POZ December 2024 by Smart + Strong

Cleve Jones

the AIDS Memorial Quilt

Jones visits the Quilt in San Francisco.

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little virus in the

it. Current research prescribed and getting prevents the transmission also known as

Why U=U matters

U=U means undetectable=untransmittable. It helps destigmatize living with HIV, raises awareness that medications can be e ective, and reminds people importance of continuing to take treatment as prescribed. Stay empowered to live a longer and healthier life.

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Dashiell

#ADVOCACY

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

#CRIMINALIZATION

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

#UNDETECTABLE

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

POZ DIGITAL

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

20 THE 2024 POZ ICONS We honor the inaugural class of inductees into our hall of fame. BY JENNIFER MORTON

26 SURVIVING TOGETHER Long-term survivors are advocating for other long-term survivors. BY TIM MURPHY

3 FROM THE EDITOR Keep It Together

4 POZ Q&A

Tom Viola—the longtime executive director of Broadway Cares/Equity Fights AIDS and a long-term survivor—shares lessons learned as he says farewell.

6 POZ PLANET

U.S. district court strikes down HIV ban against joining the military • COVID-monkeyAIDS pox? • the Centers for Disease Control and Prevention (CDC) funds a pilot pre-exposure prophylaxis (PrEP) program • another attack on the Affordable Care Act • POZ Stories: Kimberly Nail • Everyday: HIV milestones

12 VOICES

POZ contributing writer Shawn Decker reflects on his struggles aging with HIV • CDC launches PrEPared/PrEParado

14 SPOTLIGHT

Highlights from the 2024 U.S. Conference on HIV/AIDS

16 NUTRITION & FITNESS

Baba ganoush • superfoods

17 RESEARCH NOTES

Vaginal bacteria increases HIV risk • dolutegravir/lamivudine works despite resistance • CRISPR does not prevent viral rebound • rapid SARS-CoV-2 evolution in people with advanced HIV

18 CARE & TREATMENT

Twice-yearly PrEP works well for gay men

• people living with HIV have unmet needs • Department of Health and Human Services updates HIV guidelines • pain management for people with HIV

32 HEROES

HIV advocate Dashiell Sears

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Keep It Together

IREMEMBER THE 2012 DISPLAY

of the AIDS Memorial Quilt in Washington, DC, as if it were yesterday. It was shown during the XIX International AIDS Conference, marking 25 years since its first display in San Francisco. It was the first time the Quilt had been shown in its entirety since 1996.

I was deputy editor at the time. Many POZ staffers attended that conference, which was the first time it had been held in the United States in decades. President Obama had lifted the U.S. HIV travel ban, so the International AIDS Society, the conference organizer, rewarded that action by hosting the conference in DC.

The Quilt was displayed in 50 venues across DC, including the National Mall. One of the most emotional moments for me was onstage on the Mall looking out at the vast Quilt panels. I got to read a few of the names of people lost to AIDS and included a personal remembrance. I left the stage in tears and had to take a long walk to recover.

The Quilt is more than a reminder of what’s been lost. In addition to giving those who view it an opportunity to grieve, it also provides motivation to keep on fighting for those who remain. That’s what it did for me, and I know I’m not the only one.

In large part, we have one person to thank for the Quilt: Cleve Jones. Many people helped to make the Quilt a reality, but he was the person who first conceived of the Quilt. Nonetheless, as a long-term survivor and a longtime activist, our cover subject isn’t resting on his laurels.

Cleve is now working on a project to bring to life an anthology of the untold stories of HIV long-term survivors. “If I’m allowed one more big project in my life,” he tells POZ, “this is going to be it.” Go to page 26 to read more about it and the efforts of other long-term survivors to advocate for their fellow long-term survivors.

In this special issue focused on advocacy, we are also introducing POZ Icons, an

annual tribute to individuals, both living and deceased, who’ve made lasting contributions to the HIV community.

The inaugural inductees into our hall of fame are Hydeia Broadbent, Cecilia Chung, Dennis deLeon, Sean Strub and Phill Wilson. We are grateful to the 2024 POZ Icons for all they’ve done to fight HIV and AIDS. We’re also looking forward to continuing this new initiative for years to come. Go to page 20 to read more.

Another long-term survivor who has made a mark in the HIV community is Tom Viola. He has led the nonprofit Broadway Cares/ Equity Fights AIDS (BC/EFA) since 1996. The group has raised more than $300 million for hundreds of organizations across the country. Tom will be retiring from BC/EFA December 31. Go to page 4 to read about what his work has meant to grantees, and to him, and what’s to come after his farewell.

Please also go to the center of this print issue to find a special edition of Real Health, our sister publication, focusing on HIV.

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

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

EXPRESSING GRATITUDE

The executive director of Broadway Cares/Equity Fights AIDS says farewell.

ANYONE FAMILIAR WITH THE HIV AND AIDS SERVICES community—or, for that matter, with professional theater—is also likely familiar with Broadway Cares/Equity Fights AIDS (BC/EFA).

That’s the New York City–based nonprofit whose lavish, beloved annual events, including the strip-a-thon Broadway Bares and the Easter Bonnet Competition, have, since its 1992 inception, raised more than $300 million for hundreds of HIV and AIDS and adjacent service organizations throughout the United States.

Tom Viola has led BC/EFA since 1996. Viola, 70, came to New York City as an aspiring actor in the 1970s and later found himself swept up in efforts to provide aid to theater community folks hit by the AIDS epidemic in the 1980s.

When he began his tenure, BC/EFA was a small, scrappy outfit raising thousands of dollars here and there through a variety of “Hey kids, let’s put on a show!” oneoff events. Viola grew it into a sleek machine that employs dozens of people and raises revenues that, via grant processes, have funded food delivery, prevention, care and advocacy services for agencies large and small across the country serving people living with HIV and other illnesses.

Viola announced he is retiring from BC/EFA on December 31 and turning over leadership to Danny Whitman, the group’s longtime development director. Viola talks with POZ about the wild ride he’s been on the past three-plus decades, what BC/EFA’s work has meant to its beneficiaries—and to him—and what comes next.

Where were you born?

I grew up in a suburb of Pittsburgh, then went to a music conservatory in Cincinnati as a musical theater major, then moved to New York City in 1976 to be an actor. The city was such a wreck then—the parks and the subways—but for me, it was all about the theater district and the Upper West Side, where I lived with friends. I came here to be an actor but mainly to be gay—I wanted to explore all that. I got a job as a waiter at The Grand Finale, a club on 70th Street where people like Bernadette Peters and Chita Rivera performed. That was a fabulous entry into the city.

I took theater classes downtown at Uta Hagen’s studio. Those were crazy days, being here at the tail end of what I would call “the party.” I didn’t go dancing so much as I went to the baths, which were like a social club, and gay bars on

Images from BC/EFA fundraisers, clockwise from above: 2024 Broadway Bares; the cast of Merrily We Roll Along and the cast of & Juliet raise funds through the Red Bucket Follies, collecting money as audiences exit.

the Upper West Side, like The Wild Bar, Nickel Bar and Cahoots.

When did AIDS enter the picture?

I remember being at a diner on the Upper West Side in 1981 reading the first New York Times story on the mysterious cancer, Kaposi sarcoma, that was being seen in some gay men. And about five years later, I went to brunch with about eight friends, all of us in our mid-20s, everyone aspiring to be part of the Broadway scene in some way. We were talking about AIDS and pushing it away from ourselves, saying, “Oh, this only affects guys who party harder than we do—older guys.” Well, 10 years later, of those eight guys, four were dead, and two were HIV positive, including myself.

What about your own diagnosis?

I found out I was HIV positive in 1993 at a clinic on 125th Street. I’d tested negative many times before that and had gotten sober in 1988, but I seriously fell off the wagon and ended up in rehab around the same time I got my diagnosis, so it was a double whammy. Broadway Cares (BC) and Equity Fights AIDS (EFA), two groups doing basically the same kind of work, had just merged. Rodger McFarlane, who I worked for and was the executive director at the time, told me I was going to rehab or I’d be fired, so I did. If he hadn’t made me do that, I’m not sure what would’ve happened to me.

I didn’t need to start HIV meds until 1998, by which time, of course, protease inhibitors [effective antiretroviral treatment for HIV] had hit.

When did you first get connected with BC/EFA?

I first got involved with EFA in 1988. I was the assistant to [legendary actor] Colleen Dewhurst, who was president of Actors’ Equity just around when their council had created the Equity Fights AIDS committee. She said to me, “You can handle this.” All my chaotic energy got focused there, and I jumped in like it was going to save my life, and, frankly, it did.

And then when Rodger became head of Broadway Cares, he took me to lunch and suggested that, instead of competing,

BC and EFA work together. He said, “There’s too much possibility here for us to be pissed off at what the other group is doing at any one show.” So we began to work as if it were the same organization. I even mocked up stationery on the Xerox [machine] that said BC/EFA. And then we officially merged in 1992.

You’ve been leading BC/EFA for 28 years. How would you break down that long tenure into chapters?

A big change was in 1996, when we expanded support at the Actors’ Fund to the Phyllis Newman Women’s Health Initiative [which was run by Broadway actress Phyllis Newman, a

we give grants to have some HIV and AIDS component in their mission even if that isn’t the sole focus.

You went from being an aspiring actor to heading a very large nonprofit. What skills did you pick up along the way?

Thankfully, I’d been doing a lot of freelance writing to make a living before BC/EFA, so all the writing involved in running an organization was a skill I already had. But BC/EFA gave me purpose and meaning. It made me learn how important it was to say “Thank you,” to make sure that people really feel appreciated and to really listen to what they need in order to help us. And

“BC/EFA

gave me purpose and meaning.”

cancer survivor who died in 2019]. We did that because of all the women in the theater community who’d helped BC/ EFA take root the past decade, helping to care for primarily gay men.

So we felt it was imperative to support a program to help women. And that began the expansion of our mission and outreach beyond AIDS to what is now called the Entertainment Community Fund, which we’ve provided with $7 million to help with senior services, artists health insurance, addiction recovery services. That expansion was pivotal because it allowed us to keep the entire community engaged in our fundraising once the advent of protease inhibitors gave many people the impression that the AIDS epidemic was over.

Also, our National Grants Program just grew and grew. We’ve awarded more than 450 organizations nationwide a total of $160 million and a total of $150 million to the Entertainment Community Fund. All the organizations

in terms of working with a staff that’s now up to 46 from the initial 10, I learned to share the credit and also take the blame. My staff needs to feel like I have their backs.

What are your priorities before leaving?

I want my leaving to be about expressing gratitude in everything I do, all the opportunities I have to talk to people. I want people to understand how grateful I am.

What do you want to do next?

Initially, I want to make room for something else to happen. To have the time to volunteer or get engaged somewhere. Who knows what that might be? Maybe a political campaign. I’m not looking for another job. I might foster dogs.

I watched my father when he retired at 62. Over the next 20 years he was reinventing himself. He was as busy as ever and happy just giving back without having to be the boss. That didn’t escape my notice. Q

Tom Viola

U.S. DISTRICT COURT STRIKES DOWN HIV BAN AGAINST JOINING THE MILITARY

People on HIV treatment who are undetectable may enlist.

Americans living with HIV who maintain an undetectable viral load can no longer be barred from enlisting in the U.S. armed forces, a federal judge ruled in August, striking down the last remaining policy limiting enlistment for those with HIV.

The ruling came in Wilkins v. Austin, which was filed against the Department of Defense November 2022 by the LGBTQ advocacy group Lambda Legal; Peter Perkowski, Esq.; Scott A. Schoettes, Esq.; and Winston & Strawn LLP.

“Defendants’ policies prohibiting the accession of asymptomatic HIV-positive individuals with undetectable viral loads into the military are irrational, arbitrary, and capricious. Even

worse, they contribute to the ongoing stigma surrounding HIV-positive individuals while actively hampering the military’s own recruitment goal,” wrote Judge Leonie Brinkema of the U.S. District Court for the Eastern District of Virginia.

As POZ reported in November 2022, Wilkins v. Austin was filed on behalf of the plaintiffs Isaiah Wilkins, a 23-year-old Black gay cisgender man; Carol Coe, a 32-year-old Latina transgender lesbian; and Natalie Noe, a 32-year-old cisgender straight woman of Indigenous Australian descent living in California. All plaintiffs are HIV positive.

“Modern science has transformed the treatment of HIV, and this Court has already ruled that asymptomatic HIV-positive service members with undetectable viral loads who maintain treatment are capable of performing all of their military duties, including worldwide deployment,” Brinkema wrote. “Now, defendants must allow similarly situated civilians seeking accession into the United States military to demonstrate the same and permit their enlistment, appointment and induction.”

The case was filed the same year a federal judge struck down a policy that permitted the Pentagon to discharge service members living with HIV and deny them promotions. Also in 2022, the Department of Defense updated its policy to allow service members living with HIV whose viral load is undetectable to continue to serve and remain deployable. —Trent Straube

COVID-Monkey-AIDS Pox?

Don’t be alarmed by social media posts making such claims.

If you’ve scrolled through social media posts recently, you might have seen posts announcing, “the first person ever diagnosed with COVID-monkeyAIDS-pox” and stating, “This is getting serious guys.” The posts also include a news video from LA-based broadcaster ABC7. Although the posts contain some facts, they twist reality into scarysounding clickbait.

First off, there is no such thing as a single virus that causes COVID-19, mpox (formerly known as monkeypox) and HIV (the virus that, when untreated, can lead to AIDS). However, it is possible for an individual to contract each of these viruses separately within a short time period and become coinfected with all three at once.

In fact, as Reuters reports in an article investigating the claims behind these social media posts, the ABC7

news segment originally aired in August 2022 and describes the first documented case of a person coinfected with mpox, SARS-CoV-2 (which causes COVID-19) and HIV.

At the time, it wasn’t known that COVID-19 and mpox could occur simultaneously. The case was later written about in the Journal of Infection.

In that unusual case, a 36-year-old Italian man returned from a trip to Spain in 2022 and, after developing various symptoms, including fever, sore throat and a rash, tested positive for SARS-CoV-2 and mpox. He was also screened for HIV and various sexually transmitted infections and tested positive for HIV. Studies have shown that people with advanced HIV can develop more severe mpox illness.

Why would misleading posts declaring a super pox be gaining traction

now? Not only do they prey on common fears, but they also play on current news.

This past summer, COVID-19 surged and a new version of mpox was spreading in Africa, with at least one case documented in Europe. Meanwhile, updated vaccines are available for COVID, and vaccinations against the strain of mpox that appeared in the United States in 2022 also protect against the new mpox. —TS

In a First, CDC Funds Pilot

PrEP Program Grants will assist at-risk priority populations.

The federal government is, for the first time, funding a pilot program that will provide generic pre-exposure prophylaxis (PrEP) medications to prevent HIV. Specifically, the Centers for Disease Control and Prevention (CDC) has made about $10 million available for PrEP programs in jurisdictions already receiving funding for the Ending the HIV Epidemic in the United States initiative.

The initiative targets counties, cities and other jurisdictions that account for a disproportionate number of new HIV cases.

The CDC funding was announced in August. In October, the CDC announced five recipients. They are the city health departments of Baltimore, Maryland, and Houston, Texas, as well as the state health departments of Florida, Oklahoma and South Carolina.

As the federal government explains in its funding description:

“Jurisdictions with greater need for PrEP and lower uptake among priority populations disproportionately affected by HIV and low PrEP prescriptions (i.e., Black and Latino gay, bisexual, and other men who have sex with men…and Black cisgender and transgender women) need these additional resources and flexibility to accelerate PrEP uptake through patient navigation/case management services and improve access to and utilization of existing PrEP services not covered by other financial resources.”

In addition to supporting PrEP access and uptake, the CDC funding will support efforts to increase awareness of and access to post-exposure prophylaxis (PEP), which refers to the antiretroviral medications taken soon after a potential exposure to HIV in order to prevent infection, as well as doxycycline post-exposure prophylaxis (doxyPEP) to prevent sexually transmitted infections (STIs), such as chlamydia, syphilis and gonorrhea.

For several years, PrEP advocates have pressured the government to fund a national PrEP program to make the prevention tool available to those who need it most. Advocates from PrEP in Black America and PrEP4All, among others, praise this new funding opportunity by the CDC. —TS

ANOTHER ATTACK ON THE AFFORDABLE CARE ACT

Enhanced subsidies are set to expire in late 2025.

The Affordable Care Act (ACA) is back under attack. Not as in the repeal-and-replace debates of yore, but in a fresher take from Republican lawmakers who say key parts of the ACA cost taxpayers too much and provide incentive for fraud.

Several House Republican leaders have called on two watchdog agencies to investigate, while Senator Chuck Grassley (R–Iowa) fired off more than half a dozen questions in a recent letter to the Centers for Medicare & Medicaid Services.

At issue are the ACA’s enhanced subsidies, put in place during the COVID-19 pandemic as part of economic recovery legislation. Grassley said in a recent news release that the subsidies “left Obamacare, a program already riddled with problems, wide open to new waste, fraud and abuse.”

While potential fraud in government programs has always been a rallying cry for conservatives, the recent criticisms are a renewed line of attack on the ACA because repealing it is unlikely, given that more than 21 million people enrolled in marketplace plans for this year.

“I see what’s happening right now as laying the groundwork for the big fight next year,” said Debbie Curtis, a vice president at consulting firm McDermott.

The enhanced subsidies are set to expire in late 2025. Without them, millions of Americans would likely see their premiums go up.

But the debate will also likely draw in other issues, including Trump-era tax cuts, which also must be addressed next year. Also potentially in play are other aspects of the ACA, including a special year-round enrollment period and zero-premium plans for low-income consumers.

Much of what eventually happens will depend on the makeup of the Senate and House, as well as control of the White House, after the November elections. Both sides have incentive to extend all or part of the tax cuts, but each will want some kind of compromise on other issues as well. —Lauren Sausser and KFF Health News

IMPORTANT FACTS FOR BIKTARVY®

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.

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.

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.

#1 PRESCRIBED HIV TREATMENT*

*Source: , 04/19/2019 through 05/19/2023.

SWITCHED TO BIKTARVY

Listen to REAL STORIES being told by REAL VOICES.

Person featured takes BIKTARVY and is compensated by Gilead.

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

Ask your healthcare provider if BIKTARVY is right for you.

*This information is an estimate derived from the use of information under license from the following IQVIA information service: IQVIA NPA Weekly, for the period week ending 04/19/2019 through week ending 05/19/2023. IQVIA expressly reserves all rights, including rights of copying, distribution, and republication.

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

IQVIA NPA Weekly

Rising From the Ashes

Kimberly Nail turned her mess into a message.

Growing up in the ’90s, I remember the “Just Say No” antidrug campaign and the fried egg commercials that said, “This is your brain on drugs.” When I was in seventh grade, my dad went into treatment for drug addiction. I attended Al-Anon, NA and AA meetings with him. I knew of the dangers of using drugs and the risk of addiction. But at age 21, I quickly became a binge drinker and, for a short period, a blackout drunk.

In November 2014, my Nana, who helped raise me, suffered several massive strokes and was unconscious in the hospital. I had never really lost anyone close to me before and didn’t want to feel that pain. I thought meth might lift me up.

From the first hit, I felt invincible. When my parents let me know that Nana had passed away, I didn’t want to be a part of reality anymore, so I checked out.

My meth use started as a weekend hobby, then quickly turned into a 24/7 habit. On New Year’s Eve, I met a new guy, and we became involved. He was shooting meth, and I wanted to try it. I completely abandoned all my drug

EVERYDAY

education, as well as my common sense, for a guy, a drug and a needle.

At the end of February, I went to the local health department to get my birth control renewed. I didn’t hide the fact that I was using needles for meth, so they suggested an HIV test. A few weeks later, I received a phone call asking me to go to the local health unit to discuss my test results. I was told I was HIV positive. I was in shock and total disbelief.

After my diagnosis, I stopped using needles but continued to use meth. I started dating another loser who became verbally and physically abusive. During a visit to his brother’s house, he began yelling at me, and I couldn’t take it anymore. I took a big kitchen knife and all my medications to the bathroom and shut the door. I thought that I had no other way out.

I took four anxiety pills, five sleeping pills and 20 blood pressure pills. If that didn’t work, I had the knife.

He eventually found me and took me to my family and dumped me out of the car with my belongings. I collapsed as soon as I walked into my parents’ house, and they called 911.

At the hospital, my blood pressure was dangerously low. My skin was cold and gray, my eyes were fixed, I was dying. The doctors told my parents that they had done all they could and to prepare to say their goodbyes.

I was in a coma for two days. On September 25, 2015, I woke up. I had hit my rock bottom. While looking for a Christian rehab, I came across The

Dorcas House, where I took classes on domestic violence and the 12 steps. I also got baptized.

I’ve been living with HIV for nine years and clean from meth for over eight years. My mess has turned into a message.

As a community health worker with the nonprofit Engaging Arkansas Communities, I educate people about HIV, stigma, prevention and other sexually transmitted infections. I try to deliver a diagnosis with compassion and empathy and spread awareness that HIV is manageable. I am living proof of God’s miracles and am currently undetectable, making it impossible for me to transmit HIV through sex. This is known as U=U, or Undetectable = Untransmittable. In 2021, I gave birth to an HIV-negative son.

What is your greatest regret?

Regrets keep people from moving forward. I don’t really have regrets, just lessons learned for the future.

What keeps you up at night?

Being HIV positive is not a crime. Science has improved the quality of life for those living with HIV, but the laws are outdated, prejudiced and stigmatizing.

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

The Centers for Disease Control and Prevention’s Act Against AIDS initiative launches a multimedia campaign titled “DOING IT” to promote routine HIV testing. (2015) 1 7

NAKED, a documentary film about the making of the 10th anniversary cover of POZ, premieres on Cinemax. (2006)

20 27

The Food and Drug Administration approves THE FIRST LONG-ACTING INJECTABLE option for HIV pre-exposure prophylaxis (PrEP). (2021) Singer, songwriter, composer, author and activist MICHAEL CALLEN dies of AIDS-related causes at age 38. He helped draft The Denver Principles and cowrote How to Have Sex in an Epidemic: One Approach. (1993)

Kimberly Nail

PRIVILEGE AND PRICE

In a blog post titled “The Privilege, and Price, of Aging With HIV,” POZ contributing writer Shawn Decker reflects on his struggles to survive with the virus and shares thoughts on an after-life. Below is an edited excerpt.

AS I APPROACH AGE 50 NEXT year, my overall health is on the front burner in a way that it hasn’t been since I started on HIV medications at age 23.

It’s not that my health hasn’t always been a focus. When my parents found out their second son had the rare bleeding disorder hemophilia, it impacted our entire family. It wasn’t long before I contracted hepatitis B via the contaminated blood products that would also gi wrap HIV and hepatitis C. But while my health was a focus for my parents, as a kid, I did everything I could to ignore my medical résumé.

For a few years in elementary school, I played baseball. As a teenager with HIV, I got into music. I refused to read the T-cell leaves and weathered the stigma storms. I also found a measure of peace in living day-to-day without the existential pressures that come with planning for a future. Things really changed dramatically when, at age 20, I discovered my love for writing, put up one of the ﬁrst HIV websites in 1996 and was soon a contributing writer for POZ. Even then, however, I didn’t take my health seriously. It was more like putting

a “Kick Me” sign on the back of the grim reaper’s cloak at school. Everyone laughed, everyone high-ﬁved. But a lot of my biggest supporters in those early days of speaking out were worried. Recently, my wife, Gwenn, and I were going through some old boxes, and I found a stack of emails I’d printed. One was from POZ founder Sean Strub. In it, he said the o ce was worried about my health.

His email came a er I’d returned home a er a short attempt decades ago to move to New York City. That’s because soon a er I got home, I had a two-month-long bronchial infection. Sean and my friends at POZ were worried because, given my history with prescription medication, I was as scared of side effects as I was of HIV.

A er falling in love with Gwenn— who I wouldn’t have met had I not opened up about HIV—I ﬁnally had to face my virus. It ﬁnally caught me sticking that sign on its back, and it was pissed. So was I, actually. I’d just moved from my parents’ place to Charlottesville, a safe 20 or so miles away. I wanted to focus on my music and take a break from HIV. That’s a

laugher, huh? “Hey, HIV, chill while I get my synth pop on.”

My only shot at survival was to start taking HIV medications. The side effects sucked, but my T cells rebounded. Gwenn had moved in with me shortly before that big change. Part of not being able to put off starting meds was not being able to pretend I was healthier than I actually was. Within two years, she saw me at my worst health and my best.

With more T cells and motivation to educate than I’d ever had before, Gwenn and I were off to the races, educating as a couple about HIV, stigma and healthy relationships.

Denial was a safe—albeit lonely— place where I couldn’t dwell on a future of any kind for too long, because that future certainly involved an AIDSrelated death. Still, close calls with hemophilia expedited my making peace with my mortality, to the credit of my mom’s wise teachings in what had to be some really scary moments.

I actually loved the thought of an a er-life. Living without a body marred by medical mayhem seemed kind of cool. Still does, actually. Q

Shawn Decker (left) with the late Stephen Gendin, his friend and a former POZ staffer

BE PREPARED

HIV.gov reposted a CDC.gov blog entry titled “September 27 Is National Gay Men’s HIV/AIDS Awareness Day,” by Robyn Neblett Fanfair, MD, MPH, and Jonathan Mermin, MD, MPH, about a new program. Below is an edited excerpt.

RECENTLY, ENCOURAGING

progress shows declines in new HIV cases among gay and bisexual men overall as well as among many subgroups. However, gay and bisexual men continue to be most affected by the virus. Of the 31,800 estimated new HIV cases in the United States in 2022, 67% (21,400) were among this group. In 2022, almost half (47%) of new HIV cases among gay and bisexual men were in the South, and nearly three fourths (73%) of those were among Black and Latino men.

The annual number of estimated new HIV cases in 2022 compared to 2018 shows a 10% overall decrease among gay and bisexual men. Age-speciﬁc trends reveal a 31% decrease among all young gay and bisexual men ages 13 to 24; by region, there was a 16% decrease among gay and bisexual men who live in the South.

Among Black gay and bisexual men, there was a signiﬁcant 16% overall decrease, including a 26% reduction among young Black men ages 13 to 24. Similarly, among white gay and bisexual men, there was a 20% overall decrease, including a 39% reduction among young white men ages 13 to 24. Cases among Latino gay and bisexual men remained stable, indicating a need for

better understanding of the situation and improved support.

Although progress is being made, it has been uneven. Pre-exposure prophylaxis (PrEP) is a key tool in continuing to reduce new HIV cases, and recent surveillance data from the National HIV Behavioral Surveillance system show increases in PrEP awareness and use among a survey of gay and bisexual men.

From 2017 to 2023, the proportion of gay and bisexual men who were aware of PrEP increased from 85% to 93%, and PrEP use among gay and bisexual men increased from 25% to 45%.

Overall increases in PrEP prescriptions among people who could beneﬁt show that since the implementation of Ending the HIV Epidemic in the U.S. in 2019, the number of people in the United States who have been prescribed PrEP has increased.

Even so, the reach of this strategy is far from equal, and substantial racial and ethnic disparities persist. Black gay and bisexual men and Latino gay and bisexual men reported increases in PrEP awareness and use over the same period, but more culturally and linguistically appropriate access to HIV testing and prevention services is needed.

To address these disparities, the Centers for Disease Control and Pre-

vention (CDC) is launching PrEPared/ PrEParado, a social marketing initiative under the CDC’s “Let’s Stop HIV Together” campaign to increase PrEP uptake among Black and Latino gay and bisexual men in the South.

PrEPared aims to encourage conversations about PrEP between Black and Latino gay and bisexual men and their providers, increase the number of providers prescribing PrEP and increase the number of Black and Latino gay and bisexual men in the South who get and stay on PrEP. In the coming months, the CDC will partner with health departments and local partners across the South for co-implementation of the initiative.

The CDC’s “Let’s Stop HIV Together” campaign offers valuable resources to support HIV prevention efforts across the country. “Let’s Stop HIV Together” is an evidence-based campaign in English and Spanish that aims to empower communities, partners and health care providers to reduce HIV stigma and promote HIV testing, prevention and treatment. Together, we can all work to reduce HIV-related disparities among gay and bisexual men and continue our hardearned progress toward ending the HIV epidemic in the United States. Q

USCHA 2024

NMAC’s annual U.S. Conference on HIV/AIDS (USCHA), often described as a family reunion for the HIV community, brought together thousands of attendees representing hundreds of nonprofits at the Hyatt Regency New Orleans from September 12 through 15.

The theme of this year’s event, “Southern Joy,” underscored the importance of centering the South in efforts to end the HIV epidemic nationally. Workshop topics included confronting racism, smashing stigma, boosting pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) among people of color, driving equity through patient-centered interventions for people of trans experience and expanding access to doxyPEP for sexually transmitted infections, among dozens more. Given the link between injection drug use and hepatitis C and HIV infection, numerous workshops also highlighted the need to ramp up access to harm reduction methods. Throughout it all, joy and hope were very much on display at USCHA, as evidenced by these photos from social media.

1. Two-time Georgia gubernatorial candidate and voting rights champion Stacy Abrams delivered the keynote speech at a plenary luncheon and urged attendees to speak up, stand up and show up to bring about change. 2. In choosing New Orleans as the venue for USCHA, NMAC recognized the need to prioritize the South in the fight against HIV while also celebrating the resilience, strength and culture of the region that birthed the civil rights movement. 3. Arianna Lint, president and CEO of Fort Lauderdale’s Arianna’s Center, serving the area’s trans community, stopped by the AIDS United booth for a selfie. 4. Andrew Ogata and Heather Lusk of Hawai’i Health & Harm Reduction Center said, “Aloha” as they posed before panels from the AIDS Memorial Quilt. Ogata participated in a panel discussion on doxyPEP and STI prevention.

5. Managing editor Jennifer Morton, science editor Liz Highleyman and community support coordinator Sarah Pursell , of media sponsor POZ, at the magazine’s booth. 6. A. Toni Young, executive director of the Community Education Group, hoped to draw attention to, among other issues, the HIV crisis in Appalachia. Though the region’s opioid epidemic has made many headlines, the resultant HIV crisis is often neglected. 7. Francisco Ruiz , director of the White House Office of National AIDS Policy, connected with New Orleans–based advocate Arely Westley, the campaign director at BreakOUT!, which empowers Black and Latinx transgender and gender-nonconforming youth via leadership development programs. 8. Texas State Representative Venton Jones addressed attendees during the opening plenary session. 9. Advocate Mario Campos of Florida participated in a panel titled “Empowering Young Adults to Facilitate HIV Prevention Strategies and Programs.”

BABA GANOUSH

This recipe uses items you may already have in your fridge.

TAKE A BREAK FROM THE SAME old hummus and try this smoky, hearty dip. Baba ganoush is extremely easy to make, and, with the possible exception of eggplant, the ingredients for this recipe are probably already in your fridge.

SERVINGS: 6 / INGREDIENTS: 9 / PREP: 10 MINUTES

INGREDIENTS

3 medium Italian eggplants

2 cloves of garlic, peeled and crushed ½ teaspoon sea salt

DIRECTIONS

2 heaping tablespoons of tahini, unsweetened peanut butter or almond butter ½ cup low-fat Greek yogurt Juice from ½ lemon (optional)

1. Heat the grill. (See Chef Tips, if you are not grilling.)

1 teaspoon lemon zest Fresh parsley, chopped for garnish (optional) Smoked paprika, for garnish (optional)

2. Grill the eggplants until they are soft and their skins are charred and blackened. Let cool slightly. Cut them in half and scoop out the flesh into a bowl. Set aside. Discard the skins.

3. Chop the garlic and the salt together until they form a paste.

4. Place all the cooked eggplant onto the cutting board and chop it. Toss the chopped eggplant in a bowl or food processor, and add the tahini and yogurt. Chop or blend until creamy. Fold in the lemon juice if using.

5. Fold in the lemon zest and pour the mixture into a bowl. Leave covered in the fridge for 30 minutes to let the flavors blend. Serve with baked pita chips.

CHEF TIPS

If you’re not grilling, then you can simply bake the eggplant. For steps 1 and 2: Preheat the oven to 400°F. Prick the eggplants and lay them on a baking sheet. Bake for 40 minutes and let cool slightly. Cut the eggplants in half and scoop out the insides into a bowl. Set aside. Discard the skins. Continue on to step 3.

If possible, always use organic lemons when zesting because their skin is pesticide- and waxfree. When using conventional lemons, wash the skins thoroughly before you start work.

NUTRITION FACTS (per serving)

Calories: 123; fat: 4 g; saturated fat: 1 g; polyunsaturated fat: 1 g; monounsaturated fat: 2 g; carbohydrates: 19 g; sugar: 11 g; fiber: 9 g; protein: 7 g; sodium: 173 mg

SUPERFOODS: VEGETABLES

By Craig Ramsay

What if you could lower your cholesterol, reduce your risk for heart disease and cancer and improve your state of mind with food? Turns out, you can! Superfoods contain a high level of nutrients and are a great way to boost your health.

Toss these vegetables into your grocery cart:

Asparagus

Beets

Broccoli

Brussels sprouts

Garlic

Kale

Spinach

Sweet potatoes

Swiss chard

NOTE: Even though beans, dried peas and lentils are legumes (technically fruits), the Department of Agriculture dietary guidelines consider these superfoods vegetables, so enjoy them too!

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.

BY LIZ

PREVENTION

HIV Risk for Women

The vaginal microbiome and tissue inflammation may increase women’s likelihood of acquiring HIV, according to a NIAID-sponsored study. Researchers analyzed vaginal swab samples from nearly 600 women in a biomedical prevention trial in African countries with high HIV incidence. They compared bacterial and inflammatory profiles of 150 women who acquired HIV and 436 women who did not. The team identified 14 species of vaginal bacteria linked to HIV acquisition and found that women with most or all of these species had the highest odds of infection, while those with few or none had the lowest risk. They also identified six associated inflammatory cytokines and chemokines, chemical messengers that play a role in immune response. Women with all six proteins were at greatest risk for HIV acquisition. One chemokine in particular—interferongamma-induced protein 10— was associated with the highest risk of infection. The results suggest that strategies to reduce these bacteria species and infl ammatory proteins might help prevent HIV acquisition.

TREATMENT

Drug Resistance

Switching from another antiretroviral regimen to dolutegravir plus lamivudine is a feasible option even for people who experienced prior treatment failure and have drug-resistance mutations. Dolutegravir/lamivudine (DTG/3TC, the components of the Dovato combination pill) is approved as a switch option for people with an undetectable viral load, no prior virological treatment failures and no known mutations associated with resistance to either drug—which means a majority of treatment-experienced people don’t qualify. The SOLAR-3D trial enrolled 100 virally suppressed people with prior virological failure, half of whom had prior or current M184V/I resistance mutations. DTG/3TC was highly effective for people with or without these mutations. Three years aŸer switching to DTC/3TC, there were no cases of conﬁrmed virological failure among those with M184V/I mutations, and no cases of new treatmentemergent resistance were observed. These ﬁndings suggest that switching to DTG/3TC could be a costsaving approach, especially in lower-income countries.

CURE

CRISPR Gene Therapy

A CRISPR-based gene-editing therapy was safe and well tolerated in a Phase I study, but it did not prevent viral rebound aŸer stopping antiretroviral treatment. Antiretrovirals can keep HIV suppressed, but the virus inserts its genetic blueprints into human cells and establishes a long-lasting reservoir that makes a cure nearly impossible. EBT-101, from Excision BioTherapeutics, acts as “molecular scissors” to cut viral DNA out of cells. The study enrolled people on antiretrovirals with an undetectable viral load. They received a single IV infusion of EBT-101. Three of the ﬁrst four participants who undertook an analytical treatment interruption experienced viral rebound at 2, 3.5 and 4 weeks. But the fourth man had a shrinking viral reservoir and went 16 weeks before he experienced viral rebound, considerably longer than it usually takes for the virus to return aŸer stopping antiretrovirals. Rebound likely occurred because the gene therapy did not reach all cells harboring latent HIV. The ﬁndings suggest CRISPRbased therapies might play a role in a combination functional cure strategy.

CONCERNS

COVID Evolution

SARS-CoV-2, the virus that causes COVID-19, has the potential to rapidly evolve in people with a weakened immune system. Like HIV, SARS-CoV-2 can evolve quickly, giving rise to multiple new variants, some of which may evade immune defenses and cause more severe illness. SARS-CoV-2 can persist longer in people with compromised immunity, giving it more time to evolve. NIAID researchers analyzed SARSCoV-2 spike protein genes from 47 HIV-positive and HIV-negative COVID patients in South Africa. They found that people with advanced HIV—as indicated by a CD4 T-cell count below 200—had a median of 47 SARS-CoV-2 variants, and some had more than 100. What’s more, the viral population became more diverse over the course of COVID. In contrast, most HIV-negative people and HIV-positive people with a higher CD4 count had just one major SARS-CoV-2 variant, with little evidence of viral evolution. These ﬁndings conﬁrm that being on antiretroviral treatment and maintaining an undetectable HIV viral load is key to avoiding prolonged and severe COVID.

Twice-Yearly PrEP Works Well for Gay Men

Lenacapavir, Gilead Sciences’ twice-yearly HIV capsid inhibitor, was highly effective as pre-exposure prophylaxis (PrEP) in a second large study, according to data presented at the HIV Research for Prevention Conference in Lima, Peru.

The PURPOSE 2 trial enrolled more than 3,000 gay and bisexual men and genderdiverse people in the United States and six other countries. They were randomly assigned to receive either lenacapavir injections every six months or Truvada (tenofovir disoproxil fumarate/emtricitabine) pills once daily.

There were two new HIV diagnoses among the 2,180 participants in the lenacapavir group and nine cases among the 1,087 people assigned to Truvada. Lenacapavir reduced the risk of HIV acquisition by 96% compared with the background incidence rate and 89% more than daily Truvada. Lenacapavir was generally well tolerated, and no new safety concerns were identiﬁed. Some participants developed injection site reactions or nodules, but less than 1% stopped PrEP for this reason.

“These data reinforce that twice-yearly lenacapavir could be a highly effective and potentially game-changing HIV prevention choice that we have long hoped for in our efforts to end the HIV epidemic,” says Colleen Kelley, MD, MPH, of Emory University.

But this promise can only be realized if lenacapavir PrEP is available to those who need it most. Gilead plans to submit the new results—along with data from the PURPOSE 1 trial, which showed that lenacapavir PrEP was 100% effective for young cisgender women in Africa—to the Food and Drug Administration by the end of the year, anticipating approval in 2025. Responding to pressure from advocates and global health leaders, Gilead recently announced that it will work with six pharmaceutical manufacturers to produce and sell generic versions of lenacapavir for PrEP in more than 100 resource-limited countries.

PEOPLE LIVING WITH HIV HAVE UNMET NEEDS

New ﬁndings from the CDC’s Medical Monitoring Project, an annual national survey of people diagnosed with HIV, show that needs are not being adequately met. Physical and mental health, subsistence needs and stigma can all affect quality of life for people living with HIV. Older people, in particular, are more prone to comorbidities as they age, and their needs may change as they transition to Medicare.

Looking at all HIV-positive people surveyed, 72% reported that their health was good or better in 2018, falling slightly to 70% in 2022. In a separate analysis of those ages 50 and older, the rate dropped to 65% in 2022. The 2022 survey also found that 27% of people with HIV overall and 22% of those 50 and older had an unmet need for mental health services; 18% and 13%, respectively, were unstably housed or homeless; 11% and 8% were unemployed; and 19% and 14% experienced hunger or food insecurity.

Overall, these ﬁve quality-of-life indicators did not change much from 2017 to 2022, and none of them came close to reaching the U.S. National HIV/AIDS Strategy goals for improvement by 2025. For example, the 2025 goal for good or better self-rated health is 95%.

“Improving quality of life and addressing social determinants of health requires a multisectoral approach that moves beyond clinical care,” Linda Beer, PhD, of the CDC’s Division of HIV/AIDS Prevention, and colleagues wrote.

DHHS UPDATES HIV GUIDELINES

In September, the Department of Health and Human Services updated its Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents With HIV.

For people starting antiretroviral therapy, dolutegravir/ abacavir/lamivudine (the drugs in Triumeq) has been removed from the list of recommended initial regimens for most people with HIV because abacavir requires hypersensitivity testing and can increase cardiovascular risk. Regimens containing boosted elvitegravir, raltegravir or boosted atazanavir as well as the rilpivirine/tenofovir disoproxil fumarate/emtricitabine combination (the drugs in Complera) are no longer recommended for ﬁrst-line treatment due to a higher pill burden, more side effects or a lower barrier to resistance.

People with HIV and hepatitis B virus coinfection should use drugs that are dually active against both viruses.

For those who are unable to maintain viral suppression on a daily oral regimen

despite intensive adherence support, long-acting injectable cabotegravir and rilpivirine (Cabenuva) may be a feasible option. The Food and Drug Administration has approved Cabenuva only for people switching from another regimen with an undetectable viral load, but pilot studies have shown that it also works well for some people without viral suppression.

The guidelines also feature updated recommendations for people with HIV and tuberculosis, older people living with HIV (including use of statins to reduce the risk of cardiovascular disease), transgender people (including an update on interactions between antiretrovirals and gender-a rming hormone therapy), people with substance use disorders and recipients of organ or stem cell transplants. The guidelines panel emphasizes that addressing social determinants of health is essential for enhancing adherence throughout the HIV continuum of care.

Pain Management Program for People With HIV

A tailored behavioral approach known as Skills to Manage Pain, or STOMP, may help relieve chronic pain and improve daily functioning for people living with HIV, according to a recent study. Research suggests that a majority of people with HIV experience persistent pain, which can lead to disability, decreased quality of life and di culty adhering to antiretroviral treatment.

Katie Fitzgerald Jones, PhD, of the New England Geriatric Research Education and Clinical Center, and colleagues enrolled 278 HIV-positive adults who had experienced chronic pain for at least three months. At the start of the study, 78% had pain at multiple sites, and nearly a quarter reported long-term opioid use. They were randomly assigned to participate in the STOMP intervention— which involves six one-on-one skills-building sessions with trained social workers alternating with six peer group sessions— or enhanced usual care. However, due to the COVID-19 pandemic, the intervention switched to a remote telephone format eight months into the three-year study.

On average, STOMP participants attended less than half of the sessions, and about a quarter attended none at all. Nevertheless, this group saw a signiﬁcantly greater reduction in pain immediately a er the intervention and three months later, compared with the usual care group. The STOMP group reported more improvement in both pain severity and functional impairment as well as general activity, depression, feelings of self-e cacy and enjoyment of life.

“STOMP is the ﬁrst peer-involved pain self-management intervention to our knowledge that produced a clinically meaningful result,” the researchers concluded. “STOMP has the potential to improve the lives of people with HIV with chronic pain.”

HONORING THOSE WHO HAVE MADE LASTING CONTRIBUTIONS IN THE HIV COMMUNITY

BY JENNIFER MORTON

CCORDING TO MERRIAM-WEBSTER, AN ICON IS “A PER-

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HYDEIA BROADBENT

By Andy Feds

A courageous advocate and a messenger of hope

Born with HIV, Hydeia Broadbent began publicly sharing her story and speaking about HIV at age 6. In 1992, she appeared on a Nickelodeon special about HIV with basketball star Magic Johnson. She later appeared as a guest on The Oprah Winfrey Show, The Maury Povich Show, Good Morning America and many other national programs. In 1996, Hydeia addressed the Republican National Convention and read a poem she wrote, the last line of which was: “I am the future, and I have AIDS.”

As a fellow person born with HIV, I followed her career my entire life. Hydeia was a hero to many, many people. She educated people about HIV through her work with the Magic Johnson Foundation, the Elizabeth Glaser Pediatric AIDS Foundation and other AIDS organizations.

I was fortunate to be friends with Hydeia and stood by her side until the end of her historic life. I learned so much from this woman, and I wanted to be sure that she knew how much she meant to me and the world. When I moved to Las Vegas in 2017, I met Hydeia in person, and we became friends very quickly. She allowed me to pick her brain about advocacy, humanitarianism and life in general. She went from being a hero to a friend to a big sister. I spent the last few months of her life at her bedside, providing the same supportive friendship that she gave me in the hope that she would make a quick recovery and get back to inﬂuencing others.

Hydeia’s story and legacy have helped many people living with HIV learn a single word: hope. Fearlessly battling HIV- and AIDS-related stigma, Hydeia opened the door for many people living with the virus and helped them understand that they can live a long, healthy and happy life. Although physically, Hydeia left us earlier this year, there’s no doubt in my mind that her name will carry weight for a very long time!

Andy Feds is a stand-up comedian and global HIV and AIDS advocate.

Hydeia Broadbent is born.

1992

Hydeia appears on the Nickelodeon television special A Conversation with Magic

1997

Hydeia receives the Pedro Zamora Memorial Award for Youth Advocacy from AIDS Action.

2002

Hydeia and her mother publish their memoir, You Get Past the Tears: A Memoir of Love and Survival.

2012

Hydeia appears in the CDC campaign “Let’s Stop HIV Together.”

2024

Hydeia dies at age 39.

1984

1987

Hydeia’s adoptive parents learn that she is living with HIV.

1996

Hydeia addresses the Republican National Convention with activist Mary Fisher.

1999

Mariah Carey presents Hydeia with an Essence Award for her activism.

2008

Hydeia is named one of Ebony’s “150 Most In˜uential African Americans.” She makes the list again in 2011.

2014

Hydeia appears on a Where Are They Now? special on the Oprah Winfrey Network.

Hydeia Broadbent in 2017

CECILIA CHUNG

By Shelby Chestnut

Cecilia Chung is a true legend. Not only is she a tireless advocate and trailblazer for transgender rights, but she is also a beacon of hope and transformation for countless individuals within the LGBTQ+ community and beyond—particularly for those living with HIV.

A trailblazing advocate for equality and dignity

Her life’s work is nothing short of extraordinary. Spanning decades and crossing borders, Cecilia has taken the challenges she has faced and turned them into a driving force for change. From overcoming personal struggles to becoming an international advocate, Cecilia’s journey is a testament to resilience, courage and the unwavering pursuit of justice.

Her impact is undeniable. As the first transgender woman and the first Asian American to lead the board of directors of the San Francisco LGBT Pride Celebration, Cecilia shattered ceilings and paved the way for others to follow. Her visionary leadership of the Transgender Law Center, where she played an instrumental role in creating Positively Trans—a national network supporting trans people living with HIV—has had a transformative effect on health care, housing and legal protections for all. Her influence has reached the highest levels of government, as demonstrated by her appointment to President Barack Obama’s Presidential Advisory Council on HIV/AIDS.

Cecilia’s work has changed lives—not just those of trans people or people living with HIV—but also those of everyone ﬁghting for equality and dignity. Her leadership has shaped policies that ensure that people can live with hope, access health care and enjoy the dignity we all deserve. Cecilia is more than a leader; she is a mentor, a visionary and a relentless advocate for the rights and lives of the most marginalized.

Because of her unwavering ﬁght and profound dedication, we are, without question, a better and more compassionate society. We honor the powerful legacy Cecilia continues to build and thank her for inspiring us, leading us and reminding us all that true liberation is within our reach.

Shelby Chestnut is the executive director of the Transgender Law Center.

Cecilia Chung is diagnosed with HIV.

2002

Cecilia joins the board of the Asian Paciÿc Islander Wellness Center.

2005

Cecilia becomes the ÿrst deputy director of the Transgender Law Center.

1993

1994

Cecilia joins the San Francisco Transgender Discrimination Task Force.

2004

Cecilia becomes a founding producer of the Trans March.

2012

Cecilia is appointed to the San Francisco Health Commission.

2013

Cecilia is appointed to the Presidential Advisory Council on HIV/AIDS by President Barack Obama.

2017

Cecilia’s life story inspires a character on the ABC miniseries When We Rise

Cecilia is presented with the Levi Strauss and Co. Pioneer Award.

2015

Cecilia launches Positively Trans, a network to address stigma and inequity.

2020

Cecilia receives a NAAAP100 Award, which recognizes exemplary leaders in the Asian community.

Cecilia Chung in 2012

DENNIS deLEON

By Guillermo Chacon

A passionate leader and an inspiration to others

Human rights lawyer, advocate, community leader and role model—these are just a few of the titles for which Dennis deLeon will be remembered. His largerthan-life approach to the world will live on in our minds and hearts forever. Dennis was born in Los Angeles in 1948. He attended Occidental College, where he served as student body president. Shortly after graduating from college, he attended Stanford Law School and began practicing law in 1974. From the start of his career through the 1980s, Dennis built a distinguished legal career in Washington, DC, and California.

In the early ’80s, he moved to New York City, where he held appointed positions and was a civic leader. In 1990, when David Dinkins became mayor, Dennis served as director of transition for the new administration. That same year, Mayor Dinkins named him the city’s commissioner of human rights. While serving in this role, he announced in an opinion letter published in The New York Times in 1993 that he was living with HIV. His brave announcement was crucial in raising awareness and challenging the social stigma associated with HIV.

In September 1994, Dennis became the second president of the Latino Commission on AIDS. His passionate leadership and advocacy skills helped launch the commission’s platform, shaping the commission into the reputable and prominent local, regional and national community-based organization it is today. In 1995, Dennis hired me as a community organizer. From the outset, his dedication to being a voice for the voiceless in our movement and his wish to design a world without AIDS were a source of inspiration. He became a mentor to me, and I was honored when he promoted me to vice president.

We aim to honor the legacy of leaders who paved our way, like Dennis, through our daily actions until together, we end HIV and eradicate all forms of stigma—especially homophobia, transphobia and xenophobia in every family and community.

Guillermo Chacon is the president of the Latino Commission on AIDS.

Dennis deLeon earns a law degree from Stanford University.

1986

Dennis is appointed director of the Mayor’s Commission on Latino Concerns.

Dennis tests positive for HIV.

1974

1982

New York City Mayor Ed Koch appoints Dennis as senior assistant corporation counsel.

1988

Dennis is named Manhattan deputy borough president.

1990

Mayor David Dinkins appoints Dennis as New York City’s human rights commissioner, making him the highest-ranking LGBTQ city o˜cial at the time.

Dennis joins the board of Housing Works, which works to end the dual crises of homelessness and AIDS, and later serves as board chair.

1993

Dennis publicly shares his HIV status in an op-ed in The New York Times.

1994

Dennis becomes president of the Latino Commission on AIDS.

2009

Dennis dies of heart failure at age 61.

Dennis deLeon in 2007

SEAN STRUB

By Mark S. King

An innovative champion for people living with HIV

Sean Strub will be terribly uncomfortable when he learns he has been named a POZ Icon. He’ll probably blush, even if you would have to look closely for the tint in his cheeks. His stoic Iowa roots constitutionally prevent him from signs of untethered ego.

Sean will undoubtedly begin to recite the names of other, worthier HIV and AIDS ﬁgures he believes have similarly changed our community’s landscape. He won’t mention that he provided crucial guidance to most of them. His eye for talent and potential is unmatched, and he has nurtured it in our most consequential leaders for decades.

His launch of POZ magazine in 1994 is a feat easily taken for granted today, when people living with HIV are more likely to proudly appear in public media. Starting a slick, colorful magazine dedicated to the lives and opinions of people living with the most stigmatized disease of the century is truly nothing less than visionary.

People had another word for it at the time. They thought he was nuts. But those critics didn’t realize what Sean always knew: Our creative, provocative community has the guts and fortitude to turn our lived experience into fascinating, inspirational content. The magazine was an immediate sensation.

It is worth noting that Sean accomplished this while teetering on the thin edge of his own mortality, leading editorial meetings while covered in Kaposi sarcoma lesions and with no promise he would live to see each issue make it to the printer.

Sean is still very much alive, serving as mayor of the idyllic town of Milford in a deeply conservative Pennsylvania county, because his love and committed service to the town he calls home crosses party lines. Since founding an unlikely magazine, Sean has been at the forefront of other uphill climbs, such as helping to bring Undetectable Equals Untransmittable into the public lexicon and creating The Sero Project to address the criminalization of people living with HIV.

I salute Sean for all of this but perhaps most of all for the publication you are reading right now. Sean is a visionary, a hometown hero and absolutely a POZ Icon.

Mark S. King is a GLAAD Award–winning writer and the author of My Fabulous Disease: Chronicles of a Gay Survivor

Sean Strub is diagnosed with HIV a˜er having symptoms since 1980.

1991

Sean and other AIDS activists put a giant condom over U.S. Senator Jesse Helms’s home.

1994 Sean launches POZ magazine.

2010

Sean cofounds the Positive Justice Project, a national coalition working to end HIV criminalization.

Sean produces the documentary short ÿlm HIV Is Not a Crime.

2014

Sean releases his memoir, Body Counts: A Memoir of Politics, Sex, AIDS and Survival.

1985

1990

Sean runs for Congress, becoming the ÿrst person living openly with HIV to do so.

1992

Sean produces The Night Larry Kramer Kissed Me, a one-man show by David Drake.

2009 Sean joins the board of directors of the Global Network of People Living with HIV/AIDS.

2013

Sean becomes the executive director of Sero Project.

2017

Sean is elected mayor of Milford, Pennsylvania. He had been appointed to the position in 2016.

Sean Strub in 2014

PHILL WILSON

By Raniyah Copeland

Phill Wilson is the epitome of a leader who uplifts others as he rises. His legacy represents the best of Black leadership, touching countless lives and inspiring positive change across communities.

A visionary leader known for empowering generations

From my early days at the Black AIDS Institute (BAI), which Phill led, I was struck by his ability to transform the devastation of the AIDS pandemic into a powerful force for hope and action. His experience during those years, marked by a close proximity to loss, shaped his leadership with a resilience and purpose that have become his hallmark. Today, his influence is felt through the work of the Black decision-makers and organizations reshaping our social fabric. Phill’s leadership extends beyond himself; it lives on in the many people he has inspired.

Phill’s “unapologetically Black” vision and his deep commitment to uplifting Black communities have driven every initiative at the institute. From creating the African American HIV University and the Black Treatment Advocates Network to engaging Black Hollywood, Phill has been a trailblazer in the fight against HIV. His contributions have been integral to every success in the fight against HIV in Black America. There are few Black leaders and advocates in the HIV movement who have not been inspired or impacted by Phill’s leadership.

Phill and I share a special bond. As my mentor, he opened doors, advocated for me before I even entered the room and created opportunities that we both knew would uplift our people. He has always been insightful, understanding when to step back and pass the baton. At that critical moment, he entrusted the organization he had built over two decades to a new generation, confident in their ability to carry on his mission.

While the transition at BAI didn’t unfold exactly as he had envisioned, he continues to inspire by supporting Black-led organizations beyond the HIV movement. He has shown us the power of mentorship and shared leadership. Let us follow his example, embracing the next generation while guiding them as we all continue our collective journey toward progress. Q

Raniyah Copeland is the founder of Equity & Impact Solutions and a former CEO of the Black AIDS Institute.

1981 Phill Wilson begins to experience symptoms of HIV.

1982

Phill Wilson in 2010

1990

Phill is named AIDS coordinator for Los Angeles.

Phill becomes cochair of the Los Angeles HIV Health Commission.

1995

Phill becomes a member of the Health Resources and Services Administration AIDS Advisory Committee.

2001

Phill receives the Leadership for a Changing World award from the Ford Foundation.

Phill moves to Los Angeles and joins the National Association of Black and White Men Together.

1993

Phill becomes the director of policy and planning at AIDS Project Los Angeles.

1999

Phill creates the Black AIDS Institute, a national think tank focusing on HIV in the Black community.

Phill is inducted into the Chicago LGBT Hall of Fame.

2010

Phill steps down as president and CEO of the Black AIDS Institute. 2018

Phill is appointed to the Presidential Advisory Council on HIV/AIDS by President Barack Obama.

SURVIVING TOGETHER

LONG-TERM SURVIVORS ARE ADVOCATING FOR THOSE LIVING WITH OR AT RISK FOR HIV.

BY TIM MURPHY

“THIS IS NOT A NOSTALGIA THING, ALL RIGHT?” SAYS Cleve Jones of his latest HIV advocacy project. “It’s important for people to remember what happened, because someday there will be another pandemic.” In fact, notes Jones—one of the world’s bestknown long-term HIV survivors largely due to his conceiving of the now iconic AIDS Memorial Quilt—it’s already happened: COVID-19.

“Once again, we had angry parents storming school board meetings,” he says. “Once again, we had a U.S. president who failed to act, and when he did, he mocked the people suffering. Once again, we saw the horrible racial disparities play out. Once again, we saw people refusing to wear masks, just as some once refused to wear condoms. And once again, we saw quackery and misinformation.”

Cleve Jones visits the AIDS Memorial Quilt in San Francisco.

In addition to preserving the past so future generations can learn from it, Jones has another urgent reason for pursuing his latest project, which aims to preserve HIV history. Many long-term survivors have already died, if not of AIDS or AIDSrelated illness, then of cancer, heart disease or COVID. Bluntly speaking, he adds that the rest of them will likely pass in the next decade or two. So he has started working with the San Francisco AIDS Foundation, which he cofounded in 1982, and the longterm survivor network The Reunion Project to bring an HIV anthology to life.

“It’s the same reasoning as the folks who created the Holocaust Museum,” Jones says. “We need to capture this history before the people who experienced it are all gone.” He speaks these words as he’s always spoken—ever since he was a fledgling gay political operative working for the late and legendary Harvey Milk in the 1970s—with razor-sharp clarity powered by an intense passion heard in his voice.

“If I’m allowed one more big project in my life,” Jones adds, “this is going to be it.” The project’s working title? He articulates it carefully: “We Live: Voices of the First Generations to Survive HIV/AIDS.”

THE ANTHOLOGY PROJECT arrives at an inflection point for long-term survivors. For years, the group was often defined as people diagnosed with HIV before the advent of effective antiretroviral treatment in the mid-’90s, a population that likely numbers around 300,000 of the roughly 1.2 million Americans living with HIV. These days, many people have expanded the definition to include those who have been living with the virus for 10 or more years.

For the past decade or so, countless articles, seminars and social media posts have detailed the plight of the long-term survivor. The grief, loss, loneliness and guilt that come with having survived when so many others did not. The depression

and addiction that sometimes accompany those feelings. The financial instability, even poverty, that ensues after having had to put one’s life and working years on hold for so many years of illness. The uncertainty about living into their golden years. The way having HIV for years compounds the health complications of aging. The horrible feeling of having been forgotten—or, at best, seen as a relic—in a 21stcentury world where HIV is usually easily managed and is more preventable through the use of pre-exposure prophylaxis.

And all of this has been only partially offset by the fact that while many long-term survivors may feel alone, statistically they’re not. It’s been widely noted that over half of folks with HIV in the United States are now older than 50—a proportion that is expected to rise to 70% by 2030.

But in recent years, at least in the HIV community itself, much of the relationship to long-term survivorship has evolved from merely laying out the elements of the plight to concrete, uplifting and often joyous action that brings long-term survivors together, both online and inperson. These efforts not only celebrate the community’s collective resilience and help survivors enjoy some hardearned fun but also serve to crowdsource ways to make life better for survivors on both the personal and policy levels.

For the past decade, The Reunion Project (TRP) has valiantly done much of this work. Founded in 2013 by long-term survivors Jeff Berry and Matt Sharp as a “town hall” intended to weave together survivors nationwide into a sustainable network, TRP has evolved into an enterprise that hosts in-person and virtual survivor forums and has a paid staff of four and about 2,500 members.

Berry says TRP started when it did because by then, survivors of the AIDS epidemic were feeling a need to talk about what

From top: Jeff Berry, Waheedah Shabazz-El and Sanford Gaylord

had happened to them and whom and what they had lost—and also because by then it was clear that some members were dying not of AIDS-related illness per se but as a result of the collateral damage, such as depression and addiction.

“The death of Spencer Cox was in many ways a catalyst [for the start of TRP]”, says Berry, referring to the beloved New York City–based treatment activist who died in late 2012 after he stopped taking his HIV treatment amid crystal meth addiction. “Matt and I realized that loneliness and the inability to deal with [past trauma] were really affecting people’s quality of life,” says Berry.

At the heart of TRP is the message “You are not alone”—a reality check that many TRP event participants have said provides an overwhelming emotional relief, even when they’ve participated only online. The group also broadly defines long-term survivor to include anyone who has lived with HIV for 10 years or more.

That includes Jasmine Davis, diagnosed in 2012, and Kyra Kincaid, diagnosed in 2004, two transgender Black women who serve other trans women of color at Ochsner Health, a large medical network in New Orleans. In 2023, Davis and Kincaid served as regional hosts for a TRP event in that city. TRP always collaborates with local folks living with HIV who reside in the city where it’s hosting an event.

camaraderie and the sharing of personal stories in a safe space, without stigma or judgment, was very healing.”

Particularly moving, she says, was a final-day exercise in which everyone received a wooden heart with somebody else’s name on it and was then asked to say goodbye to that person with healing, affirming words while holding the heart. “It gave us a moment to show love to someone we may not even have had the chance to talk to during the event,” she says, “to say how proud we are of each other for this struggle that we’ve all survived.”

Indeed, Waheedah Shabazz-El cites TRP’s heart-holding ritual as one of her favorite things about the group. An esteemed long-term survivor and advocate based in Philadelphia, Shabazz-El, age 71, who was diagnosed in 2003, is TRP’s part-time director of community engagement. She had long volunteered with TRP prior to being hired, bringing many Black people, trans people, women and people of faith into a group that initially consisted primarily of gay white men. “[The ritual is] a chance to say to someone before you leave ‘I’m taking you with me, and I’m holding you,’” she says. “People need to be held. I know how good that feels.”

“WE NEED TO CAPTURE THIS HISTORY BEFORE THE PEOPLE WHO EXPERIENCED IT ARE ALL GONE.”

—CLEVE JONES

Davis says she considers herself a survivor of both HIV and of being “a Black woman of trans experience in the South, where my life expectancy was 34—and I’m 47.” Kincaid, 53, says that though she was diagnosed not just with HIV but also AIDS, including AIDSrelated dementia in 2004, she’s pretty sure she’s been living with HIV since the ’90s. They both say putting together the event was especially meaningful because it was coming not only after years of living with HIV and other challenges they faced as trans Black women but also after the period of isolation—and, often, loss—of COVID.

“It was really something I wanted to take part in, because people can’t forget us,” says Kincaid. “We’re still here, people who are traumatized from living with HIV.” She says the “we’re all going through this together” energy of TRP reminds her of the HIV support groups that years ago helped her get through some of the scariest times of her life.

Davis says she loved organizing the event with Kincaid and the core TRP staff. “They were amazing,” she says. “All we had to do was show them the lay of the land [in New Orleans], connecting them to the health department and various nonprofits. It was a great success to see people with HIV from different parts of Louisiana show up. The community

Shabazz-El adds, “[Survivors] have a need to be heard, to have our voices centered. We need to be on the boards of the places where we get services. Nothing about us without us!” She credits the survivor community with helping her get through the death of her only daughter two years ago. “I assumed she was going to be around to take care of me,” she says, but adds that, amid her overwhelming grief, “this community held me so tight I could feel people’s arms around me.”

“WE’RE THE GREATEST GENERATION.” THAT’S how Sanford Gaylord, 59, a Chicago-based actor, writer and HIV activist, characterizes the long-term survivor community. “We’ve survived one of the biggest wars that has been waged on humankind. I got so many nuggets of wisdom from men who’ve died,” says Gaylord, who was diagnosed HIV positive in 1989.

He’s also shared his own survivor wisdom via various roles in the HIV field, including as a featured voice in HIV and the Journey Toward Zero, a three-part docuseries coproduced by the Chicago Department of Public Health and directed by Emmy winner Chan C. Smith. Gaylord says he helped the producers of the series, which focuses on Chicago-area people living with HIV, assemble a diverse roster of subjects, including well-known activist Rae Lewis-Thornton.

Many folks featured in the series are long-term survivors. Among the major issues they discuss, he says, are “the guilt of having survived when others didn’t,” “finding and creating purpose, even as you mourn what you don’t have anymore or what could’ve been if HIV hadn’t come into the picture” and “acknowledging trauma and the benefits of therapy.”

Gaylord says most survivors, him included, need “to not be erased, to be listened to, to be honored and not put out to pasture.” Such folks also need practical support with housing and long-term care as they age, he says, because many of them are financially struggling and also, especially the gay ones, don’t have children to take care of them. “I don’t want to be found dead, like one of my greatest inspirations, Joseph Beam.” He’s referring to the gay Black activist and poet who died of AIDS-related illness in 1988. “I don’t want to die alone.”

Gaylord says he’s familiar with Chicago’s Town Hall apartments—which opened in 2014 as the first supportive affordable housing center for LGBTQ seniors in the Midwest—so he knows there are options for him and other survivors as they move into old age. The federal Ryan White CARE Act—as well as myriad other federal, state and local programs—also help folks meet their housing, health care, nutrition and other needs. According to the LGBTQ senior advocacy group SAGE, the Town Hall Apartments constitute one of about 31 such affordable complexes nationwide serving LGBTQ elders; more are under development.

TRP IS PERHAPS THE BEST-KNOWN

NATIONAL network of HIV survivors. Others include Let’s Kick ASS (AIDS Survivor Syndrome), which was started by survivor Tez Anderson, and local networks based at pioneering HIV groups such as San Francisco AIDS Foundation, where, as the head of aging services, respected survivor Vince Crisostomo coordinates survivor services, and New York City’s GMHC, which has a hub for long-term survivors.

However, most of the advocates POZ spoke with for this article acknowledge that survivors vary in their ability or willingness to connect with such groups, noting that some individuals are stuck in a rut of isolation and depression so deep they can’t even see it.

Says Jones, “I’ve been quite deliberate in trying to stay busy and engaged with the community, but the overwhelming majority of survivors I love and care about are increasingly isolated. Part of that is ageism, but also quite a few are just not interested in being connected.”

“WE CAN’T BECOME COMPLACENT. IF WE’RE REALLY A VILLAGE, THEN LET’S TAKE CARE OF EACH OTHER.”

—SANFORD GAYLORD

Long-term survivors who are not LGBTQ also have needs. Says Shabazz-El, who deals with diminished mobility as she ages, “We should challenge the federal government to lower the age for federal benefits for our community.”

Research shows that people living with HIV age faster than those without the virus. It should be noted, though, that not smoking, minimizing alcohol intake, exercising regularly, eating a Mediterranean-style diet and staying in connection with other people can offset or mitigate this discrepancy, enabling HIV-positive people to live longer, healthier lives.

Gaylord says that, given the shifting political winds in Washington, DC, and nationwide—winds not always favorable to such vulnerable groups, such as people with HIV and LGBTQ people—the survivor community needs to be more organized and united than ever. “We can’t become complacent,” he says. “We don’t need to be going back into the closet in a nursing home. If we’re really a village, then let’s take care of each other.”

As Shabazz-El points out, some survivors never even really came out with their HIV status—even within their own community. She says it’s always deeply moving when someone takes the mic at a TRP event and says it’s the first time in their lives they’ve told a roomful of people that they’re living with HIV. This usually happens at least once at every event, both she and Berry say.

For those held back by fear, isolation or depression, Shabazz-El asks that they consider starting by taking part in TRP’s virtual events. “You don’t have to turn on your camera, and we have a therapist at the event who can talk with you one-on-one if you feel triggered. Someone once said that it took courage to even come to the webinar with their camera off and that they were crying behind the camera.”

Regardless, Shabazz-El says, pushing through the fear or other blocks is worth it. “We need to not live in shame, and I love TRP because it’s the antidote to shame, which is empathy, which happens when we come together and share our stories. That’s where many of us have learned to be powerful and to speak out.” She pauses before adding, “I mean, who wants to die living in shame?” Q

If you’d like to contribute to the survivor oral history anthology, visit sfaf.org/get-involved/hiv-long-term-survivors-anthology or email AnthologyLTS@gmail.com. For more info on the networks in this story, go to reunionproject.net, letskickass.hiv and sfaf.org/ communities/people-over-50, or email ltshub@gmhc.org. Also, The Reunion Project can help you identify and connect with long-term survivor networks in your city or state.

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Here to End It

One of the ﬁrst things you notice about Dashiell Sears is his frequent use of words like eradicate and eliminate when discussing HIV. He’s here to end it.

Sears, 33, is regional director for North America for the Fast-Track Cities Institute, whose global mission is to help municipalities in their efforts to strengthen and accelerate their response to HIV, tuberculosis and viral hepatitis.

“Our goal is to strategize and develop that road map, along with our global partners at UNAIDS and the World Health Organization, to create a pathway toward HIV eradication,” Sears says.

According to Sears, the Fast-Track Cities Institute has prioritized the same HIV testing, treatment and viral suppression targets that United Nations member states adopted in June 2021. These goals are lo y indeed. The aim is to have 95% of people with HIV worldwide know their status; to have 95% of those individuals on medication suppress the virus; and to have 95% of those on medication achieve an undetectable viral load, which means they are healthier and cannot transmit the virus.

Sears, a Lancaster, Pennsylvania, native who is HIV negative, says cities o en lead the way in combating society’s greatest challenges, citing as motivation the higher concentration of at-risk populations living in urban settings. He says what happens in cities affects the rest of the world, especially the battle to end HIV and AIDS.

“Once you start inﬂuencing how cities approach and get to HIV elimination, which we know will be HIV control, elimination and eradication, then you see the national trends take shape around what’s been working,” he says.

Sears notes that while HIV science has evolved dramatically in his lifetime, the stigma surrounding this disease remains very formidable indeed, even a er all these years. In fact, Sears believes stigma is one of the biggest obstacles to ending HIV and AIDS.

“When you compartmentalize something like HIV, for which there still isn’t a cure, you allow other things, other inﬂuences to take charge of the epidemic. And that o en comes in the form of stigma,” Sears adds. “And stigma means you can compartmentalize HIV away if you don’t want to think about it, and you can pretend it’s not happening because people aren’t necessarily dying in the streets. So stigma constantly rears its ugly head.”

Tools such as antiretroviral therapy and pre-exposure prophylaxis allow Sears to contemplate an HIV-free future in his lifetime, especially if recent medical advances are leveraged to destigmatize this disease.

According to Sears, the Undetectable Equals Untransmittable (U=U) message, which communicates the fact that people on effective HIV treatment do not transmit the virus via sex, is a powerful but underutilized tool against stigma, especially in health care settings. It’s something Sears remains committed to changing.

“We have a responsibility as a medical community to continue talking about things like U=U and what viral suppression is,” Sears says. “We know that over half of people who live with HIV have not heard about U=U from their primary health care provider. That’s troubling, and it means we should redeploy efforts in the medical education community, including standardizing HIV education in medical schools.” Q

Dashiell Sears works to end the HIV epidemic.

WORKING IT

According to recent data from the Centers for Disease Control and Prevention, an estimated 35% of people living with HIV are either unemployed (11%) or unable to work (24%). Having a stable job can help improve one’s overall well-being and ﬁ nancial health. If you are living with HIV, please take our conﬁdential survey about HIV and the workplace.

1 How long have you been living with HIV?

T30 years or more T10–20 years

T20–30 years TLess than 10 years

2 What is your current employment status?

TEmployed full-time

TEmployed part-time

TSelf-employed full-time

TSelf-employed part-time

TNot employed, looking for work

TNot employed, not looking for work

TNot employed, unable to work due to a disability or illness

TRetired

TStudent

TStay-at-home spouse or partner

3 Have you ever faced employment challenges related to your HIV status?

TYes TNo

4 Has your HIV status influenced your job choices or career path?

TYes TNo

5 Has your HIV status ever affected your workplace relationships?

TYes TNo

6 Have you ever requested a reasonable accommodation at the workplace because of your HIV status?

TYes TNo

7 Have you ever experienced any type of discrimination in the workplace because of your HIV status?

8 Does your job offer any resources or support for people living with HIV?

TYes TNo TNot applicable

9 Does your local HIV organization offer any employment assistance or job training?

TYes TNo TI don’t know.

10 Do you know how to access employment-related services or resources?

TYes TNo

11 Have you ever discussed your employment and benefit options with a counselor or case manager?

TYes TNo

12 What year were you born?

13 What is your gender?

TMale TFemale TTransgender TOther

14 What is your sexual orientation?

TStraight TBisexual TGay/lesbian TOther

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

TAmerican Indian or Alaska Native

TArab or Middle Eastern

TAsian

TBlack or African American

THispanic or Latino

TNative Hawaiian or other Pacific Islander

TWhite

TOther (Please specify.): ___________________

16 What is your current level of education?

TSome high school TSome college

THigh school graduate TBachelor’s degree or higher

17 What is your annual household income?

TLess than $15,000 T$50,000–$74,999

T$15,000–$34,999 T$75,000–$99,999

T$35,000–$49,999 T$100,000 or more

18 What is your ZIP code?

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

TYes TNo

Starting + Staying

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

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

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

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

Model portrayal