25 mg tenofovir alafenamide + 200 mg emtricitabine. Tomar con o sin alimentos.

EMTRIVA *

emtricitabine (también conocida como FTC)

Una cápsula de 200 mg una vez por día. Tomar con o sin alimentos.

Inhibidores nucleósidos/nucleótidos de la transcriptasa reversa (INTR o nukes)

EPIVIR *

lamivudine (también conocida como 3TC)

Una tableta de 300 mg una vez por día, o una tableta de 150 mg dos veces por día. Tomar con o sin alimentos. También aprobado para el tratamiento del virus de la hepatitis B pero es una dosis más baja. Las personas que viven con ambos virus deben usar la dosis para el VIH.

EPZICOM * abacavir + lamivudine

Una tableta una vez por día. Cada tableta contiene 600 mg abacavir + 300 mg lamivudine. Tomar con o sin alimentos. Debe ser usado sólo por individuos que sean HLA-B*5701.

TEMIXYS tenofovir disoproxil fumarate + lamivudine

Una tableta una vez por día. Cada tableta contiene 300 mg tenofovir disoproxil fumarate + 300 mg lamivudine. Tomar con o sin alimentos.

TRUVADA * tenofovir disoproxil fumarate + emtricitabine

Una tableta una vez por día. Cada tableta contiene 300 mg tenofovir disoproxil fumarate + 200 mg emtricitabine. Tomar con o sin alimentos.

DOVATO dolutegravir + lamivudine

Una tableta una vez por día. Cada tableta contiene 50 mg dolutegravir + 300 mg lamivudine. Tomar con o sin alimentos.

GENVOYA

elvitegravir + cobicistat + tenofovir alafenamide + emtricitabine

Una tableta una vez por día. Cada tableta contiene 150 mg elvitegravir + 150 mg cobicistat + 10 mg tenofovir alafenamide + 200 mg emtricitabine. Tomar con alimentos.

Inhibidores de la proteasa (IP)

EVOTAZ atazanavir + cobicistat

Una tableta una vez por día. Cada tableta contiene 300 mg atazanavir + 150 mg cobicistat. Tomar con alimentos.

KALETRA *

lopinavir + ritonavir

Dos tabletas dos veces por día, o cuatro tabletas una vez por día, dependiendo de la resistencia a los medicamentos para el VIH. Cada tableta contiene 200 mg lopinavir + 50 mg ritonavir. Tomar con o sin alimentos.

PREZCOBIX darunavir + cobicistat

Una tableta una vez por día. Cada tableta contiene 800 mg de darunavir + 150 mg cobicistat. Tomar con alimentos.

PREZISTA darunavir

Una tableta de 800 mg o dos tabletas de 400 mg más una tableta de 100 mg de Norvir una vez por día, o una tableta de 600 mg más una tableta de 100 mg de Norvir dos veces por día, dependiendo de la resistencia a los medicamentos. Tomar con alimentos.

REYATAZ * atazanavir

Dos cápsulas de 200 mg una vez por día, o una cápsula de 300 mg más una tableta de 100 mg de Norvir una vez por día. Tomar con alimentos.

ISENTRESS

raltegravir

Inhibidores de la integrasa

VIREAD * tenofovir disoproxil fumarate

Una tableta de 300 mg una vez por día. Tomar con o sin alimentos.

ZIAGEN * abacavir

Una tableta de 300 mg dos veces por día, o dos tabletas de 300 mg una vez por día. Tomar con o sin alimentos. Debe ser usado sólo por individuos que sean HLA-B*5701 negativos.

Dos tabletas de 600 mg de Isentress HD (ver imagen) una vez por día para aquellos que nunca tomaron tratamiento o cuyo virus fue suprimido en un régimen inicial de Isentress. Una tableta de 400 mg de Isentress dos veces por día para las personas con experiencia en el tratamiento del VIH. Tomar con o sin alimentos.

TIVICAY dolutegravir

Una tableta de 50 mg una vez por día para aquellos que comienzan la terapia ARV por primera vez o que no hayan usado un inhibidor de la integrasa en el pasado. Una tableta de 50 mg dos veces por día para las personas con experiencia en tratamiento que tengan VIH resistente a otros inhibidores de la integrasa y cuando sean tomados con ciertos ARVs. Tomar con o sin alimentos.

VOCABRIA cabotegravir

Una tableta de 30 mg tomada una vez por día con Edurant de una toma diaria durante un mes como opción de régimen preparatorio antes de cambiar a las inyecciones de Cabenuva o para un tratamiento corto. Tomar con alimentos.

Regímenes completos

DOVATO dolutegravir + lamivudine

Una tableta una vez por día. Cada tableta contiene 50 mg dolutegravir + 300 mg lamivudine. Tomar con o sin alimentos.

GENVOYA elvitegravir + cobicistat + tenofovir alafenamide + emtricitabine

Una tableta una vez por día. Cada tableta contiene 150 mg elvitegravir + 150 mg cobicistat + 10 mg tenofovir alafenamide + 200 mg emtricitabine. Tomar con alimentos.

tenofovir disoproxil fumarate + 200 mg emtricitabine. Tomar con o sin alimentos.

VIREAD *

tenofovir disoproxil fumarate

Una tableta de 300 mg una vez por día. Tomar con o sin alimentos.

ZIAGEN * abacavir

Una tableta de 300 mg dos veces por día, o dos tabletas de 300 mg una vez por día. Tomar con o sin alimentos. Debe ser usado sólo por individuos que sean HLA-B*5701 negativos.

Inhibidores TIVICAY dolutegravir

Una tableta de 50 mg una vez por día para aquellos que comienzan la terapia ARV por primera vez o que no hayan usado un inhibidor de la integrasa en el pasado. Una tableta de 50 mg dos veces por día para las personas con experiencia en tratamiento que tengan VIH resistente a otros inhibidores de la integrasa y cuando sean tomados con ciertos ARVs. Tomar con o sin alimentos.

VOCABRIA cabotegravir

Una tableta de 30 mg tomada una vez por día con Edurant de una toma diaria durante un mes como opción de régimen preparatorio antes de cambiar a las inyecciones de Cabenuva o para un tratamiento corto. Tomar con alimentos.

JULUCA dolutegravir + rilpivirine

Una tableta una vez por día. Cada tableta contiene 50 mg dolutegravir + 25 mg rilpivirine. Tomar con una comida.

ODEFSEY rilpivirine + tenofovir alafenamide + emtricitabine

Una tableta una vez por día. Cada tableta contiene 25 mg rilpivirine + 25 mg tenofovir alafenamide + 200 mg emtricitabine. Tomar con una comida.

STRIBILD elvitegravir + cobicistat + tenofovir disoproxil fumarate + emtricitabine

Una tableta una vez por día. Cada tableta contiene 150 mg elvitegravir + 150 mg cobicistat + 300 mg tenofovir disoproxil fumarate + 200 mg emtricitabine. Tomar con alimentos.

SYMFI AND SYMFI LO

efavirenz + tenofovir disoproxil fumarate + lamivudine

Una tableta de Sym o Sym Lo una vez por día. Cada tableta de Sym contiene 600 mg efavirenz + 300 mg tenofovir disoproxil fumarate + 300 mg lamivudine. Cada tableta de Sym Lo (en imagen) contiene 400 mg efavirenz + 300 mg tenofovir disoproxil fumarate + 300 mg lamivudine. Tomar con el estómago vacío. La dosis debe ser tomada al acostarse para minimizar los mareos, somnolencia y pérdida de concentración.

SYMTUZA darunavir + cobicistat + tenofovir alafenamide + emtricitabine

Una tableta una vez por día. Cada tableta contiene 800 mg darunavir + 150 mg cobicistat + 10 mg tenofovir alafenamide + 200 mg emtricitabine. Tomar con alimentos.

TRIUMEQ dolutegravir + abacavir + lamivudine

Una tableta una vez por día. Cada tableta contiene 50 mg dolutegravir + 600 mg abacavir + 300 mg lamivudine. Tomar con o sin alimentos. Debe ser usado sólo por individuos que sean HLA-B*5701 negativos.

Inhibidores no-nucleósidos de la transcriptasa reversa (INNTR o no-nukes )

EDURANT rilpivirine

Una tableta de 25 mg una vez por día. Tomar con alimentos.

INTELENCE etravirine

Una tableta de 200 mg dos veces por día. Tomar con alimentos.

PIFELTRO doravirine

Una tableta de 100 mg una vez por día. Tomar con o sin alimentos.

SUSTIVA * efavirenz

Una tableta de 600 mg (ver imagen) una vez por día, o tres cápsulas de 200 mg una vez por día. Tomar con el estómago vacío o con un snack bajo en grasa. La dosis debe tomarse al acostarse para minimizar los mareos, somnolencia y pérdida de concentración.

RUKOBIA fostemsavir

Una tableta de 600 mg dos veces por día para personas con experiencia en el tratamiento del VIH. Tomar con o sin alimentos.

Inhibidores de la entrada

SELZENTRY maraviroc

Una tableta de 150 mg, 300 mg (ver imagen) o 600 mg dos veces por día, dependiendo de los otros medicamentos utilizados, para personas con experiencia en el tratamiento del VIH. Tomar con o sin alimentos.

TROGARZO ibalizumab

Un inyectable de larga duración de administración intravenosa como dosis única de 2,000 mg seguido de una dosis de mantenimiento de 800 mg cada dos semanas para personas con experiencia en el tratamiento del VIH.

Potenciadores de PK

NORVIR * ritonavir

Norvir generalmente se toma para potenciar los niveles de otros ARVs en la sangre. Tomar con alimentos.

TYBOST cobicistat

Una tableta de 150 mg una vez por día en combinación con ARVs que requieren refuerzos. Utilizado sólo para potenciar otros medicamentos. Tomar con alimentos.

Inhibidores cápsidos

SUNLENCA lenacapavir

Las tabletas de Sunlenca se toman como dosis de carga, con inyecciones cada seis meses desde ese momento en adelante. Tomar con o sin alimentos.

Estos medicamentos antirretrovirales raramente se recetan y ya no se recomiendan:

APTIVUS tipranavir

COMBIVIR * zidovudine + lamivudine

CRIXIVAN indinavir

FUZEON enfuvirtide

INVIRASE saquinavir

LEXIVA fosamprenavir

RETROVIR * zidovudine (AZT)

TRIZIVIR abacavir + zidovudine + lamivudine

VIRACEPT nelfinavir

VIRAMUNE nevirapine

ZERIT stavudine

bien con VIH

Puedes vivir bien con VIH

Es importante comenzar el tratamiento para el VIH lo antes posible y cumplirlo. Recuerda seguir tu tratamiento como te lo recetaron y mantenerte comprometido con los cuidados. Cuidarte a ti mismo es una gran manera de ayudarte a vivir bien con VIH.

Es importante comenzar el tratamiento para el VIH lo antes posible y cumplirlo. Recuerda seguir tu tratamiento como te lo recetaron y mantenerte comprometido con los cuidados. Cuidarte a ti mismo es una gran manera de ayudarte a vivir bien con VIH.

Es señal de poder mantener tu salud sexual

Es señal de poder mantener tu salud sexual

El VIH no tiene que ser un impedimento para que sigas siendo tú. Descubre consejos útiles y apoyo para seguir viviendo tu vida de forma auténtica.

VIH no que ser un sigas siendo tú. Descubre consejos útiles y apoyo para seguir viviendo tu vida de forma auténtica.

Encuentra más información y útiles HelpStopTheVirus.com

Encuentra más información y recursos útiles en HelpStopTheVirus.com

de GILEAD son marcas comerciales de Gilead Sciences, Inc.

las demás de sus respectivos

derechos reservados. US-UNBC-1236 05/23

El tratamiento ayuda transmisión

El tratamiento ayuda transmisión

Si estás viviendo hacer que tu carga que hay tan poca no puede medirse estudios actuales como te lo recetaron, mantenerlo evita sexo. Esto también

Si estás viviendo hacer que tu carga que hay tan poca no puede medirse estudios actuales como te lo recetaron, mantenerlo evita sexo. Esto también

¿Por qué I = I es importante?

¿Por qué I = I es importante?

I = I significa indetectable = intransmisible. Ayuda con el estigma de vivir con VIH, aumenta la concientización acerca de que las medicinas actuales pueden nos recuerda la importancia de seguir el tratamiento fue recetado. Mantente empoderado para vivir larga y saludable.

I = I significa indetectable = intransmisible. Ayuda con el estigma de vivir con VIH, aumenta la concientización acerca de que las medicinas actuales pueden nos recuerda la importancia de seguir el tratamiento fue recetado. Mantente empoderado para vivir larga y saludable.

Habla proveedor atención

Habla proveedor atención

Es importante que proveedor de atención tratamiento adecuado reúnes con tu proveedor las preguntas son

Es importante proveedor de atención tratamiento adecuado reúnes con tu proveedor las preguntas son

tratamiento ayuda a prevenir la transmisión del VIH

tratamiento ayuda a prevenir la transmisión del VIH

viviendo con VIH, un objetivo fundamental es carga viral sea indetectable. Esto significa poca cantidad de virus en la sangre que medirse en una prueba de laboratorio. Los actuales demuestran que seguir el tratamiento recetaron, lograr un nivel indetectable y evita la transmisión del VIH a través del también se conoce como I = I.

viviendo con VIH, un objetivo fundamental es carga viral sea indetectable. Esto significa poca cantidad de virus en la sangre que medirse en una prueba de laboratorio. Los actuales demuestran que seguir el tratamiento recetaron, lograr un nivel indetectable y evita la transmisión del VIH a través del también se conoce como I = I.

Comienza el tratamiento para el VIH lo más pronto posible

Ayuda a acabar concientización

pueden ser eficaces y tratamiento como vivir una vida más

Ayuda a acabar concientización pueden ser eficaces y tratamiento como vivir una vida más

Habla

con tu proveedor de atención médica

que seas abierto y honesto con tu atención médica para encontrar el adecuado para ti y tu rutina. Cuando te proveedor de atención médica, todas son válidas.

que seas abierto y honesto con tu atención médica para encontrar el adecuado para ti y tu rutina. Cuando te proveedor de atención médica, todas son válidas.

Aprende cómo cuidar tu salud

Aprende cómo cuidar tu salud

Si estás viviendo con VIH, habla con tu proveedor de atención médica acerca de las opciones de tratamiento.

Si estás viviendo con VIH, habla con tu proveedor de atención médica acerca de las opciones de tratamiento.

Help Stop the Virus proporciona recursos e información que pueden ayudarte a mantenerte comprometido con tu salud. Visita HelpStopTheVirus.com

Help Stop the Virus proporciona recursos e información que pueden ayudarte a mantenerte comprometido con tu salud. Visita HelpStopTheVirus.com

MIRA ADENTRO

Las personas en la fotografía son modelos