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. Tell your healthcare provider if you become pregnant while taking BIKTARVY.
` Are breastfeeding (nursing) or plan to breastfeed. Talk to your healthcare provider about the risks of breastfeeding during treatment with BIKTARVY. Tell your healthcare provider about all the medicines you take:
` Keep a list that includes all prescription and over-thecounter medicines, antacids, laxatives, vitamins, and herbal supplements, and show it to your healthcare provider and pharmacist.
` BIKTARVY and other medicines may a ect each other. Ask your healthcare provider and pharmacist about medicines that interact with BIKTARVY, and ask if it is safe to take BIKTARVY with all your other medicines.
POSSIBLE SIDE EFFECTS OF BIKTARVY
BIKTARVY may cause serious side e ects, including:
` Those in the “Most Important Information About BIKTARVY” section.
` Changes in your immune system. Your immune system may get stronger and begin to 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.
Ask your healthcare provider if BIKTARVY is right for you. For her today and her tomorrow. People featured are compensated by Gilead. tomorrow.
*Source: IQVIA NPA Weekly, 04/19/2019 through 05/19/2023.
“I’ve learned how to live with HIV, and my children and my family are a huge part of that.”
MARICELA SWITCHED TO BIKTARVY®
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.
Alex Torres Marrero is a longtime
POZ BLOGS
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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.
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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 THE POWER OF A STORY WELL TOLD Francisco Ruiz shares his vision for HIV advocacy. BY MATHEW RODRIGUEZ
28 SOMEBODY TO SHARE Shawn Decker reflects on his 20 years of marriage to Gwenn Barringer. BY SHAWN DECKER
3 FROM THE EDITOR
4 POZ Q & A
Paul Renfro, PhD—the author of a new book titled The Life and Death of Ryan White —puts the life and legacy of the late AIDS activist in context.
6 POZ PLANET
The Wall Las Memorias opens a new spot • a new HIV center in Austin, Texas • ensuring access to long-acting HIV drugs
• the International AIDS Society welcomes a new president • POZ Stories: Jordan Edwards • Everyday: HIV milestones
11 VOICES
The director of the White House Office of National AIDS Policy touts implementation updates to the National HIV/AIDS Strategy
• a farewell to aidsmap from long-term survivor and HIV journalist Gus Cairns
14 SPOTLIGHT
The 25th International AIDS Conference
16 NUTRITION & FITNESS
Citrus quinoa avocado salad • fruits
17 BASICS
HIV and your kidneys
18 CARE & TREATMENT
Twice-yearly PrEP 100% effective for women • more resources are needed to end the HIV pandemic • daily doxyPrEP to prevent sexually transmitted infections • new anal cancer screening guidelines
20 RESEARCH NOTES
STI testing • from complex regimens to one pill a day • a 7th HIV cure • abacavir and heart risk
32 HEROES
advocate Alex Torres Marrero
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Yo Soy La Voz
IGREW UP LISTENING TO
Celia Cruz. As a first-generation Cuban American, I regarded her music to be synonymous with my heritage. Singers such as Dolly Parton and Madonna have similar symbolism for other communities.
Celia’s career spanned decades. She began performing in 1950s Cuba, became the Queen of Salsa in the 1970s while living in exile in the United States and embraced reggaeton-inspired music in her later years until her death in 2003. Her catchphrase ¡Azúcar! (Sugar! ) is forever evocative of salsa music worldwide.
So I’m thrilled that Celia will be featured on the 2024 U.S. quarter. She is the first AfroLatina to have this honor. It may not seem like such a big deal, but please take my word for it that it is. These days, when Latinos, especially Latino immigrants, are facing such tough times in the United States, it matters to feel like you are seen and heard.
So many songs in Celia’s catalog stand out, but for me, one in particular always gives me the feels. “Yo Soy La Voz” (“I Am the Voice”) is a deep cut from a 1969 album titled Quimbo Quimbumbia, which also features Tito Puente, the King of the Timbales (a type of drums).
It’s a love song to Cuba, in which she shares her desire to return some day. That emotion is common to all Cubans who were exiled. Even though I was born in New York City, I understand that longing for home and the tragedy of never achieving that goal. May those undergoing similar hardships have better outcomes and brighter futures.
In that spirit, this special issue highlighting Latinos spotlights HIV advocates who are working to improve the lives of those living with or at risk for the virus.
Francisco Ruiz, our cover subject, is a fine example. The longtime HIV advocate was doing the work well before he became HIV positive himself. He’s now the first Latino director of the White House Office of National AIDS Policy (ONAP). Please go
to page 22 to learn more about his new role.
Alex Torres Marrero is another great example. As the senior director of policy, prevention and harm reduction at Hyacinth, the largest AIDS service organization in New Jersey, he has had far-reaching influence on HIV-related law in the state. Go to page 32 for more.
As ONAP director, Francisco sits at the intersection of HIV-related efforts across the federal government. Earlier this year, he met with federal agencies engaged in implementing the National HIV/AIDS Strategy. Go to page 11 to learn about their progress.
Not all Latinos speak or read Spanish, but having HIV information available in Spanish will always be an important part of the fight against the virus among Latinos.
In support of that vision, please find the 2024 edition of POZ en Español bound in the center of this print issue of POZ. HIV advocate David Ernesto Munar is the cover subject. He shares the lessons he’s learned in his 30-year journey of living with the virus.
Please also go to the back of this print issue of POZ for the 2024 HIV drug chart in Spanish.
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.
RYAN WHITE’S LEGACY
A new book puts the late AIDS activist’s life into context.
WHEN IT COMES TO MEDIA COVERAGE OF HIV, FEW Americans have garnered as many headlines as Ryan White. But there is a difference between the person and the cultural figure.
In his new book, The Life and Death of Ryan White (The University of North Carolina Press), Paul Renfro, PhD, associate professor of history at Florida State University, plumbs the depths of those contrasts.
White, who had hemophilia, contracted HIV in 1984 at age 13 from a blood transfusion. He faced intense AIDS-related discrimination from his Indiana community when he attempted to return to school after his diagnosis. He gained worldwide attention as he fought tirelessly for his right to attend school. White died in 1990 at age 18.
At the core of Renfro’s book is the notion of innocence. The book, out this month, also examines how White’s story tugged at America’s heartstrings while sometimes reinforcing hierarchies of people with AIDS.
“Innocence is such a powerful idea,” Renfro says. “A lot of AIDS activists sought to counteract the power of that perceived innocence.” Renfro spoke to POZ about why he wrote this book, what it has to say about illness in 2024 and what White’s story means in relation to other figures with HIV, such as the infamous Patient Zero. This interview has been edited and condensed for clarity.
When did you become interested in Ryan White’s story and dedicate a book to it?
It’s a story that I grew up with. As soon as I was kind of conscious of what HIV and AIDS were, he was deeply embedded in my mind. I realized that it hadn’t received a book-length treatment that matched the enormity and importance of the story. The
story has a pedagogical element to it, and that’s how I first encountered it: as a child in school, where the story is harnessed to teach lessons about tolerance. I thought there was an opportunity to complicate that story in a way that could be accessible for a variety of audiences.
You open the book with a discussion of the artist collective Gran Fury’s piece All People With AIDS Are Innocent. Why did you want that to be the first thing readers encounter?
Innocence is such a powerful idea and one that governs how people approach a variety of issues, not just HIV and AIDS. I wrote my first book about mass incarceration, and innocence is paramount to how people approach that issue, how they understand who is good or bad, who is or isn’t incarcerated. It still governs how people approach disease, how they approach the criminal legal
Paul Renfro, PhD; right: cover of The Life and Death of Ryan White
system, how we tend to rank and judge each other. So I wanted to foreground that, to demonstrate: OK, this is how a lot of people conceive of Ryan’s story but also how a lot of AIDS activists sought to counteract the power of that perceived innocence.
It reminded me of Richard McKay’s book, Patient Zero: The Making of the AIDS Epidemic, which looks at a figure on the other end of the cultural spectrum regarding innocence. I love that book. People still use “patient zero” as a descriptor, and it has this tremendous power. Richard is—and, hopefully, I am—trying to dislodge some of that and complicate how people conceive of these things that are firmly entrenched.
Your book is coming out at a time when a lot of books about AIDS are getting published. People are really reexamining the AIDS crisis and adding more and more stories to it. Why did you want to revisit Ryan White’s story, and what do you think it has to say in 2024? There’s this notion of the “pastness” of AIDS. There’s a desire to localize it within the ’80s and ’90s, which is not the case. The ongoing COVID-19 crisis looms over the book. It’s complicated, because people want to make really easy analogies, but it’s not that simple. There are lessons or patterns that we can look to and say, “This same sort of thing is happening.” And this isn’t just unique to HIV and comparing it to COVID. In the book, I talk about mpox and these sorts of patterns of blame and this desire to “move past” each one.
This book is also about disability, not only in terms of HIV but in terms of Ryan’s status as a person living with hemophilia. Were you looking to make this about disability as well? That first chapter is very much animated by disability studies. Ryan’s family approached disability as overcoming adversity. It’s something I view within the context of the book as aligning with this discourse of perseverance and resilience. It translates into how he approaches AIDS.
People with hemophilia have an interesting position within HIV and AIDS. They face HIV at enormous rates, and they’re understood to be uniquely susceptible, but they have this position as a group with a disability that has a sense of innocence that is not afforded to other populations that are disproportionately affected by AIDS, especially in the early years of the epidemic.
That understanding of disability shapes how Ryan’s story gets presented, and it enables him to become a really major figure within the early history of AIDS in the United States and beyond, because of the attitude that he is an exceptional person with AIDS.
Later in that chapter, too, you talk about how in his autobiography, Ryan discusses people in Kokomo, Indiana, where he grew up, and how he says some stigmatizing things about people who use drugs. Did it worry you at all to take Ryan’s family to task or say something critical of someone who is so universally cherished? In this passage in his book, he is saying something to the effect of, “People who use drugs are doing that because it’s a choice, it’s something they don’t fully understand the implications of because I’m someone who has to be stuck with needles.” It’s a troubling claim, but it’s also unclear whether he is the one who’s expressing these ideas or if it’s Ann Marie Cunningham, who was the coauthor of his autobiography, which was posthumously published.
To answer your question directly: Yes, I was concerned. I don’t try to just take the White family to task during the book, because I think there’s a lot to admire about his story. It’s a complicated story, one that doesn’t have heroes and villains. The ways in which Ryan’s story has been deployed by him and by others can be understood to be problematic. But at the same time, there’s also a criticism to be leveled or a critique to be developed, and I wanted to wrestle with that while at the same time—hopefully—honoring the really admirable parts of his story.
I think your book asks us to look at Ryan’s story as well as the media
construction of his story—the person and the figure.
You have people from the late Senator Jesse Helms to AIDS activists who were deploying it for these different purposes, and that speaks to the kind of malleability of his story. It would be difficult for a Ryan White–caliber figure to emerge in a time before cable news and the developing 24-hour news cycle. It says a lot about celebrity. Ryan White is very clearly the product of that cultural construction.
He was a person, but at the same time, he was larger than life. The fact that he was unassailable is important because no one, even people who were saying, “I don’t want this kid in our middle school,” was going to say, “I hate this child.” They’re all saying, “Our enemy is not Ryan White.” Q
The Wall Las Memorias Opens New Spot
The Los Angeles health organization provides HIV services.
The Wall Las Memorias (TWLM), which provides health and wellness services to Latino, LGBTQ and other underserved populations, hosted a grand opening for its new downtown Los Angeles Hub with a ribbon-cutting ceremony and open house in August.
The new office is the group’s third and its second in downtown Los Angeles. The nonprofit marks 30 years of service this year.
Serving LGBTQ people as well as low-income and harder-to-reach populations, TWLM offers various specialized services, including HIV testing and prevention, preexposure prophylaxis (PrEP) access, substance use services and mental health services.
In 2021, an estimated 50,466 people— about 4.6% of the HIV population in the country—were living with HIV in Los Angeles County, according to AIDSVu data.
TWLM opened its new office to better serve greater downtown LA.
Dozens of political and community leaders, including California State Senator Lola Smallwood Cuevas and Mayor Karen Bass, attended the grand opening.
“Dreams come true with the opening of our downtown hub to better serve our LGBTQ+ and other underserved communities. With the new location and extended hours, we can provide HIV testing to our community members,” said Richard Zaldivar, TWLM executive director and founder, in a news release.
NEW HIV CENTER IN AUSTIN
In 2004, the organization constructed The Wall Las Memorias AIDS Monument in LA’s Lincoln Park. The monument consists of eight wall panels depicting life with AIDS among Latinos and honors community members who lost their lives to AIDS. Today, it has over 1,600 names etched into it.
The nonprofit aims to improve community health through free access to quality care, public education and more.
It also offers support groups and safe spaces to promote personal growth and empowerment.
This year, TWLM launched “¡Ya Basta!” (“Stop!” or “Enough!” in Spanish), a grassroots effort to address HIV- and AIDS-related stigma; work for social justice; promote democratic norms; and fight homophobia, transphobia and racism. The program empowers individuals through education, leadership development and community action. —Laura Schmidt
Most new cases in the region are among Latino and Black men.
AIDS Healthcare Foundation (AHF) opened a new HIV clinic in Austin, Texas, that provides comprehensive care, including HIV testing, treatment, medical services, a pharmacy and services related to sexually transmitted infections (STIs), reports Fox 7.
Austin Mayor Kirk Watson joined other local and state officials at the ribbon cutting in August. The HIV clinic is located at 2927 Guadalupe Street, near West 30th Street.
Founded in 1987 and billed as the “largest provider of HIV medical care in the world,” AHF is based in Los Angeles. According to its website, HIVCare.org, AHF operates HIV health care centers in 16 states plus Washington,
DC, and Puerto Rico and nearly 50 countries globally.
Like many of its locations, the AHF clinic in Austin includes an Out of the Closet thrift store, where 96 cents of every dollar made goes into providing HIV services.
“One of our key missions for AHF is providing cutting-edge medicine and advocacy—regardless of an individual’s ability to pay,” Anthony Snipes, regional director of AIDS Healthcare Foundation–Texas, told FOX. “When you walk through the doors, not only are you getting the ability to shop, but you’re also getting the ability to be served at our health care center.”
According to data compiled at AIDSVu.org, an estimated 7,128 people were living with HIV in Austin (Travis County) in 2021, with a prevalence rate of 508 people per 100,000. For comparison, the prevalence rate in the United States is 384; throughout the South, it is 461; and in Texas it is 415.
Looking at new HIV diagnoses in Travis County, AIDSVu notes that Latinos accounted for 50.5% of new cases, African Americans accounted for 19.8% and white people accounted for 24.4%. The majority of new diagnoses (66.7%) were among people ages 25 to 44. What’s more, 72.5% of the new cases were a result of male-to-male sexual contact.
Texas remains one of 10 states (mostly in the South) that have not expanded Medicaid, the federal and state program that provides health coverage for low-income adults, children, pregnant women and others. —Trent Straube
Ensuring Access to Long-Acting HIV Drugs
A policy brief by experts makes recommendations for Medicaid.
A policy brief written by health advocate experts urges Medicaid leadership to capitalize on the promise of long-acting antiretrovirals to treat and prevent HIV. The brief spells out a series of recommendations to ensure that people eligible for Medicaid have access to these “game-changing” injectable HIV meds.
The O’Neill Institute for National and Global Health Law at Georgetown University Law Center drafted the brief in partnership with Amida Care, a nonprofit Medicaid health plan that specializes in LGBTQ and HIV clients, and Cicatelli Associates (CAI) TAP-in project (CAI helps agencies improve the quality of their services).
The eight-page brief, titled “Medicaid Leadership Must Ensure Access to Longer-Acting HIV Products,” as well as a single-page summary, is available at Oneill.Law.Georgetown.edu.
Long-acting injectable antiretrovirals are effective options for people who can’t take daily pills as HIV treatment or as pre-exposure prophylaxis (PrEP) to prevent HIV. Despite the promise of these injectables, advocates remain concerned about price and access.
Medicaid is the joint federal and state program that offers health insurance and comprehensive health care services to low-income individuals and families, pregnant women, people with disabilities and others who meet the requirements.
In describing the policy brief, the O’Neill Institute explains the importance of Medicaid and long-acting antiretrovirals in the nation’s fight against HIV and AIDS:
“As a country, the United States has made incredible strides toward the goal of ending the HIV epidemic. However, progress has been uneven and unacceptable inequities remain. Factors, such as poverty, lack of transportation, limited English proficiency and experiences of discrimination in health care settings—all common among Medicaid beneficiary communities, particularly LGBTQ communities and communities of color—regularly undermine engagement to prevention and treatment efforts.
“Pre-exposure prophylaxis is a game-changing HIV prevention medication that has been available for over a decade, yet PrEP uptake is lower among those who are covered by Medicaid than those who have private insurance. Systemic barriers disproportionately impact Black, Latinx and transgender communities, who are more likely to be Medicaid-eligible. These communities often experience multiple barriers to care, resulting in reduced access to and utilization of PrEP compared to their white counterparts and exacerbating health disparities.” —TS
IAS WELCOMES NEW PRESIDENT
Beatriz Grinsztejn heads the International AIDS Society.
The International AIDS Society (IAS) welcomed Beatriz Grinsztejn, MD, PhD, from Brazil as IAS president and Kenneth Ngure, PhD, from Kenya as president-elect. The IAS leadership also expressed deep gratitude to Sharon Lewin, MD, from Australia who stepped down as IAS president and assumed her role as immediate past president.
Grinsztejn, a leading infectious disease physician and researcher, cofounded FIOCRUZ HIV/AIDS Service, the largest care provider in Rio de Janeiro, and served for 25 years as director of the HIV/AIDS Clinical Research Unit at the Evandro Chagas National Institute of Infectious Diseases–FIOCRUZ.
Addressing delegates at the closing ceremony of AIDS 2024, the 25th International AIDS Conference, Grinsztejn underscored the conference’s theme: “Put people first!”
“As a lesbian from Latin America and the director of the first sexual and gender minorities’ health clinic in Rio de Janeiro, I witness firsthand every day how we are still failing the most marginalized people. In Brazil, new HIV acquisitions are rising among young Black men who have sex with men, illustrating the structural gender-related violence and racism fueling the epidemic,” Grinsztejn said.
Grinsztejn
Grinsztejn is also a leader in clinical research for the development of new HIV prevention tools, including an important study to evaluate long-acting injectable cabotegravir (Apretude) in HIV-negative men who have sex with men and trans women (HPTN 083). A pioneering champion of LGBTQ rights, she also led efforts to introduce gender-affirming care in Brazil.
Citing scientific breakthroughs presented at AIDS 2024, she called for equitable rollout of groundbreaking prevention drugs.
“The promise of long-acting injectables highlights the need to ensure access across the global South. For prevention to work, we need to ensure everyone everywhere has access to the latest technologies.”
She went on to warn of donor fatigue, the rise of authoritarian governments and shrinking civil space. Grinsztejn called for sustained funding and resources for efforts to achieve global HIV targets.
“Crossing the last mile to end AIDS as a public health threat will require more attention and resources. International mechanisms such as PEPFAR [The United States President’s Emergency Plan for AIDS Relief] and The Global Fund are under pressure. Now is not the time to question the value of these vital organizations.” —IAS
Beatriz
Creating Safe Space Jordan Edwards turned his sensitivity into his superpower.
As a Black queer man raised in a religious household in the South, I spent most of my life prioritizing being loved by others over loving myself. I felt that to be loved by my family, my community and God, I had to hide parts of myself. I was ashamed of my sensitive side, not realizing my empathy was a gift. Many men carry this same burden and fear being vulnerable.
When I began to understand my sexuality, I continued to search for love externally, and in 2013, I was diagnosed with HIV. This journey has not been easy, but it has helped me to begin to shed the pressures of living with shame or living for others. It gave space for me to start a new relationship with myself and see that I am loved, accepted and in community as my truest version of myself. Now, I create safe space and advocate for everyone to live authentically. I have turned my Achilles’ heel, my sensitivity, into my superpower.
EVERYDAY
October
What adjectives best describe you? Empathetic. Vulnerable. Nonjudgmental. These traits enable me to connect deeply with others and create a safe space for sharing and healing.
What is your greatest achievement? Helping others find their start in the HIV field and self-empowerment. Through my own journey, I’ve created pathways for others to discover their passion for sexual health and personal wellness.
What is your greatest regret?
My greatest regret is not sharing my full self with my grandmother before her passing. She always advocated for my freedom, and I know she would be proud to see how I love myself and live freely.
What is the best advice you’ve received? “You have already disappointed them, and you probably will again, so now, what is holding you back?” Meaning we have no control of others, and we should stop living to meet their expectations of us.
If you could change one thing about living with HIV, what would it be?
The issue is not the status itself, but the stigma about what being positive means. I wish for greater understanding about HIV and more inclusivity in these conversations for cis women and trans men.
What person in the HIV community do you most admire? Hydeia Broadbent. As a young girl, she advocated for awareness, but most importantly, she led with joy and hope through normalizing that she was not less than human due to her HIV status.
What keeps you up at night?
The fear that I am not doing enough. HIV is still stigmatized, and there is always more to be done to create the world I want to see, where everyone is able to live proudly as their true selves.
What drives you to do what you do?
My 8-year-old self who didn’t think he would live past 21. I want to now give him the love that he deserved so many years ago and help others in similar situations achieve that same self-acceptance.
What is your motto?
I want peace—within myself, for others, for my community and for the world. In a world that tries to make us feel at conflict with ourselves and each other, peace of mind is worth fighting for.
Read other POZ Stories or share your own at poz.com/stories.
These dates represent milestones in the HIV epidemic. Visit poz.com/aidsiseveryday to learn more about the history of HIV and AIDS. BY
U2’s Bono and Oprah Winfrey go on a shopping spree on Chicago’s Magnificent Mile to promote the launch of (PRODUCT) RED, which supports The Global Fund. (2006)
12 15
16
Nan Goldin organizes WITNESSES: AGAINST OUR VANISHING, an exhibition at Artists Space of New York artists responding to the AIDS crisis. (1989)
29
LATINX HIV/AIDS AWARENESS DAY
Pop star MILEY CYRUS becomes the latest celebrity spokesperson for MAC Cosmetics’ Viva Glam makeup line, which raises money to help people living with HIV. (2014)
November 23
27
The United Nations announces that, for the first time, about HALF OF ADULTS LIVING WITH HIV WORLDWIDE ARE WOMEN. (2002)
The film version of RENT, the awardwinning musical about bohemians struggling with life, love and AIDS in New York City’s East Village neighborhood, opens in the United States. (2005)
JENNIFER MORTON
Jordan Edwards
Nan Goldin
Bono and Winfrey
ACTION ITEMS
EARLIER THIS YEAR, I WAS pleased to meet with more than 35 representatives of federal agencies engaged in implementing the National HIV/AIDS Strategy (NHAS). The NHAS Federal Implementation Workgroup (FIW) consists of representatives of the agencies that contributed to developing the strategy and who share responsibility for its implementation.
During the meeting, we reviewed the latest national HIV data from the Centers for Disease Control and Prevention (CDC), which are being used to monitor the 21 NHAS indicators of progress. The data, from 2022, indicate that we are going in the right direction in most cases. But the progress is incremental, and it varies across jurisdictions and demographic groups. Soon, additional data that are being used to monitor some of the indicators will be published. Later this year, we anticipate sharing an update on our progress toward the NHAS goals.
Members from 16 different agencies and o ces shared updates about their work to pursue the action items detailed in the NHAS Federal Implementation Plan. Among the things we heard about:
• The Department of Justice’s con-
tinued work on HIV services in the Federal Bureau of Prisons, which have resulted in very high rates (>96%) of viral suppression among people in custody who have HIV;
• Recent work by the Department of Justice’s Civil Rights Division addressing both health care discrimination and HIV criminalization;
• Work by the Substance Abuse and Mental Health Services Administration across several programs to advance integration of behavioral and physical health, including HIV, STI [sexually trans mitted infections] and viral hepatitis services;
• The Department of Veterans Affairs’ work to expand syringe services programs;
• The integration of people with HIV into programing led by the HHS [Health and Human Services] Administration on Community Living addressing social isolation and chronic disease selfmanagement among older Americans;
• Technical assistance being offered by the Department of Housing and Urban Development to support communities in preparing for and swi ly responding to HIV outbreaks;
• New efforts within the Title X program to scale up HIV pre-exposure
prophylaxis services offered at family planning clinics;
• CDC’s work to update guidelines on HIV screening in clinical settings, which will help providers know where to focus screening for most impact;
• Continued annual increases in the number of HIV tests at health centers and analysis indicating that about 19% of recent HIV PrEP users are being served by health centers as they have worked to scale up PrEP services;
• Collaborative work by Health Resources and Services Administration’s HIV/AIDS Bureau and the CDC over the past year on community engagement and current work to synthesize the themes from 14 regional listening sessions that will be shared with the community soon.
We also discussed initial plans to begin work on developing the 2026–2030 NHAS. The current Strategy continues through 2025. As we work together, we will be reflecting on the progress made under the current one; considering how best to incorporate new tools, policies and other assets into our work; and gathering input from state, tribal and local partners and members of the HIV community. Q Go to page 22 for a profile of Ruiz.
Below is an edited excerpt from an HIV.gov blog post titled “ONAP Convenes National HIV/AIDS Strategy Federal Implementation Workgroup,” by Francisco Ruiz, director of the Office of National AIDS Policy at the White House.
PERSONAL FAREWELL
In a blog post titled “A Personal Farewell to aidsmap From the Activist Who Was There,” POZ contributing writer Mark S. King gives the last word to long-term survivor and HIV journalist Gus Cairns. Below is an edited excerpt.
THE ABRUPT CLOSING OF aidsmap.com, the stalwart HIV and AIDS information and resource site based in the United Kingdom, has sent a mortal shudder through the ranks of those with a history in the HIV arena. The loss is incalculable.
It is also a very personal milestone for people like Gus Cairns, an HIV survivor and journalist who discovered his powers of activism, and his identity as a leader, through his work with aidsmap and the groups that preceded it.
Gus is a master storyteller, and his remembrances on social media about his years in the thick of HIV drama, triumphs and losses are dishy and fascinating. His behind-the-scenes tales literally chart the history of HIV treatment, pre-exposure prophylaxis (PrEP) and Undetectable Equals Untransmittable (U=U) and bring a lot of its most important figures to life. Why am I talking? Gus should tell you himself. Here is the post Gus shared on social media. Enjoy. From Gus Cairns:
I’m so, so sad—and angry—about the demise of aidsmap. Sad to lose an organization that served as a nexus of HIV activism, joining together academics, physicians, policymakers, activists and
patients in a channel they all read and relied on (I have the emails to prove it).
And sad to see the sunset of one of the most significant chapters of my own life, with an accompanying feeling of loss of contact and identity.
Angry because aidsmap was a shining example of the patient-led organizations that grew out of activism and Made a Difference, and we still don’t seem to have a way of sustaining those beyond the emergency phase of HIV.
The AIDS crisis was the first time in history that the fight to tame a violent plague was initiated by its targets, by people like me, instead of health professionals. But, like much of the rest of the HIV movement, it remained reliant on pharma money too much for too long, and we should perhaps have taken steps to wean ourselves off it many years ago. Too late now for aidsmap, I hope not for others who need to take note of our demise.
Aidsmap changed my life. It helped turn me from someone who might have muddled along being an occasional helper into someone who helped bring about change himself, in league with some brilliant colleagues.
Aidsmap allowed me to pair information with activism. We gave readers
the facts and then used the facts— but just the facts—to compel change.
Knowledge is power, and aidsmap understood that better than almost any other organization I know of.
But it also understood its own need to survive to spread that knowledge. In that respect, I’d pay tribute to Caspar Thomson, the executive director at the time I joined. Caspar quietly kept the SS Aidsmap engines running, nurturing its crew through the turbulent seas of finance while the wild-eyed Darwins on deck steered toward whatever new Galapagos of fact loomed on the horizon. (Matthew Hodson, his successor, was more the Admiral on the bow deck.)
Other aidsmap colleagues have played crucial roles too. I’d especially pay tribute to Roger Pebody for nurturing and mentoring other writers from all over the world to equip themselves with the scientific literacy and eloquence to be mobilizers of change too.
The discipline aidsmap’s mission demanded had its own reward. I was given a key to a huge and ever-growing mound of information, ready to fish out a gem for anyone who needed it.
I’m honored to have been one of the Monks of AIDS, one of the chroniclers of the story of How We Beat AIDS. Q
THE 25TH INTERNATIONAL AIDS CONFERENCE
Held biennially, the International AIDS Society’s (IAS) International AIDS Conference brings together scientists, policymakers, health care professionals, people living with HIV, funders, media, activists and others to showcase community-led efforts and scientific advances in the fight against HIV and AIDS. This year’s 25th iteration of the confab (AIDS 2024) took place in Munich from July 22 through 26. The theme was “Put people first!”
Attended by over 11,000 participants and featuring 40 abstract sessions, 50 speaker sessions and 22 workshops, AIDS 2024 also served to introduce to the world IAS’s new president, Beatriz Grinsztejn, MD, PhD, a Brazilian infectious disease physician and researcher who has led or participated in many global research studies on HIV prevention and treatment. Grinsztejn currently cochairs the HPTN 083 study evaluating injectable cabotegravir for pre-exposure prophylaxis (PrEP) in HIV-negative gay men and trans women. (Turn to page 7 to read more about her appointment and past work.)
1. Marc Franke, Paul Edmonds and Adam Castillejo, three of the seven individuals cured of HIV following stem cell transplants for cancer, pose with POZ’s science editor, Liz Highleyman, as they display issues of the magazine featuring their stories. 2. Jesse Milan Jr., the director and CEO of AIDS United, speaks with Miguel Gomez , the director of HIV.gov, about the importance of promoting the message that Undetectable Equals Untransmittable. 3. IAS’s new president, Beatriz Grinzstejn, addresses the audience at AIDS 2024’s closing session. 4. Photographer Wolfgang Tillmans designed the Munich AIDS Memorial in Sendlinger-Tor-Platz. A replica of one of the many columns in the subway station located below, the sculpture is inscribed with the phrase: “AIDS—for the decedents, for persons with HIV, for their friends, for their families, 1981 until today.” The transportation hub in downtown Munich also serves as the “gate” to the gay and and lesbian neighborhood Glockenbachviertel.
5. Protesters representing the global sex workers’ rights movement, with support from the Red Umbrella Fund, advocate for the decriminalization of sex work.
6. Speaking at the conference, UNAIDS executive director Winnie Byanyima , declared, “Choice matters! People at risk of HIV must have options. Women and girls cannot be offered a one-size-fits-all solution; they need a full range of tools to choose from.”
7. Mariana Iacondo, of ICW Latina, an international organization of women living with HIV, advocates for the autonomy of women with HIV, particularly regarding family planning and breastfeeding, which women with HIV can safely do if they have an undetectable viral load. 8. Axel Bautista , of Mexico City, makes a loud and clear statement against HIV criminalization.
9. Troy Grennan, MD, of Vancouver’s BC Centre for Disease Control, presents promising research on the use of doxycycline as PrEP for sexually transmitted infections, such as syphilis, among gay men.
CITRUS QUINOA AVOCADO SALAD
This plant-based dish is a satisfying meal for everyone.
THIS COLORFUL QUINOA AVOCADO SALAD with zesty lemons and fresh cilantro is full of vibrant flavors. It’s also rich in cancer-fighting foods, including avocados, which contain healthy monounsaturated fat, and fiber-rich quinoa, chickpeas and fresh vegetables. This plant-based meal is hearty and filling enough to satisfy everyone.
SERVINGS: 4 / INGREDIENTS: 17 / PREP: 20 MINUTES
INGREDIENTS
For the salad:
½ cup cucumber, diced
1 cup cherry tomatoes, cut in half
2 small cloves garlic, minced
For the dressing:
Juice of 2 lemons
Zest of 1 lemon
2 teaspoons Dijon mustard
DIRECTIONS
¼ cup red onion, chopped
1 bunch cilantro
1 (15.5 ounce) can chickpeas, no-salt-added or lowsodium (drained and rinsed)
1 tablespoon olive oil
1 teaspoon honey
½ teaspoon ground cumin Salt and pepper, to taste
1. Place all salad ingredients in a bowl.
2. Whisk together all dressing ingredients in a separate bowl.
2 cups spinach, thinly sliced
1 cup cooked and cooled quinoa
2 medium avocados, diced
Dash of cayenne pepper (optional)
3. Drizzle dressing over salad mixture and gently toss ingredients together until dressing is incorporated throughout.
CHEF TIPS
This recipe contains cancer-fighting foods: whole grains.
Imagine if you could lower your cholesterol, reduce the risk of heart disease and cancer and improve your state of mind with food? Turns out, you can! Superfoods contain a high level of certain nutrients and are a great way to boost your health.
Put these fruits in your grocery cart:
Apples
Avocados
Bell peppers
Blueberries
Cherries
Goji berries
Lemons
Limes
Pineapples
Pumpkins
Tomatoes
Winter squashes
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Craig Ramsay is a fitness expert, an author and a winner of season 8 of The Amazing Race Canada . Follow him on Instagram at @craigramsayfit.
HIV AND YOUR KIDNEYS
Maintaining viral suppression is one of the best ways to preserve kidney function.
HEALTHY KIDNEYS ARE KEY to a good quality of life. Kidney function diminishes as we age, but you can take steps to keep them in good working order.
The kidneys filter the blood, sending waste products and excess water to the bladder to be excreted in urine. Kidney tubules reabsorb fluid, minerals and nutrients and return them to the bloodstream. The kidneys also regulate blood pressure and maintain blood chemistry.
Acute kidney failure can occur suddenly—for example, due to toxins or physical injury. Chronic kidney disease (CKD), in contrast, leads to a slow decline in function over time. Kidney disease symptoms may include frequent urination, fatigue, brain fog, muscle cramps and swelling, but early stages are o en asymptomatic.
Older age is the biggest risk factor for CKD. Others include male sex, Black race, family history, diabetes, hepatitis C and use of certain medications. High blood pressure (hypertension) is both a leading cause of kidney damage and a sign of kidney impairment.
Studies have found that up to one third of people living with HIV have abnormal kidney function, but some of these were done before the era of effective antiretroviral treatment. HIV
can directly harm the kidneys (known as HIV-associated nephropathy, or HIVAN) and cause damaging inflammation.
Certain HIV medications can themselves cause kidney problems. Among widely used modern antiretrovirals, this occurs most o en with tenofovir disoproxil fumarate, or TDF (a component of Truvada). A newer version, tenofovir alafenamide, or TAF (a component of Descovy), is easier on the kidneys and bones. Kidney problems are uncommon among HIV-negative people taking Truvada for pre-exposure prophylaxis (PrEP). Some older antiretrovirals and drugs used to treat opportunistic illnesses caused more severe kidney toxicity, and long-term survivors may have lingering kidney problems.
Kidney function is assessed in various ways. The presence of protein or blood in the urine is one early sign of kidney damage. The estimated glomerular filtration rate (eGFR) is calculated using blood creatinine levels, age, sex and body size. A normal eGFR for a healthy adult is 90 to 120 milliliters per minute. An eGFR between 60 and 90 indicates early CKD, but the kidneys still mostly function well at that stage. People with moderate kidney disease (eGFR 30 to 59) may start to experience symptoms. An eGFR below 15 indicates end-stage
renal disease, or kidney failure. HIV treatment guidelines recommend that kidney function should be assessed at the time of HIV diagnosis, measured before starting a new HIV treatment or PrEP regimen and monitored regularly therea er. People with impaired kidney function and those at high risk should avoid medications linked to kidney toxicity or use them with caution. Fortunately, drug-related kidney problems o en resolve if they are caught early and the offending medication is stopped.
Kidney disease treatment focuses on managing comorbidities to slow disease progression. Various types of drugs are used to control high blood pressure and diabetes. A balanced diet, good hydration, exercise, weight loss, smoking cessation and limited alcohol consumption all contribute to kidney health. Starting antiretroviral treatment promptly and maintaining an undetectable viral load is one of the best ways to preserve kidney function.
Once people progress to end-stage renal disease, kidney damage is likely to be irreversible, and they may need hemodialysis (using a machine to filter the blood) or a kidney transplant. Diagnosing and managing kidney problems early are therefore key to preventing life-threatening kidney failure. Q
TWICE-YEARLY PrEP IS 100% EFFECTIVE FOR WOMEN
Lenacapavir, Gilead Sciences’ twice-yearly capsid inhibitor, demonstrated 100% e cacy for preventing HIV acquisition in a large study of young cisgender women in Africa, according to a presentation at the International AIDS Conference in July.
The PURPOSE 1 trial enrolled over 5,000 women ages 16 to 25 in South Africa and Uganda. They were randomized to receive lenacapavir injections once every six months or Descovy (tenofovir alafenamide/emtricitabine) or Truvada (tenofovir disoproxil fumarate/emtricitabine) pre-exposure prophylaxis (PrEP) pills once daily.
Lenacapavir PrEP significantly reduced HIV incidence compared with the background rate, and it was more effective than Truvada. None of the women who received lenacapavir acquired HIV. The news was not so good for Descovy, which did not provide significant protection.
Adherence to lenacapavir was high, with more than 90% of participants receiving their injections on time, but adherence to both daily pills was poor. All three PrEP methods were generally well tolerated. About 500 women became pregnant during the study, and there were no differences in pregnancy outcomes.
Lenacapavir (sold as Sunlenca) is currently only available for treatment of people with multidrug-resistant HIV. Before it can be approved for PrEP, it must demonstrate effectiveness in other populations. Results from PURPOSE 2, a parallel study of gay and bisexual men and transgender and nonbinary people, are expected in late 2024 or early 2025. Advocates stress that if this new prevention tool is
approved, it must be made accessible to the people most affected by HIV worldwide.
“These stellar results show that twice-yearly lenacapavir for PrEP, if approved, could offer a highly effective, tolerable and discreet choice that could potentially improve PrEP uptake and persistence, helping us to reduce HIV in cisgender women globally,” said presenter Linda-Gail Bekker, MD, of the University of Cape Town in South Africa.
More Resources Needed to End the HIV Pandemic
In advance of the International AIDS Conference, UNAIDS released its annual report, “The Urgency of Now: AIDS at a Crossroads.” According to the report, in 2023, 39.9 million people were living with HIV worldwide, and there were 1.3 million new infections and 630,000 AIDS-related deaths. While deaths have dropped by more than half over the past decade, one person still dies of HIV-related causes every minute.
Nearly 30.7 million people with HIV are on antiretroviral therapy, but that still leaves 9.3 million without treatment. UNAIDS estimates that in 2023, 86% of people with HIV knew their status, 89% of people diagnosed were on treatment and 93% of those had viral suppression. The global 95-95-95 targets call for all three metrics to reach 95% by 2030.
A study presented at the conference showed that rapidly scaling up the global HIV response could avert nearly 35 million new infections and prevent nearly 18 million deaths between now and 2050, but inadequate funding is a concern. At the end of 2023, $19.8 billion was available for the global response—about $9.5 billion less than needed.
Despite progress on biomedical prevention and treatment, social issues— including a growing backlash against LGBTQ and women’s rights—are proving more di cult to resolve. “We have to tackle the discrimination and stigma that are pushing the most marginalized people away from lifesaving services,” says UNAIDS executive director Winnie Byanyima.
DAILY DOXYPrEP PREVENTS STIs
Doxycycline post-exposure prophylaxis (doxyPEP) for prevention of sexually transmitted infections (STIs) has been big news at recent AIDS conferences, but for people who have sex o en, daily doxycycline pre-exposure prophylaxis (doxyPrEP) may also be an option. DoxyPEP is a single 200 milligram dose of the antibiotic taken within 72 hours a er sex. DoxyPrEP, in contrast, involves taking half that dose every day.
In a study of 52 HIV-positive gay and bisexual men in Toronto and Vancouver, daily doxycycline reduced the incidence of chlamydia by 92%, syphilis by 79% and gonorrhea by 68% compared with a placebo. Another study of 40 women sex workers seen at a clinic in Tokyo found that those who used doxycycline every day saw a 67% decliine in overall STI incidence. In both studies, daily doxycycline was safe and generally well tolerated.
“We need to provide patients with choice,” says Troy Grennan, MD, of the British Columbia Centre for Disease Control. “One of the assumptions we o en make is that we know what patients will prefer, but we just don’t know that.”
New Anal Cancer Screening Guidelines
For the first time, government guidelines for the management of opportunistic infections now include recommendations on anal cancer prevention for people living with HIV, who are at higher risk than the general population. Anal cancer is caused by the human papillomavirus (HPV), which triggers abnormal cell growth that can progress to invasive cancer.
According to the new guidelines, men who have sex with men and transgender women should start anal cancer screening at age 35, while other HIV-positive people should start at age 45. This should include symptom assessment and a digital anal-rectal exam; those with abnormalities should receive follow-up evaluation. The screening algorithm includes recommendations for anal cytology (Pap tests) and testing for high-risk HPV types if high-resolution anoscopy (HRA)—a technique that uses a magnifying scope to examine the anal canal—is available.
The new recommendation is supported by evidence from the ANCHOR study, which showed that screening HIV-positive men and women ages 35 and older for precancerous lesions and treating them promptly lowered the risk of progression to anal cancer by more than half. A recent study that compared anal screening strategies for people with HIV found that combining cytology and high-risk HPV testing was more effective than either method alone and reduced the need for follow-up HRA evaluation, which is limited due to a shortage of trained providers. A recent analysis estimated that over 400,000 HIV-positive people may have abnormal anal cytology, but more than a third have no access to follow-up HRA.
“We need better screening strategies and potentially additional biomarkers to identify people who are at the highest risk, because the infrastructure is just so dire,” says Michael Gaisa, MD, PhD, of the Icahn School of Medicine at Mount Sinai.
While screening and prompt treatment can prevent progression to anal cancer, HPV vaccination can prevent
infection in the first place. The CDC recommends the Gardasil 9 vaccine for girls and boys at ages 11 or 12, with catch-up vaccination through age 26, but the Food and Drug Administration has approved it for people up to age 45. Yet men who have sex with men are missing out on vaccination. A recent study found that more than half of HIV-positive and HIV-negative gay men in San Francisco had not received an HPV vaccine, o en because they were too old. The researchers suggest that guidelines should be changed to recommend HPV vaccination for gay and bisexual men of all ages.
BY LIZ
STI Testing PREVENTION
Men on HIV pre-exposure prophylaxis (PrEP) who were tested for sexually transmitted infections (STIs) every six months instead of every three months may be no more likely to test positive for STIs. In the U.S., CDC guidelines recommend STI screening once every three months for gay and bisexual men and transgender women. In the Dutch EZI-PrEP study, 448 participants were randomized to receive STI monitoring twice-yearly or quarterly; they could also get tested between scheduled appointments—for example, if they developed STI symptoms. Those who were monitored every six months had more in-between clinic visits than the every-three-month group (274 versus 157), but their total number of visits was still lower (862 versus 1,288). There was no significant difference between the two groups in overall STI positivity rates, though people in the twice-yearly group were slightly more likely to test positive for asymptomatic STIs. Twice-yearly monitoring would be less burdensome for PrEP users and could reduce costs, enabling clinics to put more people on PrEP for the same budget.
TREATMENT
Simpler Treatment
A once-daily oral combination of bictegravir and lenacapavir could enable simpler HIV treatment for people taking more complex regimens. Standard antiretroviral therapy is highly effective for most people, but some can’t use convenient singletablet regimens due to drug resistance or side effects.
The ARTISTRY-1 trial evaluated the integrase inhibitor bictegravir plus the capsid inhibitor lenacapavir for people who had achieved viral suppression on a more complex regimen. The 128 participants were randomly assigned to receive bictegravir plus one of two doses of lenacapavir once daily or to stay on their current regimen. A er 48 weeks, 92% of people in the lower-dose lenacapavir group and 90% in the higher-dose group had a viral load below 50, as did everyone who stayed on their baseline regimen. Changes in CD4 counts were comparable. Bictegravir plus lenacapavir was generally safe and well tolerated. Gilead Sciences is now testing a combination pill containing bictegravir and lenacapavir, which could enable more people to switch to a simple single-tablet regimen.
CURE
7th Stem Cell Cure
A German man dubbed the Next Berlin Patient appears to be the seventh person cured of HIV a er a stem cell transplant to treat cancer. But unlike the original Berlin Patient, Timothy Ray Brown, he received stem cells from a donor with only one copy of the rare genetic mutation CCR5-delta32, which prevents HIV from entering cells. Only about 1% of people of Northern European descent have two copies of the mutation, but around 16% have one copy, which could expand the donor pool. The man received a stem cell transplant to treat leukemia in October 2015. Prior to the transplant, he underwent whole-body radiation and intensive chemotherapy, and he developed mild graversus-host disease. He stopped antiretroviral therapy in September 2018, but his viral load did not rebound. Six years later, he is still in remission with no detectable virus or HIV-specific T-cell responses. The risky transplant procedure is not an option for most people with HIV, but each new case provides clues that could help researchers develop more widely applicable strategies for long-term remission.
CONCERNS
Abacavir
Current or previous use of the antiretroviral drug abacavir (sold alone as Ziagen and a component of older combination pills) is associated with an elevated risk of major cardiovascular events, such as heart attacks and strokes, according to an analysis from the large REPRIEVE trial. This international study enrolled nearly 7,800 HIVpositive people ages 40 to 75 who had an undetectable viral load and low-tomoderate cardiovascular disease risk. The main study finding was that a daily statin medication reduced the risk of major cardiovascular events by 35%. The study team also assessed whether certain antiretrovirals previously linked to heart problems were associated with these events. Overall, 13% of participants were currently taking abacavir, and 22% reported prior use. Current abacavir users had a 50% higher risk for cardiovascular events, and former users had a 42% elevated risk compared to those with no exposure. Use of other antiretrovirals, including tenofovir, AZT and protease inhibitors, was not associated with any changes in cardiovascular event risk.
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.
cdc.gov/HIVTreatmentWorks
BY MATHEW RODRIGUEZ | PHOTOGRAPHY BY LIZ ROLL
Francisco Ruiz at the White House
EVEN PEOPLE APPOINTED TO THEIR POSITION BY THE PRESIDENT OF THE UNITED STATES
can feel the icy sting of imposter syndrome. When Francisco Ruiz, currently serving as the director of the White House Office of National AIDS Policy (ONAP), first learned he was being considered for the post, he felt at times like an Oscar hopeful. Despite his extensive résumé, hard-earned credentials and first-person experience, he considered it an honor just to be nominated.
“I was like, Me? Are you sure?” he says. “Often, as a member of a community that is not invited to the table—or is invited but not given a mic—I was sort of like, Am I equipped to be in this role?”
But those feelings melted away as he continued to interview for and, eventually, secure the position. The stars seemed to align. He began contending for the role just as he was finishing up his coursework for a doctorate in public health at Harvard University, meaning he would no longer need to be in a Massachusetts classroom. And now, having served in President Biden’s White House for less than a year, he has already made a visible and felt difference to the HIV community.
“I don’t know how he sleeps,” says Christopher Cuevas, senior program manager of Latino programs at AIDS United. “I have seen his name pop up on so many calls. He’s everywhere, and it shows his continued investment in our community.”
Speaking with Ruiz, you’d never guess that he could catch a case of the nerves. He speaks calmly but with authority and a disarming charm. His answers are direct, not wishywashy. Despite his long tenure in Washington, DC, he resists speaking in bureaucratese.
Ruiz became the 11th ONAP director in April 2024, more than three years after his predecessor, Harold Phillips, first took office. He is the first Latino to occupy the role and only the second to hold it after a four-year gap in leadership, since former President Trump left the office vacant when President Obama appointee Amy Lansky departed at the end of his administration.
RUIZ’S HIV WORK STRETCHES BACK ABOUT TWO DECADES AND includes service in the federal government. After graduating from Loyola University in Chicago in 2001, he spent two years educating children and families in Ecuador about HIV prevention as a Peace Corps volunteer. After his time in Ecuador, Ruiz continued along a path of HIV work that included a stint at DC’s Latin American Youth Center. He didn’t set out to do HIV work—in his own words, he just “fell into it”—but it ended up being an outlet for his passion around social justice issues, such as racism, homophobia, xenophobia, homelessness and substance use.
Ruiz also spent more than a decade at the Centers for Disease Control and Prevention (CDC), where he molded the agency’s messaging around HIV. He developed well-known public health campaigns, such as “Let’s Stop HIV Together,” and empowered members from diverse backgrounds to be
community and clinical ambassadors for the campaigns.
Six years ago, while working on an HIV stigma campaign at the CDC, Ruiz tested HIV positive. Even as he dedicated his public life and professional energy toward eradicating stigma, he was facing the realities of it in his private life. He kept his diagnosis to himself for almost a year, not sharing it with any colleagues, friends or family. “I knew I was going to be fine,” he says. “But it still took me eight months to verbalize that I was diagnosed with HIV.”
Ruiz says he wears a red ribbon to work almost daily. Sometimes, it prompts conversation. Sometimes, folks ask him whether he has an extra one on hand. Overall, he hopes the ribbon reminds others that he is a person living with HIV who is doing the work at the federal level. “I know that visibility matters, that representation matters,” he says. “Having an office that focuses on HIV with someone who is living with HIV says a lot.”
That personal experience has given Ruiz unique insight into the power of stigma. When he was diagnosed, he had a secure job and housing but nonetheless felt shame regarding his diagnosis. That reality reinforced to him that fighting HIV will always require more than a public health or biomedical approach, a fact that informs his role at the White House, where he works across disciplines—a necessity in addressing the ongoing crisis.
“I’m trying to break down the boxes and the silos within this work,” he says. “Public health is social justice. Public health is housing rights.”
Fighting the HIV epidemic holistically has always been a strength of his, according to those who have worked with Ruiz. “He takes his life experience and his academic background and finds a really good path that allows him to speak directly to the community and to the heart of policy issues,” Cuevas says.
Ruiz relishes the opportunity to break his talk of HIV out of a health-only bubble. “I work with people who are working on diabetes, nutrition, housing, LGBTQ rights,” he says. As AIDS activists have taught us, each of these is part of a holistic approach to HIV prevention and treatment, as opposed to just focusing on the biomedical approach to treatment. “People who work in HIV know that it’s not just about the biomedical. It’s about the whole tapestry.”
Ruiz continues, “We can’t forget about the human aspect of this work. When we talk about education [and] economic mobility, we need to talk about what it means
Ruiz is the first Latino to serve as ONAP director.
for José or María down the street to be successful, to know their HIV status, get on PrEP [pre-exposure prophylaxis] or get into care.”
THAT ABILITY TO THINK HOLISTICALLY ABOUT THE HIV EPIDEMIC and how it affects marginalized people will be an asset to Ruiz during his tenure. His appointment comes at a dire time for queer Latinos facing the ongoing HIV and AIDS crisis. In June, a KFF analysis of CDC data found that queer Latinos are experiencing an increase in new diagnoses.
While overall HIV rates declined 23% in the decade between 2012 and 2022, Latinos have experienced a much smaller decline and, in certain areas, have even seen a rise in new infections. Public health officials in some municipalities— such as counties in North Carolina and Tennessee as well as in San Francisco—have recorded an increase in infections among Latinos, especially queer Latinos.
In the face of such data, Latino advocates have called for the federal government to declare a public health emergency in the hope that more money will be directed to Latino communities. “Our invisibility is no longer tolerable,” Vincent Guilamo-Ramos, PhD, MPH, cochair of the Presidential Advisory Council on HIV/AIDS, tells The Associated Press (AP).
Cuevas echoes that sentiment and underscores that specific efforts are needed to reach Latinos. “Resources are not really reaching queer Latinx people,” they say. “We are not getting to the heart of the challenges that Latinx communities are having to navigate.”
While Black Americans continue to have the highest rates of HIV overall, Latinos had the largest share of new HIV diagnoses among gay and bisexual men in 2022. Though Latinos make up 19% of the U.S. population, they accounted for about one third of new HIV diagnoses.
“My goal is that we see the numbers going down,” Ruiz says of the latest data. “We haven’t seen that much investment in the Latino community.”
Ruiz sees his appointment as a signal from the Biden administration that it takes the needs of Latino people living in the United States seriously. “The Latino community has been yearning for visible leadership,” he says. “I don’t take my appointment lightly.”
And while it’s certainly helpful to have an out queer Latino person living with HIV in this specific role at this time and
“I KNOW THAT VISIBILITY MATTERS, THAT REPRESENTATION MATTERS.”
though Ruiz may have momentarily hesitated when handed the mic, he knows that it’s important to pass the mic to others in his communities so that they may tell their stories.
“My focus has been making sure we do a better job of telling our story,” he says. “There’s an obligation for our leadership to bring folks who maybe haven’t been to the table and not just bring them to the table but give them the pen to write policies and inform decisions versus just tokenism.”
RUIZ ALSO KNOWS THAT AN IMPORTANT PART OF HIS JOB IS identifying new lawmakers on Capitol Hill who will champion HIV causes and funding. Although HIV funding has long been a bipartisan issue, as anti-LGBTQ sentiment within the Republican party grows, dollars meant to fight the AIDS crisis are now in danger of disappearing.
A 2025 spending bill put forward by Congressional Republicans suggested gutting HIV funding by up to $767 million, according to GMHC. Funding for HIV prevention and treatment is under attack from all sides of the political spectrum. For example, in New York City, Mayor Eric Adams proposed a cut to a program meant to help people stay undetectable. However, public outcry led to a reversal of that proposal.
“We’ve always had advocates like Maxine Waters, Barbara Lee and Nancy Pelosi,” Ruiz says of the longtime congresswomen. “They’re still there, and they’re still strong, but one of my priorities is to identify new champions on the Hill to carry that message.”
To that end, Ruiz will set out to do what he loves most about his work: forging connections and telling stories. While early announcements about his selection touted him as the first Latino person to take on the role, perhaps it’s even more important that he has a deep network within the Latino community. He is not a spotlight hog; he is a connector, someone who wants to play matchmaker between the right voices and the right people in power.
Ruiz hopes he can bring a level of complexity to the way Latinos are discussed, represented and catered to in government. Although some marginalized communities have received big investments because of the disproportionate burden of the epidemic they shoulder, the Latino community hasn’t, he says.
His plan includes convening multiple groups that focus on Latinos, both inside and outside of the public health sphere, to ensure that they are addressing the specific needs of subsets of the Latino community.
“What newly arrived Mexicans need differs from third-generation Mexican Americans,” Ruiz says. “It’s very nuanced and complex.”
Making inroads for a community as multifaceted as Latinos might seem a daunting challenge to some. But for Ruiz, caring for people he knows, people who are part of his many communities, grounds him and helps make the enormous task ahead of him tenable.
“I’ve been trying to bring the fusion of public health with policy,” he says, “which is always bringing it back to humanity.” Q
Clockwise from top left: celebrating their birth decade, the ’70s (2021); their wedding day at King Family Vineyards in Crozet, Virginia (2004); at a Madonna concert in Las Vegas (2024); playing with baby goats (2022); enjoying summertime at IX Art Park in Charlottesville, Virginia (2018)
SHAWN DECKER REFLECTS ON 20 YEARS OF MARRIAGE TO GWENN BARRINGER AND THEIR LIFE TOGETHER AS HIV ADVOCATES.
BY SHAWN DECKER
“Iwant somebody to share, share the rest of my life / Share my innermost thoughts, know my intimate details.”—from “Somebody” by Depeche Mode
I had lyrics from the song “Somebody,” a tender ode to the longings of love by Depeche Mode, etched inside my soon-to-be wife’s wedding ring. Unbeknownst to me, Gwenn had also plucked a line from the same song for mine.
Despite being the kind of magical-thinking daydreamer who usually looks for larger-than-life signs to guide the way, I saw the rings “à la Mode” as a cute coincidence.
That’s because I knew long before I’d answered yes to the easiest question of my life, sitting beside Gwenn 20 years ago on a porch swing on a cool fall evening in Milford, Pennsylvania, that my heart was in the right hands.
I felt particularly safe because no one else—not even my family—had seen what Gwenn had seen in me in the five years
we’d been together: the full range of “in sickness and in health,” from starting HIV medications with 38 T cells to speaking six times in six different states during World AIDS Week.
In the two decades since Gwenn and I exchanged rings, we’ve literally run rings around the United States—and the world—telling our love story to thousands of college students and reaching millions of people worldwide via various media outlets.
Though I love nothing more than to read my own press
clippings, I found that personal interactions resonate the most and leave the longest-lasting impression.
AFTER ONE OF THOSE TALKS, A STUDENT PULLED Gwenn aside. She confided that, like me, her boyfriend was living with HIV and that, like Gwenn, she was HIV negative. It wasn’t a somber confession either.
To her, we were the same kind of revelation that Pedro Zamora, of MTV’s The Real World , and his partner, Sean Sasser, were to me in 1994, when I was 18. Seeing two people laughing—and loving—in the presence of all the extra baggage that comes with HIV? That really changed my outlook and gave me hope.
POZ magazine shared our wedding photos, which encouraged one of my new friends, who, like me, lives with hemophilia and HIV, to share his feelings for someone. They not only ended up getting married (we were invited!), but they also had two children.
One of the questions we answered at every one of those talks was whether we wanted— or could even have—kids. Early in our courtship, Gwenn let it be known that children weren’t high on her life’s priority list, which was music to my synth-pop-lovin’ ears.
My early years were plagued by doubt as to where I belonged in the carbon copy, nuclear family model. Even as a teen, I knew anyone with that kind of vision for their future wouldn’t have much interest in my humble adult offerings. Sure, they’d have their fun with my hot body, but once they wanted to get serious and settle down? They’d move on.
It’s been 25 years since Gwenn volunteered that her maternal instincts weren’t a strong suit. Since then, however, we’ve become the cool aunt and uncle to two nieces and two nephews—a very nice fit for our lifestyle.
And our first niece, born two months after Gwenn and I met—well, I just had the distinct honor of officiating at her wedding, finally paying her back for the incredible flower girl services she provided for us.
bleed that just wouldn’t stop. Nothing had plagued my childhood with hemophilia more than the dreaded nosebleed. My special set of medical skills sure came in handy that morning.
First, you have to calm a kid who’s in a state of peril by being calm yourself. That’s what my mom did. Next, some proper pressure. Then add a nice cold, damp rag on the forehead. “Hey, that feels good, right?”
Voilà! The nosebleed stopped. And faster than I thought possible. Until I realized that my goddaughter had the advantage of having the clotting factor I lacked. Later on, as Christmas dinner was being prepared, our goddaughter’s mom sliced her hand on a mandoline, a kitchen tool that has maimed many a cook.
ABOUT A DECADE AFTER OUR DEBUT AS AUNT GWENN AND Uncle Poo, a close friend asked whether we would be her daughter’s godparents. Of course, we said yes, even though we weren’t sure what it would entail.
Soon enough, as part of the two-car caravan that took our friend to the hospital while she was in labor, we found out what it all meant. During our initial at-home encounter, my goddaughter stopped crying the first time I held her, and that was it. Just like with our nieces and nephews, our goddaughter instantly had my heart.
Early one Christmas, our goddaughter woke up with a nose-
I took one look at the wound and my stomach turned. All I could offer, as I helped myself to another glass of wine, was: “Thank God you have more clotting factor than I do.”
I have seldom felt more useful—or more love—than I did that gruesome, gory, enchanting Christmas Day.
None of these contributions in the lives of my loved ones would have been possible if my health had not been so stable. For so many years, debilitating fatigue had impacted not only my physical stamina but also my mental bandwidth.
After several years of being on effective HIV medications, combined with that sweet, soul-nurturing, straight-shootin’ love that only Gwenn could provide, I had the energy. Enough to be everything I’d ever wanted to be: a globe-trotting sex educator, a bleed-bashing godfather, a POZ columnist, the cool uncle and a compelling, consistent presence on the local music scene.
In my teens, making it in music was the only safe haven that I could dare to imagine a future in. Becoming a rock star was a far better destiny than a death from AIDS. I’d have said you were insane if you’d told me my medical trauma—and my ability to crack wise about it—would be my ticket to getting on MTV.
ON OUR WEDDING DAY, MY HEALTH WAS CONTINUING ITS
incredible upward trend. We had no idea that our roles “in sickness and in health” could someday be reversed. But that’s exactly what happened when Gwenn was blindsided by her own health issues in her mid-30s.
I quickly gained newfound respect and appreciation for what my loved ones must have gone through when I wasn’t doing well. I wasn’t prepared for the emotional uncertainty that accompanies being thrust into caregiving because it was the antithesis of my life’s experience.
But I was a quick study. I wanted to give Gwenn the kind of love I’d received at the beginning of our relationship. She booked my doctor’s appointments. She filled the
POZ covers from 2006 (top) and 2013
pillbox. She researched side effects.
I’d been pretty aloof with regard to my health up to that point, which didn’t bode well when I got sick right after I moved out on my own. I was beyond lucky that Gwenn took a shine to me. I honestly don’t know what would’ve happened if I hadn’t met her when I did.
Needless to say, I was more than motivated to help Gwenn through her sickness. Thankfully, over time, we got her health back on track. Ever since, in the spirit of fairness, we’ve been volleying those caregiving roles back and forth. I love that we’ve both proved, time and again, that we can spike that ball from either side of the net.
plan was in effect. I quickly found out I’d have to make a U-turn.
Mom took pride in being strong. She grew up poor and as a teenager started working a job to support her family and younger siblings. As a parent, she worked even harder, providing a safe childhood for two boys with vastly different needs.
“LIFE / IS FULL OF SURPRISES / IT ADVERTISES / NOTHING”
from the song “Nothing” are some other favorite Depeche Mode lyrics because the tax of surviving and thriving is living to see things you never expected: the inevitable and unpredictable heartbreaks of the adult human experience. In 2022, my original caregiver, Mom, passed to spirit.
Gwenn had no bigger fan than my mother. After we finished eating the first time we had my parents over for dinner, I got up to clear the table. As I loaded the dishwasher, my mom bellowed, “Whoa!” She craned her neck and turned her body, further drawing attention to the shocking spectacle before her. Wide-eyed, she grabbed Gwenn’s arm, demanding to know what she’d done with her son.
I was embarrassed. I’d been a choreless wonder growing up. Grunt work? That fell on my husky big bro. Why would you assign a quick duty to the son who might get injured on the job and slow things down with a one-hour trip to the hospital? I was learning to be helpful.
These days, nothing makes me happier than helping out around the house and freeing time up for Gwenn to watch another episode of Law & Order: SVU. One of my low-key dreams is to fully take over laundry duties, which my dad did growing up.
For now, like during my childhood, it’s a tough sell. I have the self-awareness to know I’d definitely ruin a lot of clothes learning on the job. When Dad joins Mom and breaks on through to the other side, I’m going to use the spiritual capital to make a victorious push to achieve that goal.
“It’s a tribute, Gwenn,” I’ll say. “To my dead dad.” She’ll laugh. Then, she’ll tell me to go watch some wrestling while she sorts the laundry.
BEFORE SHE PASSED, MY MOM’S HEALTH HAD BEEN ON
the decline for a couple of years. When things really took a turn for the worse, the family was ready to spring into action. I wanted to return the early caregiving I’d received. If she was surprised by my loading a dishwasher, what she was about to witness would really blow her mind. When she agreed to let me drive her to a doctor’s appointment, my
Gwenn and Shawn truly enjoy sharing their love story with the world.
After I’d been kicked out of the sixth grade for having HIV, she fought to get me back into school. For her, my medical conditions were like the spider bite that brought out Peter Parker’s incredible powers. In my cult classic Gen X memoir, My Pet Virus: The True Story of a Rebel Without a Cure, I was afforded the unique opportunity to fully laud my praises for all the asses she kicked on my behalf.
Was Mom perfect? No. “Everybody’s shit stinks,” she was fond of saying. My friends growing up loved that I had the only mom on the block who talked like a sailor.
After that drive to her doctor’s appointment, she abruptly shut me and everyone else out. Only my dad was allowed to take care of her. A tremendous relief was that my brother lived right across the street. Plus, when I talked to my dad, he assured me he’d call the crew if help was needed.
My U-turn was driving past my parents’ house and to my brother’s. There, Gwenn, my brother, my sister-in-law, my nieces and I shared in our collective grief. We laughed, we cried, we admitted to being a little pissed at the whole deal. I knew in my soul that Mom needed to pass to spirit in the same way she lived: on her own terms. In the end, the family bonded around her wishes.
NO ONE’S LIFE IS EASY. WE ALL GET CAUGHT
OFF GUARD, knocked down. Sometimes, we bounce right back; other times, it takes a little bit longer to get our feet under us.
Together, Gwenn and I have done things we could have never done without sharing this wonderful life, where the great victories and the agonizing defeats come and go. Sometimes, it’s the steak; sometimes, you’re roasting marshmallows over nothing but sizzle. As we celebrate our 20-year wedding anniversary, with my big 5-0 birthday right around the corner, I am so grateful. Each gray hair is a gift. Even the awkward, wayward white nipple hair.
The boys from Basildon, England, Depeche Mode, whom I met as my “final wish” in 1990, summed it up best. Life has certainly been full of surprises. And the best one—by far— has been the long, incredible journey I’ve had the pleasure of sharing with Gwenn.
I love you, babe. I’d rather do nothing with you, than everything with anyone else. Q
The Long Game
Axel Torres Marrero is one of the most influential HIV activists in New Jersey. As the senior director of policy, prevention and harm reduction at Hyacinth, the largest AIDS service organization in the state, his fingerprints are on nearly every HIV-related law in New Jersey.
His recent legislative victories include expanded needle exchange access in New Jersey. Marrero, who is HIV negative, was also the principal lobbyist for New Jersey’s effort to decriminalize HIV transmission, upending a law that criminalized the sex lives of people with the virus.
Marrero, a native Puerto Rican who now splits his time between Jersey City and Florida, embraced activism early.
“Early on, I saw commonalities between ethnicity and people who are LGBTQ, people who tended to be marginalized,” he says. “And I saw what that means in terms of the political structure, where you have no power and very little ability to change things.”
That compelled him to protest government policies that disproportionately harmed Black and brown people. He quickly noticed the deadly intersection of AIDS and drug use, which he labels a “twin epidemic.”
“I came to AIDS activism by way of addiction first,” he says. “There are a lot of individuals who have forgotten what it was like when the twin epidemics, HIV and crack, hit Latin American and African-American communities in the New York area, including Jersey City and Newark. And when they hit, I had a front seat to the devastation.”
That’s when Marrero discovered ACT UP, which brought much-needed attention to the AIDS crisis.
The biggest hurdle he encountered in the fight against HIV was stigma. “A code of silence fell over communities of color,” Marrero says. “They didn’t want to speak about it.”
He describes a stigma so corrosive it drove grieving families to conceal the actual cause of an AIDS death.
“Even as a young person, I knew there was no reason for that to happen,” Marrero says. “I understood that the government doesn’t care because we’re talking about either a person of color or another marginalized group.”
He notes that sex workers, people who inject drugs, immigrants and LGBTQ people were especially harmed by government inaction.
“It felt like the entire system was saying, ‘Because you are less-than, your community deserves the twin epidemics of addiction and HIV.’ So it didn’t take much for me to get involved with ACT UP,” Marrero adds.
That’s when he learned that activism in the streets directly shapes public opinion and public policy.
“If it wasn’t for ACT UP doing the fight on the front lines, the backroom deals would never have happened,” he says. “I just happened to have been mentored by someone who did both.” And that’s how Marrero became one of the most influential HIV lobbyists in the business.
His time with ACT UP also helped him hone the skills and patience to play the long game, especially regarding unpopular solutions to combat HIV transmission, like expanding syringe access.
“Feelings o en trumped our facts,” Marrero says about his efforts. “Those lessons that I learned early on, I apply to every policy challenge I’ve had. When feelings trump facts—and they o en do—that doesn’t shock me. Work a different chessboard when that happens.” Q
TAMARA FLEMING
Axel Torres Marrero is a longtime HIV advocate.
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.
¿Por qué 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.
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.
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.
Una tableta una vez por día. Cada tableta contiene 25 mg rilpivirine + 300 mg tenofovir disoproxil fumarate + 200 mg emtricitabine. Tomar con una comida.
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.
DOVATO
dolutegravir + lamivudine
Una tableta una vez por día. Cada tableta contiene 50 mg dolutegravir + 300 mg lamivudine. Tomar con o sin alimentos.
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.
TABLA DE MEDICAMENTOS PARA EL VIH 2024
Esta tabla de consulta rápida compara opciones de antirretrovirales (ARVs) para el tratamiento del VIH, incluyendo las dosis para adultos y las restricciones alimenticias. Para más información, visita poz.com/drugchart/espanol.
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.
Inhibidores nucleósidos/nucleótidos de la transcriptasa reversa (INTR o nukes)
EMTRIVA * emtricitabine (también conocida como FTC)
Una cápsula de 200 mg una vez por día. Tomar con o sin alimentos.
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.
Una tableta una vez por día. Cada tableta contiene 300 mg tenofovir disoproxil fumarate + 200 mg emtricitabine. Tomar con o sin 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
dolutegravir + rilpivirine
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.
Una tableta una vez por día. Cada tableta contiene 300 mg tenofovir disoproxil fumarate + 300 mg lamivudine. Tomar con o sin alimentos. NORVIR * ritonavir Norvir generalmente
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.
Inhibidores de la integrasa 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.
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.
JULUCA
dolutegravir + rilpivirine
Una tableta una vez por día. Cada tableta contiene 50 mg dolutegravir + 25 mg rilpivirine. Tomar con una comida.
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.
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 (ver 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.
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.
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.
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.
Potenciadores de PK
Inhibidores cápsidos
NORVIR * ritonavir
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.
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.
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.
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. Inhibidores de la entrada
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
Inhibidores no-nucleósidos de la transcriptasa reversa (INNTR o no-nukes )
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
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.
Encuentra más información y recursos
útiles en HelpStopTheVirus.com
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
¿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 ser nos recuerda la importancia de seguir el tratamiento fue recetado. Mantente empoderado para vivir larga y saludable.
Es importante que proveedor de atención tratamiento adecuado reúnes con tu proveedor las preguntas son
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.
Ayuda a acabar concientización ser eficaces y tratamiento como una vida más 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
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.
