You may not be too familiar with LA County Assessor Jeffrey Prang. You’ve probably never heard of the office of the LA County Assessor, or you might only have a vague notion of what it does.
But with a career in city politics spanning nearly thirty years, he’s among the longest-serving openly gay elected officials in the United States, and for his work serving the people of Los Angeles and championing the rights of the city’s LGBTQ people, the Stonewall Democratic Club is honoring him at their 50th Anniversary Celebration and Awards Night Nov 15 at Beaches Tropicana in West Hollywood.
Prang moved to Los Angeles from his native Michigan after college in 1991, specifically seeking an opportunity to serve in politics as an openly gay man. In 1997, he was elected to the West Hollywood City Council, where he served for 18 years, including four stints as mayor.
“I was active in politics, but in Michigan at the time I left, you couldn’t really be out and involved in politics… My life was so compartmentalized. I had my straight friends, my gay friends, my political friends, and I couldn’t really mix and match those things,” he says.
“One of the things that was really impactful was as you drove down Santa Monica Boulevard and saw those rainbow flags placed there by the government in the median island. That really said, this is a place where you can be yourself. You don’t have to be afraid.”
One thing that’s changed over Prang’s time in office is West Hollywood’s uniqueness as a place of safety for the queer community.
“It used to be, you could only be out and gay and politically involved if you were from Silver Lake or from West Hollywood. The thought of being able to do that in Downey or Monterey Park or Pomona was foreign. But now we have LGBTQ centers, gay pride celebrations, and LGBT elected officials in all those jurisdictions, something that we wouldn’t have thought possible 40 years ago,” he says.
Prang’s jump to county politics is emblematic of that shift. In 2014, amid a scandal that brought down the previous county assessor, Prang threw his name in contention for the job, having worked in the assessor’s office already for the previous two years. He beat out eleven contenders in the election, won reelection in 2018 and 2022, and is seeking a fourth term next year.
To put those victories in perspective, at the time of his first election, Prang represented more people than any other openly gay elected official in the world.
Beyond his office, Prang has lent his experience with ballot box success to helping get more LGBT people elected through his work with the Stonewall Democrats and with a new organization he co-founded last year called the LA County LGBTQ Elected Officials Association (LACLEO).
LACLEO counts more than fifty members, including officials from all parts of the county, municipal and state legislators, and members of school boards, water boards, and city clerks.
“I assembled this group to collectively use our elected strength and influence to help impact policy in Sacramento and in Washington, DC, to take advantage of these elected leaders who have a bigger voice in government than the average person, and to train them and educate them to be better advocates on behalf of the issues that are important for us,” Prang says.
“I do believe as a senior high-level official I need to play a role and have an important voice in supporting our community,” he says.
Ok, but what is the LA County assessor, anyway?
“Nobody knows what the assessor is. 99% of people think I’m the guy who collects taxes,” Prang says.
The assessor makes sure that all properties in the county are properly recorded and fairly assessed so that taxes can be levied correctly. It’s a wonky job, but one that has a big impact on how the city raises money for programs.
And that wonkiness suits Prang just fine. While the job may seem unglamorous, he gleefully boasts about his work overhauling the office’s technology to improve customer service and efficiency, which he says is proving to be a role model for other county offices.
“I inherited this 1970s-era mainframe green screen DOS-based legacy system. And believe it or not, that’s the standard technology for most large government agencies. That’s why the DMV sucks. That’s why the tax collection system sucks. But I spent $130 million over almost 10 years to rebuild our system to a digitized cloud-based system,” Prang says.
“I think the fact that my program was so successful did give some impetus to the board funding the tax collector and the auditor-controller to update their system, which is 40 years behind where they need to be.”
More tangible impacts for everyday Angelenos include his outreach to promote tax savings programs for homeowners, seniors, and nonprofits, and a new college training program that gives students a pipeline to good jobs in the county.
As attacks on the queer community intensify from the federal government, Prang says the Stonewall Democrats are an important locus of organization and resistance, and he encourages anyone to get involved.
“It is still an important and relevant organization that provides opportunities for LGBTQ people to get involved, to have an impact on our government and our civic life. If you just wanna come and volunteer and donate your time, it provides that, if you really want to do more and have a bigger voice and move into areas of leadership, it provides an opportunity for that as well,” he says.
Thousands gathered Sunday at West Hollywood Park for the 41st annual AIDS Walk Los Angeles.
This year’s theme, “Community is the Cure,” was meant to reflect a sobering reality: the fight against HIV is not over, and the community must once again lead the way.
Founded in 1985 as a response to government inaction, AIDS Walk Los Angeles continues to raise critical funds for APLA Health, which provides comprehensive services to more than 22,000 Angelenos each year, with a strong focus on people with or at risk for HIV.
Team ABC7 | Disney PRIDE shows their spirit at AIDS Walk Los Angeles
These include access to free and low-cost HIV medical care, PrEP and PEP, testing, case management, benefits counseling, mental health services, and the nation’s largest food pantry for people living with HIV.
“This event was born out of urgency, and it’s just as relevant today,” said Craig E. Thompson, CEO of APLA Health. “We’ve made incredible progress in the fight against HIV, but that progress is under direct threat from funding cuts and political attacks.”
While scientific advances like U=U (Undetectable = Untransmittable) and PrEP have transformed HIV prevention and treatment, organizers say too many people still face barriers to accessing the care they need.
“We’re being pushed back-but we’re still facing forward,” said Thompson. “AIDS Walk is how we protect each other, amplify our voices, and keep moving forward, together.”
Participants in the 41st AIDS Walk LA tell us why they walk
This year’s opening ceremony was hosted by ABC7’s Coleen Sullivan, and featured speakers U.S. Rep. Maxine Waters, West Hollywood Mayor Chelsea Lee Byers and L.A. County Supervisor Lindsey P. Horvath among others, as well as a special live performance by Heidi N Closet, star of RuPaul’s Drag Race, who was introduced by fellow Drag Race alum Monét X Change.
Troy Masters was a cheerleader. When my name was called as the Los Angeles Press Club’s Print Journalist of the Year for 2020, Troy leapt out of his seat with a whoop and an almost jazz-hand enthusiasm, thrilled that the mainstream audience attending the Southern California Journalism Awards gala that October night in 2021 recognized the value of the LGBTQ community’s Los Angeles Blade.
That joy has been extinguished. On Wednesday, Dec. 11, after frantic unanswered calls from his sister Tammy late Monday and Tuesday, Troy’s longtime friend and former partner Arturo Jiminez did a wellness check at Troy’s L.A. apartment and found him dead, with his beloved dog Cody quietly alive by his side. The L.A. Coroner determined Troy Masters died by suicide. No note was recovered. He was 63.
Considered smart, charming, committed to LGBTQ people and the LGBTQ press, Troy’s inexplicable suicide shook everyone, even those with whom he sometimes clashed.
Troy’s sister and mother – to whom he was absolutely devoted – are devastated. “We are still trying to navigate our lives without our precious brother/son. I want the world to know that Troy was loved and we always tried to let him know that,” says younger sister Tammy Masters.
Tammy was 16 when she discovered Troy was gay and outed him to their mother. A “busy-body sister,” Tammy picked up the phone at their Tennessee home and heard Troy talking with his college boyfriend. She confronted him and he begged her not to tell.
“Of course, I ran and told Mom,” Tammy says, chuckling during the phone call. “But she – like all mothers – knew it. She knew it from an early age but loved him unconditionally; 1979 was a time [in the Deep South] when this just was not spoken of. But that didn’t stop Mom from being in his corner.”
Mom even marched with Troy in his first Gay Pride Parade in New York City. “Mom said to him, ‘Oh, my! All these handsome men and not one of them has given me a second look! They are too busy checking each other out!” Tammy says, bursting into laughter. “Troy and my mother had that kind of understanding that she would always be there and always have his back!
“As for me,” she continues, “I have lost the brother that I used to fight for in any given situation. And I will continue to honor his cause and lifetime commitment to the rights and freedom for the LGBTQ community!”
Tammy adds: “The outpouring of love has been comforting at this difficult time and we thank all of you!”
Troy Masters and his beloved dog Cody.
No one yet knows why Troy took his life. We may never know. But Troy and I often shared our deeply disturbing bouts with drowning depression. Waves would inexplicitly come upon us, triggered by sadness or an image or a thought we’d let get mangled in our unresolved, inescapable past trauma.
We survived because we shared our pain without judgment or shame. We may have argued – but in this, we trusted each other. We set everything else aside and respectfully, actively listened to the words and the pain within the words.
Listening, Indian philosopher Krishnamurti once said, is an act of love. And we practiced listening. We sought stories that led to laughter. That was the rope ladder out of the dark rabbit hole with its bottomless pit of bullying and endless suffering. Rung by rung, we’d talk and laugh and gripe about our beloved dogs.
I shared my 12 Step mantra when I got clean and sober: I will not drink, use or kill myself one minute at a time. A suicide survivor, I sought help and I urged him to seek help, too, since I was only a loving friend – and sometimes that’s not enough.
(If you need help, please reach out to talk with someone: call or text 988 Suicide and Crisis Lifeline. They also have services in Spanish and for the deaf.)
In 2015, Troy wrote a personal essay for Gay City News about his idyllic childhood in the 1960s with his sister in Nashville, where his stepfather was a prominent musician. The people he met “taught me a lot about having a mission in life.”
During summers, they went to Dothan, Ala., to hang out with his stepfather’s mother, Granny Alabama. But Troy learned about “adult conversation — often filled with derogatory expletives about Blacks and Jews” and felt “my safety there was fragile.”
It was a harsh revelation. “‘Troy is a queer,’ I overheard my stepfather say with energetic disgust to another family member,” Troy wrote. “Even at 13, I understood that my feelings for other boys were supposed to be secret. Now I knew terror. What my stepfather said humiliated me, sending an icy panic through my body that changed my demeanor and ruined my confidence. For the first time in my life, I felt depression and I became painfully shy. Alabama became a place, not of love, not of shelter, not of the magic of family, but of fear.”
At the public pool, “kids would scream, ‘faggot,’ ‘queer,’ ‘chicken,’ ‘homo,’ as they tried to dunk my head under the water. At one point, a big crowd joined in –– including kids I had known all my life –– and I was terrified they were trying to drown me.
“My depression became dangerous and I remember thinking of ways to hurt myself,” Troy wrote.
But Troy Masters — who left home at 17 and graduated from the University of Tennessee at Knoxville — focused on creating a life that prioritized being of service to his own intersectional LGBTQ people. He also practiced compassion and last August, Troy reached out to his dying stepfather. A 45-minute Facetime farewell turned into a lovefest of forgiveness and reconciliation.
Troy discovered his advocacy chops as an ad representative at the daring gay and lesbian activist publication Outweek from 1989 to 1991.
“We had no idea that hiring him would change someone’s life, its trajectory and create a lifelong commitment” to the LGBTQ press, says Outweek’s co-founder and former editor-in-chief Gabriel Rotello, now a TV producer. “He was great – always a pleasure to work with. He had very little drama – and there was a lot of drama at Outweek. It was a tumultuous time and I tended to hire people because of their activism,” including Michelangelo Signorile, Masha Gessen, and Sarah Pettit.
Rotello speculates that because Troy “knew what he was doing” in a difficult profession, he was determined to launch his own publication when Outweek folded. “I’ve always been very happy it happened that way for Troy,” Rotello says. “It was a cool thing.”
Troy and friends launched NYQ, renamed QW, funded by record producer and ACT UP supporter Bill Chafin. QW (QueerWeek) was the first glossy gay and lesbian magazine published in New York City featuring news, culture, and events. It lasted for 18 months until Chafin died of AIDS in 1992 at age 35.
The horrific Second Wave of AIDS was peaking in 1992 but New Yorkers had no gay news source to provide reliable information at the epicenter of the epidemic.
“When my business partner died of AIDS and I had to close shop, I was left hopeless and severely depressed while the epidemic raged around me. I was barely functioning,” Troy told VoyageLA in 2018. “But one day, a friend in Moscow, Masha Gessen, urged me to get off my back and get busy; New York’s LGBT community was suffering an urgent health care crisis, fighting for basic legal rights and against an increase in violence. That, she said, was not nothing and I needed to get back in the game.”
Staff of Gay News City in New York City, which Troy Masters founded in 2002.
“We were always in total agreement that the work we were doing was important and that any story we delved into had to be done right,” Schindler wrote in Gay City News.
Though the two “sometimes famously crossed swords,” Troy’s sudden death has special meaning for Schindler. “I will always remember Troy’s sweetness and gentleness. Five days before his death, he texted me birthday wishes with the tag, ‘I hope you get a meaningful spanking today.’ That devilishness stays with me.”
Troy had “very high EI (Emotional Intelligence), Schindler says in a phone call. “He had so much insight into me. It was something he had about a lot of people – what kind of person they were; what they were really saying.”
Troy was also very mischievous. Schindler recounts a time when the two met a very important person in the newspaper business and Troy said something provocative. “I held my breath,” Schindler says. “But it worked. It was an icebreaker. He had the ability to connect quickly.”
The journalistic standard at LGNY and Gay City News was not a question of “objectivity” but fairness. “We’re pro-gay,” Schindler says, quoting Andy Humm. “Our reporting is clear advocacy yet I think we were viewed in New York as an honest broker.”
Schindler thinks Troy’s move to Los Angeles to jump-start his entrepreneurial spirit and reconnect with Arturo, who was already in L.A., was risky. “He was over 50,” Schindler says. “I was surprised and disappointed to lose a colleague – but he was always surprising.”
“In many ways, crossing the continent and starting a print newspaper venture in this digitally obsessed era was a high-wire, counter-intuitive decision,” Troy told VoyageLA. “But I have been relentlessly determined and absolutely confident that my decades of experience make me uniquely positioned to do this.”
Troy launched The Pride L.A. as part of the Mirror Media Group, which publishes the Santa Monica Mirror and other Westside community papers. But on June 12, 2016, the day of the Pulse Nightclub shooting in Orlando, Fla., Troy said he found MAGA paraphernalia in a partner’s office. He immediately plotted his exit. On March 10, 2017, Troy and the “internationally respected” Washington Blade announced the launch of the Los Angeles Blade.
Troy Masters and then-Rep. Adam Schiff. (Photo courtesy of Karen Ocamb)
In a March 23, 2017 commentary promising a commitment to journalistic excellence, Troy wrote: “We are living in a paradigm shifting moment in real time. You can feel it. Sometimes it’s overwhelming. Sometimes it’s toxic. Sometimes it’s perplexing, even terrifying. On the other hand, sometimes it’s just downright exhilarating. This moment is a profound opportunity to reexamine our roots and jumpstart our passion for full equality.”
Troy tried hard to keep that commitment, including writing a personal essay to illustrate that LGBTQ people are part of the #MeToo movement. In “Ending a Long Silence,” Troy wrote about being raped at 14 or 15 by an Amtrak employee on “The Floridian” traveling from Dothan, Ala., to Nashville.
“What I thought was innocent and flirtatious affection quickly turned sexual and into a full-fledged rape,” Troy wrote. “I panicked as he undressed me, unable to yell out and frozen by fear. I was falling into a deepening shame that was almost like a dissociation, something I found myself doing in moments of childhood stress from that moment on. Occasionally, even now.”
From the personal to the political, Troy Masters tried to inform and inspire LGBTQ people.
“Just recently he invited us to participate with the LA Blade and other partners to support the LGBTQ forum on Asylum Seekers and Immigrants. He cared about underserved community. He explored LGBTQ who were ignored and forgotten. He wanted to end HIV; help support people living with HIV but most of all, he fought for justice,” Zaldivar says. “I am saddened by his loss. His voice will never be forgotten. We will remember him as an unsung hero. May he rest in peace in the hands of God.”
“It pains me to know that my dear, beautiful and amazing friend Troy is no longer with us … He always gave me and many people light,” Salcedo says. “I know that we are living in dark times right now and we need to understand that our ancestors and transcestors are the one who are going to walk us through these dark times… See you on the other side, my dear and beautiful sibling in the struggle, Troy Masters.”
“Troy was immensely committed to covering stories from the LGBTQ community. Following his move to Los Angeles from New York, he became dedicated to featuring news from the City of West Hollywood in the Los Angeles Blade and we worked with him for many years,” says Joshua Schare, director of Communications for the City of West Hollywood, who knew Troy for 30 years, starting in 1994 as a college intern at OUT Magazine.
“Like so many of us at the City of West Hollywood and in the region’s LGBTQ community, I will miss him and his day-to-day impact on our community.”
Troy Masters accepting a proclamation from the City of West Hollywood. (Photo by Richard Settle for the City of West Hollywood)
“Troy Masters was a visionary, mentor, and advocate; however, the title I most associated with him was friend,” says West Hollywood Mayor John Erickson. “Troy was always a sense of light and working to bring awareness to issues and causes larger than himself. He was an advocate for so many and for me personally, not having him in the world makes it a little less bright. Rest in Power, Troy. We will continue to cause good trouble on your behalf.”
Erickson adjourned the WeHo City Council meeting on Monday in his memory.
Masters launched the Los Angeles Blade with his partners from the Washington Blade, Lynne Brown, Kevin Naff, and Brian Pitts, in 2017.
Cover of the election issue of the Los Angeles Blade.
“Troy’s reputation in New York was well known and respected and we were so excited to start this new venture with him,” says Naff. “His passion and dedication to queer LA will be missed by so many. We will carry on the important work of the Los Angeles Blade — it’s part of his legacy and what he would want.”
AIDS Healthcare Foundation President Michael Weinstein, who collaborated with Troy on many projects, says he was “a champion of many things that are near and dear to our heart,” including “being in the forefront of alerting the community to the dangers of Mpox.”
“All of who he was creates a void that we all must try to fill,” Weinstein says. “His death by suicide reminds us that despite the many gains we have made, we’re not all right a lot of the time. The wounds that LGBT people have experienced throughout our lives are yet to be healed even as we face the political storm clouds ahead that will place even greater burdens on our psyches.”
May the memory and legacy of Troy Masters be a blessing.
Veteran LGBTQ journalist Karen Ocamb served as the news editor and reporter for the Los Angeles Blade.
Four months after seeking asylum in the U.S., Fernando Hermida began coughing and feeling tired. He thought it was a cold. Then sores appeared in his groin and he would soak his bed with sweat. He took a test.
On New Year’s Day 2022, at age 31, Hermida learned he had HIV.
“I thought I was going to die,” he said, recalling how a chill washed over him as he reviewed his results. He struggled to navigate a new, convoluted health care system. Through an HIV organization he found online, he received a list of medical providers to call in D.C., where he was at the time, but they didn’t return his calls for weeks. Hermida, who speaks only Spanish, didn’t know where to turn.
By the time of Hermida’s diagnosis, the U.S. Department of Health and Human Services was about three years into a federal initiative to end the nation’s HIV epidemic by pumping hundreds of millions of dollars annually into certain states, counties, and U.S. territories with the highest infection rates. The goal was to reach the estimated 1.2 million people living with HIV, including some who don’t know they have the disease.
Overall, estimated new HIV infection rates declined 23 percent from 2012 to 2022. But a KFF Health News-Associated Press analysis found the rate has not fallen for Latinos as much as it has for other racial and ethnic groups.
While African Americans continue to have the highest HIV rates in the U.S. overall, Latinos made up the largest share of new HIV diagnoses and infections among gay and bisexual men in 2022, per the most recent data available, compared with other racial and ethnic groups. Latinos, who make up about 19 percent of the U.S. population, accounted for about 33 percent of new HIV infections, according to the Centers for Disease Control and Prevention.
The analysis found Latinos are experiencing a disproportionate number of new infections and diagnoses across the U.S., with diagnosis rates highest in the Southeast. Public health officials in Mecklenburg County, North Carolina, and Shelby County, Tennessee, where data shows diagnosis rates have gone up among Latinos, told KFF Health News and the AP that they either don’t have specific plans to address HIV in this population or that plans are still in the works. Even in well-resourced places like San Francisco, HIV diagnosis rates grew among Latinos in the last few years while falling among other racial and ethnic groups despite the county’s goals to reduce infections among Latinos.
“HIV disparities are not inevitable,” Robyn Neblett Fanfair, director of the CDC’s Division of HIV Prevention, said in a statement. She noted the systemic, cultural, and economic inequities — such as racism, language differences, and medical mistrust.
And though the CDC provides some funds for minority groups, Latino health policy advocates want HHS to declare a public health emergency in hopes of directing more money to Latino communities, saying current efforts aren’t enough.
“Our invisibility is no longer tolerable,” said Vincent Guilamo-Ramos, co-chair of the Presidential Advisory Council on HIV/AIDS.
Lost without an interpreter
Hermida suspects he contracted the virus while he was in an open relationship with a male partner before he came to the U.S. In late January 2022, months after his symptoms started, he went to a clinic in New York City that a friend had helped him find to finally get treatment for HIV.
Too sick to care for himself alone, Hermida eventually moved to Charlotte to be closer to family and in hopes of receiving more consistent health care. He enrolled in an Amity Medical Group clinic that receives funding from the Ryan White HIV/AIDS Program, a federal safety-net plan that serves over half of those in the nation diagnosed with HIV, regardless of their citizenship status.
His HIV became undetectable after he was connected with case managers. But over time, communication with the clinic grew less frequent, he said, and he didn’t get regular interpretation help during visits with his English-speaking doctor. An Amity Medical Group representative confirmed Hermida was a client but didn’t answer questions about his experience at the clinic.
Hermida said he had a hard time filling out paperwork to stay enrolled in the Ryan White program, and when his eligibility expired in September 2023, he couldn’t get his medication.
He left the clinic and enrolled in a health plan through the Affordable Care Act marketplace. But Hermida didn’t realize the insurer required him to pay for a share of his HIV treatment.
In January, the Lyft driver received a $1,275 bill for his antiretroviral — the equivalent of 120 rides, he said. He paid the bill with a coupon he found online. In April, he got a second bill he couldn’t afford.
For two weeks, he stopped taking the medication that keeps the virus undetectable and intransmissible.
“Estoy que colapso,” he said. I’m falling apart. “Tengo que vivir para pagar la medicación.” I have to live to pay for my medication.
One way to prevent HIV is preexposure prophylaxis, or PrEP, which is regularly taken to reduce the risk of getting HIV through sex or intravenous drug use. It was approved by the federal government in 2012 but the uptake has not been even across racial and ethnic groups: CDC data show much lower rates of PrEP coverage among Latinos than among white Americans.
Epidemiologists say high PrEP use and consistent access to treatment are necessary to build community-level resistance.
Carlos Saldana, an infectious disease specialist and former medical adviser for Georgia’s health department, helped identify five clusters of rapid HIV transmission involving about 40 gay Latinos and men who have sex with men from February 2021 to June 2022. Many people in the cluster told researchers they had not taken PrEP and struggled to understand the health care system.
They experienced other barriers, too, Saldana said, including lack of transportation and fear of deportation if they sought treatment.
Latino health policy advocates want the federal government to redistribute funding for HIV prevention, including testing and access to PrEP. Of the nearly $30 billion in federal money that went toward things like HIV health care services, treatment, and prevention in 2022, only 4% went to prevention, according to a KFF analysis.
They suggest more money could help reach Latino communities through efforts like faith-based outreach at churches, testing at clubs on Latin nights, and training bilingual HIV testers.
Latino rates going up
Congress has appropriated $2.3 billion over five years to the Ending the HIV Epidemic initiative, and jurisdictions that get the money are to invest 25 percent of it in community-based organizations. But the initiative lacks requirements to target any particular groups, including Latinos, leaving it up to the cities, counties, and states to come up with specific strategies.
In 34 of the 57 areas getting the money, cases are going the wrong way: Diagnosis rates among Latinos increased from 2019 to 2022 while declining for other racial and ethnic groups, the KFF Health News-AP analysis found.
Starting Aug. 1, state and local health departments will have to provide annual spending reports on funding in places that account for 30 percent or more of HIV diagnoses, the CDC said. Previously, it had been required for only a small number of states.
In some states and counties, initiative funding has not been enough to cover the needs of Latinos.
South Carolina, which saw rates nearly double for Latinos from 2012-2022, hasn’t expanded HIV mobile testing in rural areas, where the need is high among Latinos, said Tony Price, HIV program manager in the state health department. South Carolina can pay for only four community health workers focused on HIV outreach — and not all of them are bilingual.
In Shelby County, Tennessee, home to Memphis, the Latino HIV diagnosis rate rose 86 percent from 2012 to 2022. The health department said it got $2 million in initiative funding in 2023 and while the county plan acknowledges that Latinos are a target group, department director Michelle Taylor said: “There are no specific campaigns just among Latino people.”
Up to now, Mecklenburg County, North Carolina, didn’t include specific targets to address HIV in the Latino population — where rates of new diagnoses more than doubled in a decade but fell slightly among other racial and ethnic groups. The health department has used funding for bilingual marketing campaigns and awareness about PrEP.
Moving for medicine
When it was time to pack up and move to Hermida’s third city in two years, his fiancé, who is taking PrEP, suggested seeking care in Orlando, Fla.
The couple, who were friends in high school in Venezuela, had some family and friends in Florida, and they had heard about Pineapple Healthcare, a nonprofit primary care clinic dedicated to supporting Latinos living with HIV.
The clinic is housed in a medical office south of downtown Orlando. Inside, the mostly Latino staff is dressed in pineapple-print turquoise shirts, and Spanish, not English, is most commonly heard in appointment rooms and hallways.
“At the core of it, if the organization is not led by and for people of color, then we’re just an afterthought,” said Andres Acosta Ardila, the community outreach director at Pineapple Healthcare, who was diagnosed with HIV in 2013.
“¿Te mudaste reciente, ya por fin?” asked nurse practitioner Eliza Otero. Did you finally move? She started treating Hermida while he still lived in Charlotte. “Hace un mes que no nos vemos.” It’s been a month since we last saw each other.
They still need to work on lowering his cholesterol and blood pressure, she told him. Though his viral load remains high, Otero said it should improve with regular, consistent care.
Pineapple Healthcare, which doesn’t receive initiative money, offers full-scope primary care to mostly Latino males. Hermida gets his HIV medication at no cost there because the clinic is part of a federal drug discount program.
The clinic is in many ways an oasis. The new diagnosis rate for Latinos in Orange County, Florida, which includes Orlando, rose by about a third from 2012 through 2022, while dropping by a third for others. Florida has the third-largest Latino population in the U.S., and had the seventh-highest rate of new HIV diagnoses among Latinos in the nation in 2022.
Hermida, whose asylum case is pending, never imagined getting medication would be so difficult, he said during the 500-mile drive from North Carolina to Florida. After hotel rooms, jobs lost, and family goodbyes, he is hopeful his search for consistent HIV treatment — which has come to define his life the past two years — can finally come to an end.
“Soy un nómada a la fuerza, pero bueno, como me comenta mi prometido y mis familiares, yo tengo que estar donde me den buenos servicios médicos,” he said. I’m forced to be a nomad, but like my family and my fiancé say, I have to be where I can get good medical services.
That’s the priority, he said. “Esa es la prioridad ahora.”
KFF Health News and The Associated Press analyzed data from the U.S. Centers for Disease Control and Prevention on the number of new HIV diagnoses and infections among Americans ages 13 and older at the local, state, and national levels. This story primarily uses incidence rate data — estimates of new infections — at the national level and diagnosis rate data at the state and county level.
Bose reported from Orlando, Fla.. Reese reported from Sacramento, Calif.AP video journalist Laura Bargfeld contributed to this report.
The Associated Press Health and Science Department receives support from the Robert Wood Johnson Foundation. The AP is responsible for all content.
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CAPITAL REGION, N.Y. (NEWS10) — June 27 is National HIV testing day, and the New York State Department of Health says New York is at an all-time low of new infection rates. NEWS10 speaking with a local group on their efforts here in the capital region to help eradicate the disease.
New York has hit historic lows in HIV new infection rates since the pandemic’s height in the 1990s. However local HIV specialists say now is not the time to relax.
“The battle is not over. There are places and populations that are increasing in rates of infection, and we need to get those individuals identified and we need to help them get into the care that they need. Because there are things that we can do now that’ll make life normal and long lived,” said Kim Atkins, Executive Director Alliance for Positive Health.
New York’s new infection rates have plummeted 42% since 2011 from nearly 4000 new infections a year down to just over 2000 a year in 2022. 18% of new infections tested positive for AIDS and 69% of new infection rate diagnoses are people under the age of 40.
The Alliance for Positive Health has been providing free testing for nearly 40 years. “Testing needs to continue, and we need to identify people because people are still getting infected,” said Atkins.
And now, the Alliance for Positive Health teams can get to more people in further away places with their new mobility fleet. “This is the newer one we have a larger one that we could test two people at once. Recover 15 counties so we go all the way up to Plattsburgh and all the way down to Hudson and anywhere in between,” said Testing Supervisor Alliance for Positive Health, Niurka Diaz Gonzalez.
Chris Francis has been with the Alliance team for over 10 years and is part of the Care Coordination. He tells NEWS10 Reporter James De La Fuente about the importance of testing.
“I suggest people get tested every couple, of every two to three months. Especially if they’re sexually active.” Francis says testing is personal. “I care about my physical and mental health. It can take a toll on your mental health if you don’t get tested not knowing what you have or if you’re clean.”
As black and brown communities are adversely affected Chandler Hickenbottom, co-founder of Saratoga BLM says her organization is taking focus on testing, as well.
“As of right now we don’t have anything posted. But I think that is something that after having this conversation, I think it would be really great and important for us to start getting more involved in. So, joining the campaign to show the importance of not just getting tested in general, not just even for HIV, but for all sexually transmitted infections and STD’s. That is definitely very important,” said Hickenbottom.
A spokesperson with NYDOH says, “HIV in New York State has fallen to historic lows. At its peak in the mid-1990s, New York diagnosed nearly 15,000 new cases per year; that number was down to 2,318 in 2022.”
Cannabis is widely used to help mitigate the symptoms of a variety of conditions and diseases. Specifically, a number of state medical cannabis programs list HIV/AIDS as a qualifying condition, as cannabis can help to eliminate a variety of symptoms associated with HIV/AIDS treatment.
Though, some clinicians have expressed concern how regular cannabis treatments in this regard may impact patient cognition.
Researchers affiliated with the University of California at San Diego sought to investigate the cognitive impacts of cannabis use in people with HIV through a newly published meta-analysis in the journal Current HIV/AIDS Reports.
Ultimately, they conclude that neither the use of whole-plant cannabis or cannabis-based medicines are associated with significant cognitive changes in those with HIV.
Cannabis Use Among People with HIV
In the study abstract, researchers note the potential benefits that cannabis use can offer patients with HIV while recognizing this population’s “high burden of persisting neurocognitive impairment” and physician concerns with adding cannabis into the mix, specifically its potential cognitive effects.
Cannabis use among those with HIV is far from a new trend. The U.S. Food and Drug Administration first approved synthetic oral THC capsules (dronabinol) to treat HIV-induced cachexia, or loss of appetite, in 1985.
Additionally, surveys have consistently affirmed that cannabis use is common among people with HIV, with one 2007 study predating the bulk of medical reform measures in the U.S. still finding that more than 60% of HIV/AIDS patients self-identified as medical cannabis users.
Another more recent 2022 study noted that 77% and 34% of people with HIV reported lifetime and past-year cannabis use, respectively.
While some of these patients report recreational use as one reason, research over the years has found that cannabis is largely used among people with HIV to stimulate appetite, reduce pain, relax and ease anxiety and help with sleep.
‘Little Evidence’ of Harmful Cognitive Cannabis Impacts
With plenty of existing data to pull from, researchers reviewed data from 34 clinical studies to determine the extent that cannabis impacts cognition among patients with HIV. The results, according to the study, revealed that there is “little evidence” to support that cannabis has a harmful impact on cognition among those with HIV.
“Overall, the number of reported adverse effects were largely outnumbered by beneficial or null findings, providing insufficient support for the detrimental impact of CU [cannabis use] on cognition in PWH [people with HIV],” researchers reported, adding that the results suggest both cannabis and cannabis-based medications can be prescribed to people with HIV “while posing little threat to cognitive function.”
The topic of cannabis use and cognition has seen a recent uptick in popularity, especially given recent conversations surrounding cannabis-induced psychosis (which has largely been linked to pre-existing conditions and vulnerabilities and is not a widespread issue among cannabis consumers, with some advocates arguing that the focus on this topic is a repackaged version of “Reefer Madness” propaganda from decades past).
Of course, it’s important to look at the full picture and recognize how cannabis use and abuse may impact a variety of populations, and myriad studies attempt to look a bit more broadly at the topic.
Recent research shows that cannabis users may actually have a lower chance of cognitive decline overall. Previous studies have also noted links between heavy cannabis use and cognitive performance, though researchers noted that particular products used, methods of consumption and the reasons for use can also impact cognitive effects associated with cannabis use.
Another recent study similarly found that adolescents who occasionally use cannabis do not see cognitive differences compared to those who abstain, once again highlighting a distinction surrounding frequency of use among other variables.
Hundreds of people sashayed, power-walked, jogged and ran their way to raising funds for HIV organizations across the state during the AIDS Walk Arizona & 5K on April 6. By Monday, the event had raised nearly $222,000 of its $250,000 goal, according to a fundraising tracker on its website…
Broadbent never stopped speaking out about the virus and disease — and Johnson thanked her for her courage.
A leading activist in HIV/AIDS awareness, Broadbent, who was born with HIV, died Wednesday at age 39, her father said in a Facebook post. The cause of death was not specified.
“With great sadness, I must inform you all that our beloved friend, mentor and daughter Hydeia, passed away today after living with AIDS since birth,” Loren Broadbent wrote. “Despite facing numerous challenges throughout her life, Hydeia remained determined to spread hope and positivity through education around HIV/AIDS.”
Johnson took to X (formerly Twitter) on Wednesday to pay tribute to his longtime friend. His post included a video clip of their interaction on “Nick News with Linda Ellerbee” as well as photos of the two of them together in the years since then.
AIDS Healthcare Foundation President Michael Weinstein, left, Hydeia Broadbent and Magic Johnson attend the premiere of ESPN Films’ “The Announcement” on March 6, 2011, in Los Angeles.
(Joe Kohen / Associated Press Images For Aids Healthcare Foundation)
“I’m devastated to hear about the passing of an incredible young woman, activist and hero Hydeia Broadbent,” Johnson wrote. “In 1992, I did a Nickelodeon special called ‘A Conversation with Magic’, and 7-year-old Hydeia and I made an incredible impact. Hydeia changed the world with her bravery, speaking about how living with HIV affected her life since birth. She dedicated her life to activism and became a change agent in the HIV/AIDS fight.
“By speaking out at such a young age, she helped so many people, young and old, because she wasn’t afraid to share her story and allowed everyone to see that those living with HIV and AIDS were everyday people and should be treated with respect. Thanks to Hydeia, millions were educated, stigmas were broken, and attitudes about HIV/AIDs were changed. We will miss her powerful voice in this world. Cookie and I are praying for the Broadbent family and everyone that knew and loved Hydeia.”
Broadbent was abandoned as a newborn at a Las Vegas hospital and adopted by her parents, Loren and Patricia, as an infant. They didn’t know that Broadbent was born with HIV until she got seriously ill at 3. At that age, she was diagnosed as HIV-positive, and two years later, the virus developed into AIDS. Her biological mother was an intravenous drug addict.
Broadbent’s public speaking career began when she was 6. Soon after, in March 1992, Broadbent was one of 13 children who appeared with Johnson and Ellerbee on Nickelodeon after Johnson shocked the world with his HIV announcement in November 1991.
Broadbent was one of two children who raised their hands when Ellerbe asked if any of them were HIV-positive. Her “normal people” comment was the only sentence she uttered during the program.
Immediately after speaking, Broadbent started wiping away tears, then broke down sobbing. Johnson rubbed her back and spoke to her in a soothing tone.
“You don’t have to cry,” he said. “‘Cause we are normal people. OK? We are. You just wanna be treated like that, right? You just want your friends to play with you? And call you up and come by and still have sleepovers and things like that? Right? Yeah. And it’s OK to cry, it’s OK to cry. You know, I think that you — with this program I feel that we’ll be able to educate all your friends and everybody else.”
Broadbent would end up having plenty more to say over the next 32 years.
At age 11, she told Oprah Winfrey the worst part of having HIV/AIDS was “when your friends die.” Speaking at the 1996 Republican National Convention, a 12-year-old Broadbent said, “I am the future, and I have AIDS.”
AIDS activist Mary Fisher kisses 12-year-old Hydeia Broadbent as they address the evening session of the 1996 Republican National Convention in San Diego.
(Ron Edmonds / Associated Press)
Broadbent continued her advocacy as an adult — making appearances, doing interviews and giving lectures. She also worked with the AIDS Healthcare Foundation on several AIDS advocacy and awareness campaigns, riding on the foundation’s float in the 2013 Rose Parade and appearing in AHF’s “God Loves Me” billboard campaign.
“I try to tell it as real as I can, that this isn’t a disease they want,” Broadbent told CNN in 2012. “The current generation, they don’t know the reality of HIV/AIDS. They look at me and Magic Johnson and think you can pop a pill and be OK. They don’t know the seriousness of the disease. They don’t know the side effects of the medicine. They don’t know the financial realities of the situation.
A writer is an essentially lonely person. Someone, in fact, who usually prefers to be alone. Except when they start to realize that perhaps they became a writer precisely because of that inherent loneliness in the first place. This seems to be the case for the mononymous Adam (Andrew Scott), living practically alone in a new building that still has yet to lease out any of its apartments to fresh tenants. The apartment tower seems to lie just out of reach of London, though Adam and his soon-to-be-lover, Harry (Paul Mescal), keep referring to how they live “in” London. Indeed, Adam admits that he’s the last of his friends to remain “in” the city, with everyone else surrendering to the inevitable move to the country, where they can properly raise their families. Adam, being a gay man, automatically counts himself out from “that life.” The so-called conventional one, that is. Because, even for as “modern” as these times are supposed to be, there are still so many judgments and limitations projected onto the LGBTQIA+ community. And for a man of Adam’s generation (X), there remains so many lingering insecurities about his sexuality as a result of a childhood spent not only in the “wrong” era to be gay, but the wrong place as well. For Thatcher-run Britain wasn’t exactly open and inviting to the homo set (any more than Reagan-run America was).
Which is why homosexuality started to feel like an “underground movement” rather than a mere sexual preference. The illicit nature of it, particularly in the late 70s and early 80s, served as a means to condition many gay men to get off on the secrecy and anonymity aspects of it more than the sex act itself. Not quite knowing how to “function” sexually once things became slightly less taboo. This is the transitional mind fuck Gen X gay men were subjected to, enduring the repression of sexuality in the 80s, the AIDS scare that lasted from the beginning of that decade and well into the mid-90s and the sudden about-face toward total gender and sexual fluidity in the twenty-first century. It would be enough to give anyone sexuality whiplash, particularly a British person, with their background so fundamentally steeped in stodginess and restraint. This is the place Adam (whose biblical name feels deliberately tongue-in-cheek [no BJ pantomime intended]) is coming from. And it’s compounded by the fact that he’s partially “stuck” at the age he was when his mother (Claire Foy) and father (Jamie Bell) both died in a car accident on Christmas Eve of 1987 (this year is also significant as it’s when the book the film is based on, Strangers by Taichi Yamada, was released).
Our introduction to Adam is one of palpable loneliness as writer-director Andrew Haigh (known for Weekend and Looking, among other things) shows him staring longingly out of his floor-to-ceiling glass window at the outline of London. Which is, again, just beyond his reach. The city hasn’t fully expanded to his neck of the woods quite yet, though with rising prices and a shortage of housing, London will make it to his “outskirts” soon enough. The building, in fact, was actually shot in East London’s Stratford. Which is at least forty-five minutes’ worth of travel into Central London. His perennial position as an outsider is thus solidified to viewers geographically as well. This “outsiderness” extends even to his chosen profession as a writer (though, as he says, not a “proper” writer, but one for TV). This being the most voyeuristic kind of profession there is. A skill rooted in observation and recording. Never being quite “in the story” yourself, though constantly trying to put “a version” of who you think you are in it. That Adam chooses to write scripts wherein he can control the narrative also has Psych 101 implications. Since he couldn’t control the death of his parents or the way in which he was treated by homophobes in his youth. But he can control everything in the scenarios he comes up with on the page.
Unlike trying to control Harry’s direct approach one evening after seeing Adam so many times staring up at his window from down below. This being the umpteenth time he’s done so after a false fire alarm goes off and Adam is the only person (out of two) foolish enough to fall for it by vacating the building. Knocking on his door once Adam goes back inside and essentially begging to, er, enter, Harry makes a final effort to win Adam over by riffing on Frankie Goes to Hollywood’s “The Power of Love” with the line, “There’s vampires at my door.” This specifically alludes to the lyrics, “I’ll protect you from the hooded claw/Keep the vampires from your door.” While Harry likely wouldn’t have any idea what that song is (if we’re to go by Mescal’s own cusping between millennial and Gen Z age of twenty-eight), it’s nice to think that he could be attuned enough with British pop music’s past to make such a casual reference. To that end, there is a moment where he tells Adam he wants to “watch old episodes of Top of the Pops from before I was born” with him. Sit on the couch eating takeaway together like a right proper couple that’s surrendered fully to the dull comfort of monogamy. Because, yes, even the gays have settled for it by now. Gotten used to the idea that monogamy is for everyone. Even though, as Henry Willson (Jim Parsons) in Hollywood put it, “Sure, holding a guy’s hand in public, walking down the street, you know, you wait for a brick in the back of the head. It doesn’t come. Well, then, before you know it, your guy wants to play house. Have you ever spent a Saturday picking out some cheerful, daffodil-colored linoleum for the kitchen? I have, Ernie. And it is enough to make you wistful for the days of secretive sodomy.”
Adam is not necessarily “that type of gay,” but he is very clearly still imbued with the “gay guilt” of his generation. This being one of the reasons why he refuses Harry’s initial forward advances. That and, well, his heart sort of had to close entirely after his parents died. An automatic defense mechanism against ever attaching again. What with getting so badly burned the first time around via every person’s most formative attachment: the one with their parents. This is why Adam seeks so desperately to return to the past—the only known period in his life where he still had two (theoretical) protectors.
While Adam tries to wrap himself as much as possible up into the past by writing about it in screenplay form, he doesn’t seem to realize that he’s been trapped in it for quite some time. Perpetually locked inside that traumatic period of his life. Not just because of his parents’ death, but because losing them, in a certain sense, kept him frozen in a false identity. That is, a false hetero identity. One that didn’t allow him to ever fully be himself, or rather, be known as his true self. Because, although it’s “liberating,” in a way, to lose your parents and be forever free of any judgments they might have over you, it also means that you’ll never know if that formerly hidden part of yourself might have actually been accepted and embraced. As Haigh stated, “What I’ve always been interested in doing, and especially with this [film], is talking about queerness in relationship to family, and how complicated it can be in relationship to family…especially if you grew up in a generation of the 80s and into the early 90s, where it was very different than it is now—thank God.” And yet, there are times when it doesn’t seem that different. And the fact that a still-young Harry can recall his own childhood being rife with anti-gay sentiments (“It’s probably why we hate [the word] ‘gay’ so much now. It was always like, ‘Your haircut’s gay.’ Or, ‘The sofa’s gay.’ ‘Your trainers are gay, your school bag’s gay’”) speaks to how “drastic change” didn’t occur until very recently (something the present generation of twinks takes endlessly for granted).
This is part of why, when Adam tells his mother about his sexuality, she can’t believe he would actually “choose” such a life. Such a lonely life, at that. Still trapped in her 1987 Britain mentality, she asks, “Aren’t people nasty to you?” He assures, “No, no. Things are different now.” She asks again, “So they aren’t nasty?” He shrugs, “Not allowed, anyway.” But, of course, as Trump supporters (and Trump himself) have shown, people always find ways of getting around things that “aren’t allowed.” When Adam also informs her that men and women can marry the same sex now, she balks, “Isn’t that like having your cake and eating it?” Turns out, his confession to Mother isn’t going as well as he thought. Is actually bringing him a worse kind of pain than before. Compounded by her saying, “Oh God, what about this awful, ghastly disease? I’ve seen the adverts on the…on the news and with the gravestone.” “Everything is different now,” he insists again. Or so we would like to believe…
In an interview with Time, Haigh addressed one of the criticisms the LGBTQIA+ community has accused the movie of, which is that it reemphasizes the notion (which was only just starting to slightly go away) that being queer is the most isolating and alienating experience a person could have. But Haigh feels differently about the underlying message of his film, stating, “I understand that that can be an interpretation. Personally, I don’t feel that. There is hope in the fact that he has understood that, basically, he is capable of being in love and being loved and being there for someone else that might need him in that moment. By the end of the film, to me, it is basically saying that what is important in life is love in whatever way you manage to find that, whether it’s in a relationship, whether it’s with your parents, whether it’s with a friend. You go through life finding love, losing love, and finding it again.” And Adam has found it again, however ephemerally, with his spectral parents.
As for Adam’s mother, the more she thinks about it, the more his gayness makes sense to her. He was so “odd” and “sensitive,” after all. And apparently always trying to run away. When she asks where he was trying to run away, he tells her that he reckons London. Making him yet another Bronski Beat cliche. Luckily, Haigh stops short of featuring “Smalltown Boy” in the movie, instead opting for a “less overt” queer band in the form of Pet Shop Boys. Who have never much talked about their sexuality (why bother when all of their music is dripping with the subject and “lifestyle”). But as recently as their latest single, “Loneliness,” it’s clear the duo knows all about the distinct kind of loneliness that a man such as Adam suffers from. A loneliness that his mother is also convinced gay men are more prone to, even if, as Adam asserts, “Everything is different now.”
The past itself is, alas, as much of a ghost as his parents are. And it’s a kind of haunting that Adam seems to relish for its unique sting of pain-pleasure. For example, listening to Fine Young Cannibals’ “Johnny Come Home” as he writes, “EXT. SUBURBAN HOUSE, 1987” on his computer, it’s easy to see that the past is the present for Adam. As it is for many other people who prefer not to admit that to themselves. Even Adam tries not to fully admit it aloud, brushing aside Harry’s heartfelt apology when he finds out that Adam’s parents died in a car accident just before he turned twelve. “It was a long time ago,” he tells Harry. “Yeah, I don’t think that matters,” Harry replies. And it doesn’t. For trauma and woundedness never really go away. Especially when ceaselessly suppressed.
And yes, listening to the music from his childhood is a key part of crawling into the “comfortable” pain of his youth. Comfortable because it is familiar. Seeing his room just as it was when he was a preteen leads him to thumb through records like Erasure’s Circus and Frankie Goes to Hollywoood’s Welcome to the Pleasuredome (which “The Power of Love” appears on). Even when Adam goes out to a club with Harry, the song playing for the dance floor, Joe Smooth’s “Promised Land,” is straight out of 1987. Everywhere he goes, that year, that time in his life haunts him. At one point during post-coital candor, he muses to Harry, “Things are better now, of course they are, but…it doesn’t take much to make you feel the way you felt.” It reiterates what he already told his mother, but with the admission that, if you grow up a certain way, are conditioned to have a certain “look over your shoulder” response to people, it doesn’t ever truly dissipate. Even in the late 90s, when things were starting to shift more palpably, especially with AIDS “calming down,” a Gen X man like Adam was never truly going to feel “safe” enough to be “himself.”
Talking of the 90s, Haigh’s decision to include 1997’s “Death of a Party” by Blur as the soundtrack to a very trippy portion of the club sequence is also pointed. For, in addition to Blur speaking about the end of Britpop’s reign, this song has long been regarded as a metaphor for AIDS. After all, gay men were only too happy to party in the late 70s and early 80s…until an unknown disease, a “mysterious illness” started making people—primarily “fags”—drop like flies. So much for the “party.” A word Madonna famously included as part of an AIDS awareness insert placed among the liner notes of her Like A Prayer album with the phrase, “AIDS Is No Party!” In other words, don’t think you can go around fucking freely as you used to in the days before the novel virus. With AIDS came yet more cannon fodder for suppression. To turn inward and avoid one’s desires altogether. As Adam seemed to do, telling Harry, “I’d always felt lonely, even before [my parents died]. This was a new feeling. Like, uh, terror. That I’d always be alone now. And then, as I got older, that feeling just…solidified. It just, uh, it did not…” He motions toward his heart after trailing off, finishing the thought with, “…here all the time.” Harry looks at him with teary-eyed empathy, prompting Adam to continue, “And then losing them just got tangled up with all the other stuff. Like being gay. Just feeling like…the future doesn’t matter.” Of course, it also felt like it didn’t matter when, as a gay man, death was all around. Pervasive. Perhaps, in some sense, Adam could even associate his parents’ death with the “gay disease” that caused everyone who came into contact with “queers” to die.
Getting the chance to tell his parents—even if only their ghosts—who he really is proves to be, if not “cathartic” then at least a release. When Adam’s father tells his son that he’s proud of him, Adam replies, “I haven’t done anything to be proud of. I’ve just muddled through.” His father rebuts, “No, but you got through it. Some tough times, I’m sure, and…you’re still here.” Even this, too, feels like a nod to the generation of gay men who were not only mercilessly ridiculed, but also forced to watch so many of their own fall prey to the cruelest kind of death. To survive through something like that would, of course, serve as a lingering trauma unto itself. Indeed, there are times when the viewer might think that Adam himself is a ghost who doesn’t know it yet (Bruce Willis in The Sixth Sense-style), that maybe his telltale “fever” was a symptom he had while dying of AIDS. But no, that’s not the Shyamalan-oriented element here. Instead, Adam is subjected to a much more heartbreaking fate.
One that only Frankie Goes to Hollywood (“The Power of Love” is a subliminal essence during the tripped-out club scene as well, its presence seemingly omni—a punctuating motif to cut through the loneliness) can try to even vaguely soothe. The band’s lead singer, Holly Johnson, was himself diagnosed with HIV in 1991. But it was even before then that he sang on “The Power of Love,” “Dreams are like angels/They keep bad at bay, bad at bay/Love is the light/Scaring darkness away/I’m so in love with you/Purge the soul/Make love your goal.” Even when you’ve been burned in such an inexplicably horrible way by it in the past.
Part of the late Princess Diana’s enduring legacy, decades after her untimely death, is her persona as “the people’s princess.” Former UK prime minister Tony Blair coined the nickname after her death in tribute to Diana’s relatability and humble nature, especially opening herself up to ostracized communities and advocating for them. Boy George, in his recently released autobiography, seems to agree, saying that Diana came through for him when “my reputation was ragged.”
In his new memoir Karma, which hit shelves on Tuesday, the iconic performer shared the story of meeting the princess in the late ‘80s. He came to an event and was told by the host, nightclub owner Peter Stringfellow, that Diana wanted to meet him. One problem: He wasn’t on the official guest list. At the time, he was making headlines for his struggle with heroin addiction. The former Culture Club frontman was “shooed away” by a palace official, he wrote, per People, and went to the bar to hang out.
All hope was not lost, however: Diana, “broke protocol and approached me,” Boy George writes. She complimented his outfit, which was covered in a myriad of safety pins, saying that it must have “taken forever.”
“I didn’t do it myself, love,” he joked back.
Diana also met Boy George’s mother, Dinah, and the two hit it off.
“They spent 10 minutes chatting,” he writes. “She told Mum I was a true survivor.”
In her life, Diana was an advocate for many social causes, but especially the gay community. By one account, in the late ‘80s Diana once disguised herself as a male model and crashed a gay bar with Queen frontman Freddie Mercury after a Golden Girls marathon. She was also loud in her support for HIV and AIDS treatment, working to lift the stigma around the disease. Famously, she very publicly shook hands with an AIDS patient in 1987 when she attended the opening of the UK’s first HIV/AIDS ward at London’s Middlesex Hospital. Her younger son, Prince Harry, has championed the cause as well, carrying on her legacy.
During National HIV Testing Week in the UK in 2022, Harry spoke of continuing his mother’s work on the issue.
“What my mom did, and what so many other people did at that time, was to smash that wall down. To kick the door open and say, ‘No. When people are suffering, then we need to learn more, and if there’s a stigma that’s playing such a large part of it, then what we really need to do is talk about it more,’” he said. “That kind of made people feel a little bit uncomfortable to start with. But stigma thrives on silence. We know that. What my mom started all those years ago was creating empathy and understanding…but also curiosity, which I think was really powerful.”
SARASOTA, Fla., July 24, 2023 (Newswire.com)
– Nationally renowned CAN Community Health (CAN) has named Terry Dyer as the Director of Donor Development. In this new role, Dyer will lead the charge to expand donor development and stewardship across CAN’s national markets which include Central and South Florida, Dallas/ Arlington, Texas, Phoenix, Arizona, Virginia, South Carolina, and recently Nevada.
“We are excited to have Terry join us at this pivotal moment of growth and development across the United States,” said Rogelio Capote, Senior Vice President, Chief Communications Officer. “We welcome his keen ability to establish new partnerships, engage donors who share our mission and to brand our successful model of healthcare.”
Dyer has a solid history of working with Fortune 100 and 500 companies and nonprofit organizations to help reach their maximum potential and growth. His background consists of talent acquisition management, recruitment, client services and program management. Most recently, Dyer was the Executive Director of the World AIDS Museum and Education Center. During his tenure, he is credited with initiating fundraising efforts that raised more than $400,000. In addition, he established several impactful partnerships that resulted in innovative programming to end the stigma of HIV.
Additionally, Dyer has volunteered his time to various organizations throughout the San Francisco Bay Area, Sacramento, Salt Lake City and South Florida communities. For several years, he served as a member of the San Francisco LGBTQ Speakers Bureau, which aimed to dispel homophobic and transphobic violence by educating people about the everyday lives of those in the community. In 2010, while working with STOP AIDS Project, POZ Health magazine named him “African American Person of the Month.”
In July 2020, Dyer became the bestselling author of “Letters to a GAY BLACK BOY,” a memoir sparking conversations around racism, inequality, homophobia and more. Also in 2020, he was the recipient of the Kujichagulia Award for Self-Determination, presented at the Black Brothers Esteem (San Francisco AIDS Foundation) annual Kwanzaa event.
In 2021, Dyer was presented the Ujima Men’s Collective Community Leadership Award and named by South Florida Gay News (SFGN) as 2021 Best New LGBT Activist. In 2022, he received SFGN’s nomination for Best LGBT Activist. During Black History Month 2023, Dyer received a proclamation from the City of Wilton Manors naming February 14th “Terry Dyer Day”. In May 2023, he was also recognized by the White House for his advocacy work. Currently, he is a board member of Plays of Wilton (POW) and is a member of the South Florida HRC Steering Committee. He also chairs the Black LGBTQ Planning Council.
Dyer received his bachelor’s degree in vocal performance from Chico State University and a second degree in communications with an emphasis in public relations from Sacramento State University. He is a former All American collegiate volleyball player, a high school All-American track and field athlete, a competitive tennis player and a former contestant on the acclaimed TV show Star Search.
ABOUT CAN COMMUNITY HEALTH
CAN Community Health (CAN) is a not-for-profit, community-based organization with clinics in Florida, Arizona, New Jersey, South Carolina, Texas, and Virginia. CAN provides medical, pharmacy, dental, case management, mental health, and comprehensive prevention and services such as nPEP, PrEP, and education. CAN also provides screening and treatment for Viral Hepatitis, STDs and Gender Affirming Services. For more information about CAN Community Health and its services, please call (844) 922-2777 or visit www.cancommunityhealth.org.
Moderna Inc. said Tuesday it’s working to develop its first bacterial vaccine to protect against Lyme disease, the tick-borne illness that causes a range of painful symptoms, including fever, headaches, fatigue, joint pain and rash.
The biotech MRNA, -2.75%,
whose first product to be approved by the U.S. Food and Drug Administration was its mRNA-based COVID vaccine, said it has two candidates in development to address Lyme disease, named mRNA-1982 and mRNA-1975.
It announced the news at its fourth Vaccine Day, where it offered a full update on its clinical pipeline, which includes vaccines to protect against flu and respiratory syncytial virus, or RSV, as well as HIV, Epstein-Barr virus and herpes simplex virus, among others.
There are about 120,000 cases of Lyme disease in the U.S. and Europe every year, creating a “significant quality of life burden,” the company said in a statement. Rising temperatures are helping the disease spread more easily, and it is difficult to diagnose, because the symptoms are similar to those of many other diseases. It most seriously affects children below the age of 15 and older adults.
“Older adults appear to have higher odds of unfavorable treatment response as compared with younger patients, and neurologic manifestations are more common at presentation for this older adult population,” said the statement.
Tick and Lyme disease season is here, and scientists warn this year could be worse than ever. Dr. Goudarz Molaei joins Lunch Break’s Tanya Rivero to explain what triggered the rapid spread of the disease and how people can avoid being affected. Photo: Kent Wood/Science Source
The mRNA-1982 candidate is designed to create antibodies for Borrelia burgdorferi, the pathogen that causes almost all Lyme disease in the U.S., while mRNA-1975 is designed to elicit antibodies specific to the four major Borrelia species that cause the disease in the U.S. and Europe.
Other new candidates in Moderna’s pipeline include mRNA-1405 and mRNA-1403, which aim to address the enteric virus norovirus. Norovirus is highly contagious and is the leading cause of diarrheal disease globally, Moderna said. It’s associated with about 18% of all such illnesses worldwide and causes about 200,000 deaths every year.
Overall, Moderna is expecting to launch six major vaccine products in the next few years, all of them with large addressable markets.
The company expects the annual global endemic market for COVID boosters alone to be worth about $15 billion.
It has dosed the first participant in a late-stage trial of its next-generation, refrigerator-stable COVID-19 vaccine candidate, mRNA-1283. The vaccine “has demonstrated encouraging results in multiple clinical studies,” the company said.
A separate trial of a flu vaccine called mRNA-1010 fared less well, however.
That trial “did not accrue sufficient cases at the interim efficacy analysis to declare early success in the Phase 3 Northern Hemisphere efficacy trial and the independent DSMB recommended continuation of efficacy follow-up,” the company said.
The company expects the market for respiratory-product sales to range from $8 billion to $15 billion by 2027 and for operating profit that year to range from $4 billion to $9 billion.
The stock was down 4% Tuesday and has fallen 15% in the year to date, while the S&P 500 SPX, +0.17%
has gained 7%.
March 30, 2023 — A federal judge in Texas on Thursday struck down the preventive services mandate of the Affordable Care Act, ruling that the need to provide these services violated the religious rights of the plaintiffs.
One of the plaintiffs who filed the lawsuit is Steven Hotze, MD, a Texas doctor and conservative talk radio host. He said providing health insurance coverage for medication taken daily to prevent HIV to his employees would make him complicit in behaviors that he said violate his religious beliefs.
The ruling applies nationwide, and public health experts were quick to criticize the decision.
“The human cost of this decision is very real,” said Meredithe McNamara, MD, an assistant professor of pediatrics and adolescent medicine specialist at Yale University. Yale researchers, anticipating the ruling, estimated in a recent study that eliminating coverage of the medication, known as PrEP (preexposure prophylaxis), which was mandated for health insurers under the Affordable Care Act, will result in at least 2,000 new HIV infections within a year.
The two brand-name medications approved for PrEP, Truvada and Descovy, cost about $1,800 a month or more without insurance. Generic versions are available for less but are not always available, experts said. Other financial programs, including some by drugmakers, offer assistance to those who qualify. The mandate to provide PrEP coverage began in June 2020, after the U.S. Preventive Services Task Force (USPSTF), an independent panel of experts, gave it an “A” recommendation. Federal law requires any preventive services with an A or B to be covered.
The ruling could also affect much more than just insurance coverage of PrEP. American Medical Association President Jack Resneck Jr., MD, in a statement, said the ACA required insurers and health plans to cover dozens of preventive health services with no cost to patients for things like early detection of cancer, hypertension, diabetes, and sexually transmitted infections.
“Millions of patients could lose first-dollar coverage for cholesterol treatment, tobacco and alcohol cessation, immunizations, and childhood screenings for lead poisoning, hearing loss, and autism,” he said. “Care that is critical to reducing maternal mortality would also be jeopardized. These preventive-care requirements that for 10 years have enabled millions of Americans to improve their health could just go away as a result of this flawed ruling.”
“The government will surely appeal, and has every right to do so,” said Nicholas Bagley, a professor of law at the University of Michigan. “The big question is whether the courts will enter a stay, pending the appeal. I’d expect them to do so, but we will see.”
Even without a stay, Bagley said, most insurance plans are annual, so coverage may not change right away, but that’s not certain. The ruling applies to preventive care guidelines issued after 2010, when the Affordable Care Act was enacted. The contraceptive mandate has been challenged in this case, Bagley said, but was rejected in September. He expects that decision to be appealed.
HIV Prevention: Key Strategy
Prevention, including the use of PrEP, is a key strategy of the federal initiative Ending the HIV Epidemic in the U.S. It aims to decrease new diagnoses to 3,000 by 2030. New diagnoses had decreased 8% from 2016 to 2019, according to the CDC, but there is work to be done to reach the 2030 goal. In 2020, there were 30,635 new HIV diagnoses. When taken correctly, PrEP reduces the risk of becoming infected by 99%, according to the CDC.
In 2020, about 25% of the 1.2 million people in the U.S. for whom PrEP was recommended were actually prescribed it, up from about 3% in 2015, according to the CDC.
One of those is Dan, a gay marketing professional in the Midwest who asked that his real name not be used. He has taken PrEP for about a decade. His employer’s health insurance plan covers it, and it’s important to him.
“I am sexually active, but not that much,” he said. Even so, he counts on the medication for protection when he is sexually active. If the coverage is taken away? “I would probably stop taking it,” he said.
Yale Study and the Effect of Ending the Coverage
Researchers from Yale University estimate that eliminating the PrEP coverage would result in at least 2,000 entirely preventable HIV infections in the following year, as PrEP usage declines without the mandated coverage. That estimate only takes into account the effect on men who have sex with men, not other people also at risk for HIV infection who could benefit from PrEP, such as those who inject drugs or women who have sex with an infected person.
As a result, the estimate is very conservative, says study leader A. David Paltiel, PhD, a professor of health policy at the Yale School of Public Health. His team used U.S.-based data on HIV infection, current rates of PrEP coverage and effectiveness, and the estimated reduction in coverage if access to private health insurance benefits were curtailed.
“We underestimated the number knocked out of PrEP coverage” if the repeal goes national, he said. Right now, about 28% of all men who have sex with men are getting coverage for PrEP, Paltiel estimates. “For every 1% drop from the 28%, there would be 114 new infections,” he said. The researchers also calculated that the percentage of people taking the drug would drop to about 10%. “If that happened, it will result in about 2,000 new infections in the following year. OK? There are people who are going to be left high and dry.”
More on Braidwood Management v. Becerra
In the lawsuit, Braidwood Management v. Becerra, several Christian-owned businesses and several people in Texas sued the federal government, saying the preventive services mandate violates their religious beliefs under the Religious Freedom Restoration Act, a 1993 federal law that guarantees interests in religious freedom are protected.
The plaintiffs also argue that the Affordable Care Act requirement to provide recommended preventive services violates the Constitution’s Appointments Clause, which requires people the president appoints to positions be confirmed by the Senate. The Preventive Services Task Force members are instead appointed by the heads of agencies within the Health and Human Services Department.
Since it was created in 1984, the task force has weighed in on numerous preventive measures, such as when to screen people for diseases and other questions, making evidence-based recommendations to help health care providers care for patients.
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In a statement, Bruce J. Packett, executive director of the American Academy of HIV Medicine, said the Yale report “highlights the critical necessity of taking into account public health repercussions of judicial decisions.”
The effects of eliminating coverage could be catastrophic for HIV reduction efforts, he said. And, he pointed out, “the report only accounts for the effects of not requiring insurers to cover PrEP through one year; the authors did not calculate primary HIV transmissions that would happen well after a year and the secondary infections from those primary infections.”
Also at risk, Packett said, is the authority of the Preventive Services Task Force.
“Striking down the USPSTF’s ability to recommend important evidence-based health care preventive services would be detrimental across the entirety of the public health goals of the United States,” he said.
The Braidwood Management case is “misreading science,” according to McNamara and other Yale researchers. In mid-February, they posted a report, explaining how the PrEP mandate promotes public health not for a segment of the population but the population as a whole. PrEP benefits public health, much like any vaccine or other preventive measure for avoiding infection.
The researchers call PrEP “one of the most celebrated biomedical successes in the global fight to end the HIV epidemic.”
The harms of granting a nationwide injunction against requiring health insurance plans to cover PrEP would affect some ethnic groups disproportionately, McNamara said. Most affected, she said, would be Black and Latino gay and bisexual men, as well as transgender women.
Younger at-risk people would also be at a disadvantage, said McNamara, who cares for adolescents in her clinic. “I can tell you that not having cost sharing for HIV prevention essentially means they aren’t going to use it at all,” she said.
WEDNESDAY, March 29, 2023 (HealthDay News) — Researchers are closing in on another immune system “hideout” that HIV uses to persist in the human body for years.
A subset of white blood cells called myeloid cells can harbor HIV in people who’ve been virally suppressed for years, according to a new small-scale study funded by the U.S. National Institutes of Health (NIH).
The researchers showed that HIV in specific myeloid cells can be reactivated, with the virus going on to infect new cells. These specific cells include short-lived monocytes and longer-lived monocyte-derived macrophages.
The results suggest that myeloid cells contribute to a long-lived reservoir of HIV in those infected, researchers said.
In that case, the white blood cells would be an important but overlooked target in efforts to eradicate HIV.
“Our findings challenge the prevailing narrative that monocytes are too short-lived to be important in cure efforts,” said study author Rebecca Veenhuis, an assistant professor of molecular and comparative pathobiology and of neurology at Johns Hopkins University School of Medicine in Baltimore.
“Yes, the cells are short-lived, but our follow-up data show that HIV can persist in monocytes over several years in people who are virally suppressed,” Veenhuis said in an NIH news release. “The fact that we can detect HIV in these cells over such a long period suggests something is keeping the myeloid reservoir going.”
Antiretroviral drugs are effective in suppressing HIV, by preventing the virus from infecting new cells and multiplying.
However, HIV already present in cells can remain dormant, creating an HIV reservoir that awaits the chance to spring back into action.
CD4 T-cells, another type of white blood cell, are the most well-studied HIV reservoir, but researchers suspect others exist.
Monocytes circulate in the blood for about three days before traveling to different tissues in the body, where they can mature into macrophages, researchers said. Up to now, it’s not been clear whether latent HIV in these cells can reactivate and infect other cells.
“What’s really important in the long run is understanding how monocytes contribute to the tissue macrophage reservoir,” said senior study author Janice Clements, a professor of molecular and comparative pathobiology at Hopkins School of Medicine. “If monocytes can carry virus to the brain, or lung, or another part of the body and infect resident macrophages that are self-renewing and live almost indefinitely, that’s a real problem.”
In the study, researchers measured HIV DNA in myeloid cells belonging to 30 patients infected with HIV, all of whom had been on antiretroviral therapy for at least five years.
The team found detectable levels of HIV genetic material in monocytes and macrophages, although the levels were much lower than has been observed in CD4 T-cells.
In some patients, the HIV genetic material found in monocytes was intact, suggesting it could reactivate and infect new cells.
The researchers then used a new quantitative method to directly measure the viral spread of HIV found in myeloid cells.
They isolated monocytes from the blood of 10 patients, and nurtured the cells in cultures that contained antiretroviral drugs, just like the patients.
After the monocytes developed into macrophages, researchers introduced an agent that activates the immune system and then added fresh white blood cells to the cultures — giving the HIV a potential new target.
Cultures of five of the 10 participants had detectable HIV genetic material in their macrophages that could be reactivated to infect other cells and replicate, researchers reported. Those patients also had higher overall levels of HIV DNA material.
Follow-up data from three patients showed this reservoir can harbor latent HIV for up to several years. The reservoirs were stable and could be reactivated over time, indicating that monocyte-derived macrophages could contribute to HIV viral rebound if antiretroviral therapy is interrupted.
The researchers called for larger studies with more diverse participant pools, to gain a better idea of how many people might carry latent HIV in myeloid cells and figure out how the monocyte HIV reservoir replenishes itself over time.
The study was published March 27 in the journal Nature Microbiology.
More information
The U.S. National Institutes of Health has more about the latent HIV reservoir.
SOURCE: U.S. National Institutes of Health, news release, March 27, 2023
WEDNESDAY, Feb. 22, 2023 (HealthDay News) – The mpox virus — formerly known as monkeypox — often causes severe illness and death in those with advanced HIV infection that is not under control, researchers report.
What does that mean? All people diagnosed with mpox should also be tested for HIV, the investigators said.
The international collaboration of scientists also recommends that the World Health Organization and the U.S. Centers for Disease Control and Prevention add this strain of mpox to its list of severe infections considered particularly dangerous to people with advanced HIV disease.
“Currently, there is a list of fourteen infections which behave differently and are particularly dangerous to immunosuppressed people with advanced HIV infection. These are called ‘AIDS-defining conditions’ by international public health agencies. Clinicians worldwide use this classification to guide their management of people most at risk of dying from these infections,” lead author Chloe Orkin, a professor of HIV medicine at Queen Mary University of London, explained in a university news release.
The data highlight the fact that mpox remains a significant threat to people with advanced HIV, said Matthew Hodson, executive director of NAM aidsmap.
“Although mpox is rarely severe for those of us whose HIV is controlled with treatment, the rates of serious illness and mortality as a result of mpox for people with untreated or unsuppressed HIV are worrying,” Hodson said. “This again highlights the urgency of ensuring people with HIV are diagnosed and have secure access to treatment. Routine HIV testing for all people diagnosed with mpox has the potential to reduce mpox-related deaths and advanced HIV disease.”
The mpox outbreak that spread around the world last year was linked to networks of gay, bisexual and other men who have sex with men, according to the study.
Researchers estimated that between 38% and 50% of people diagnosed with mpox in the 2022 outbreak also had HIV. Most, however, were on HIV treatment and living healthy lives, the study noted.
In this study, clinicians looked at 382 people who had advanced HIV disease and mpox. This included 27 of the 60 people who died of mpox during the outbreak.
This latest strain of mpox includes widespread necrotizing skin lesions. There are also high rates of severe infections. In some cases, patients have had unusual lung lesions.
“We describe a severe form of mpox affecting mostly young men who have sex with men and which results in death in 15% of people with advanced HIV,” said study first author Oriol Mitjà, an associate professor of infectious disease and global health at the Fight Infectious Diseases Foundation.
“When clinicians recognize necrotizing skin lesions and/or lung involvement, they should use a differentiated clinical pathway and an intensified approach,” Mitjà said. “Also, health authorities should prioritize the vaccination of people living with HIV, particularly in countries with low levels of diagnosis or without universal free access to antiretroviral treatment.”
In addition to testing all people with mpox for HIV, all at-risk persons with HIV and immunosuppression should be prioritized for mpox vaccination and antivirals, the researchers said.
Study findings were published Feb. 21 in The Lancet journal.
More information
The World Health Organization has more on mpox.
SOURCE: Queen Mary University of London, news release, Feb. 21, 2023
Jan. 30, 2023 – When he was a young boy growing up in Brooklyn, Anthony Fauci loved playing sports. As captain of his high school basketball team, he wanted to be an athlete, but at 5-foot-7, he says it wasn’t in the cards. So, he decided to become a doctor instead.
Fauci, who turned 82 in December, stepped down as the head of the National Institute of Allergy and Infectious Diseases that same month, leaving behind a high-profile career in government spanning more than half a century, during which he counseled seven presidents, including Joe Biden. Fauci worked at the National Institutes of Health for 54 years and served as director of the National Institute of Allergy and Infectious Diseases for 38 years. In an interview last week, he spoke to WebMD about his career and his plans for the future.
This interview has been edited and condensed.
It’s only been a few weeks since your official “retirement,” but what’s next for you?
What’s next for me is certainly not classical retirement. I have probably a few more years of being as active, vigorous, passionate about my field of public health, public service in the arena of infectious diseases and immunology. [I’ve] had the privilege of advising seven presidents of the United States in areas that are fundamentally centered around our response and preparation for emerging infections going back to the early years of HIV, pandemic flu, bird flu, Ebola, Zika, and now, most recently the last 3 years, with COVID. What I want to do in the next few years, by writing, by lecturing, and by serving in a senior advisory role, is to hopefully inspire young people to go into the field of medicine and science, and perhaps even to consider going into the area of public service.
Almost certainly, I’ll begin working on a memoir. So that’s what I’d like to do over the next few years.
Are you looking forward to going back and seeing patients and being out of the public eye?
I will almost certainly associate myself with a medical center, either one locally here in the Washington, DC, area or some of the other medical centers that have expressed an interest in my joining the faculty. I am not going to dissociate myself from clinical medicine, since clinical medicine is such an important part of my identity and has been thus literally for well over 50 years. So, I’m not exactly sure of the venue in which I will do that, but I certainly will have some connection with clinical medicine.
What are you looking forward to most about going back to doctoring?
Well, I’ve always had a great deal of attraction to the concept of medicine, the application of medicine. I have taken care of thousands of patients in my long career. I spent a considerable amount of time in the early years of HIV, even before we knew it was HIV, taking care of desperately ill patients. I’ve been involved in a number of clinical research projects, and I was always fascinated by that because there’s much gratification and good feeling you get when you take care of, personally, an individual patient, when you do research that advances the field, and those advances that you may have been a part of benefit larger numbers of patients that are being taken care of by other physicians throughout the country and perhaps even throughout the world.
So those are all of the aspects of clinical medicine that I want to encourage younger people that these are the opportunities that they can be a part of, which can be very gratifying and certainly productive in the sense of saving lives.
Looking back over your career, what were some of the highs and lows, or turning points?
I first became involved in the personal care and research on persons with HIV, literally in the fall of 1981. [That was] weeks to months after the first cases were recognized. My colleagues and I spent the next few years taking care of desperately ill patients, and we did not have effective therapies because the first couple of years, we did not even know what the ideologic agent was. Even after it was recognized after 1983 and 1984, it took several years before effective therapies were developed, so there was a period of time where we were in a very difficult situation. We were essentially putting Band-Aids on hemorrhages, metaphorically, because no matter what we did, our patients continued to decline. That was a low and dark period of our lives, inspired only by the bravery and the resilience of our patients. A very high period was in [the late 1990s] and into the next century [with the development] of drugs that were highly effective in prolonged and effective suppression of viral loads to the point where people who were living with HIV, if they had access to therapy, could essentially lead a normal lifespan..
We put together the President’s Emergency Plan for AIDS Relief program know as PEPFAR, which now, celebrating its 20th anniversary, has resulted in saving 20-25 million lives. So, I would say that is … the highest point in my experience as a physician and a scientist, to have been an important part in the development of that program.
Do you feel like there’s any unfinished business? Anything you would change?
Certainly, there’s unfinished business. One of the goals I would have liked to have achieved, but that is going to have to wait another few years, is the development of a safe and effective vaccine for HIV. A lot of very elegant science has been done in that regard, but we’re not there yet, it’s a very challenging scientific problem.
The other unfinished business is some of the other diseases that cause a considerable amount of morbidity and mortality globally, diseases like malaria and tuberculosis. We’ve made extraordinary progress over the 38 years that I’ve been director of the institute We have a vaccine, though it isn’t a perfect vaccine [for malaria]; we have monoclonal antibodies that are now highly effective in preventing malaria; we have newer drugs, better drugs for tuberculosis, but we don’t have an effective vaccine for tuberculosis. So, malaria vaccines, tuberculosis vaccines, those are all unfinished business. I believe we will get there.
These new COVID-19 variants keep getting more and more contagious. Do you see the potential for a serious new variant that could plunge us back into some level of public restrictions?
Anything is possible. One cannot predict, exactly, what the likelihood of getting yet again another variant that’s so different that it eludes the protection that we have from the vaccines and from prior infection. Again, I can’t give a number on that. I don’t think it’s highly likely that will happen.
Ever since Omicron came well over a year ago, we have had sublineages of Omicron that progressively seem to elude the immune response that’s been developed. But the one thing that’s good and has been sustained is that protection against severity of disease seems to hold out pretty well. I don’t think that we should be talking about restrictions in the sense of draconian methods of shutting things down; I mean, that was only done for a very brief period of time when our hospitals were being overrun. I don’t anticipate that that is going to be something in the future, but you’ve got to be prepared for it. There are some things that have been highly successful, and that is the vaccines that were developed in less than 1 year. And now, our challenge is to get more people to get their updated boosters.
There’s already been criticism of the FDA’s discussion about of an annual COVID-19 vaccine. One criticism is that the COVID vaccines’ effectiveness appears to wane after several months, so it would not offer protection for much of the year. Is that a legitimate criticism?
There’s no perfect solution to keeping the country optimally protected. I believe that it gets down to, “It’s not perfect, but don’t let the perfect be the enemy of the good.” We want to get into some regular cadence to get people updated with a booster that is hopefully managed reasonably well to what the circulating variant is. There are certainly going to be people – perhaps the elderly, some of the immune-compromised, and perhaps children – who will need a shot more than once per year, but the FDA’s leaning towards getting a shot that is [timed] with the flu shot, would at least bring some degree of order and stability to the process of people getting into the regular routine of keeping themselves updated and protected to the best extent possible.
Do you think we need to move on from mRNA vaccines to something that hopefully has longer-lasting protection?
Yes, we certainly want next-generation vaccines – both vaccines that have a greater degree of breadth, namely covering multiple variants, as well as a greater degree of duration. So, the real question is, “Is it the mRNA vaccine platform that is inducing a response that is not durable, or is the response against coronaviruses not a durable response?” That’s still uncertain. Yes, we need to do better with a better platform, or an improvement on the platform; that could mean adding adjuvants, that could mean a [nasal] vaccine in addition to a systemic vaccine.
Do you always wear a mask when you go out into the world? How do you evaluate the relative risk of situations when you go out in public?
I’ve been vaccinated, doubly boosted, I’ve gotten infected, and I’ve gotten the bivalent boost. So, I evaluate things depending upon what the level of viral activity is in the particular location where I’m at. If I’m going to go on a plane, for example, I have no idea where these people are coming from, I generally wear a mask on a plane. I don’t really go to congregate settings often. Many of the events I do go to are situations where a requirement for [attending] is to get a test that’s negative that day.
When you’re in a situation like that, even if it’s a crowded congregant setting, I don’t have any problem not wearing a mask. But when I’m unsure of what the status is and I might be in an area where there is a considerable degree of viral activity, I would wear a mask. I think you just have to use [your] judgment, depending on the circumstances that you find yourself in.
Doctors and health care professionals have been through hell during COVID. Do you think this might bring a permanent change to how doctors perceive their jobs?
Health care providers have been under a considerable amount of stress because this is a totally unprecedented situation that we find ourselves in. This is the likes of which we have not seen in well over 100 years. I hope this is not something that is going to be permanent, I don’t think it is, I think that we are ultimately going to get to a point where the level of virus is low enough that it’s not going to disrupt either society or the health care system or the economy.
We’re not totally there yet. We’re still having about 500 deaths per day, which is much, much better than the 3,000 to 4,000 deaths that we were seeing over a year ago, but it is still not low enough to be able to feel comfortable.
As a scientist, even a semi-retired one, what scares you? What wakes you up at night with worry?
The same thing I have been concerned about for, you know, 40 years: the appearance of a highly transmissible respiratory virus that has a degree of morbidity and mortality that could really be very disruptive of us in this country and globally. Unfortunately, we’re in the middle of that situation now, finishing our third year and going into year 4. So what worries me is yet another pandemic. Now that could be a year from now, 5 years from now, 50 years from now. Remember, the last time a pandemic of this magnitude occurred was well over 100 years ago. My concern is that we stay prepared. [We may] not necessarily prevent the emergence of a new infection, but hopefully we can prevent it from becoming a pandemic.
“I became so incensed and personally frustrated at the rejection I was receiving by just trying to get people’s attention. I was made so aware of the silence, this huge, loud silence regarding AIDS, how no one wanted to talk about it and no one wanted to become involved. Certainly no one wanted to give money or support, and it so angered me that I finally thought to myself, Bitch, do something yourself. Instead of sitting there getting angry. Do something.”
In 1987, Taylor launched her first perfume, Passion, and followed it up in 1991 with White Diamonds, another enormous hit. She traveled around the country visiting the department stores that sold her perfume, and she vowed to visit AIDS hospices in every city that she could. But there were two caveats: She did not want any press to interrupt those private visits, and the perfume company and the department store would have to donate money to each of the hospices she visited. She vowed to match their contributions.
At the Coming Home Hospice in San Francisco’s Castro District, nurses were told in hushed tones that Taylor was on her way. She stopped in each of the hospice’s 15 small rooms, and she spent several minutes talking with each patient. She asked them if she could arrange to have their dogs walked; she asked if she could call their mothers for them or write letters for them.
Some patients cried when they saw her, said Guy Vandenberg, a health care worker and AIDS activist who was at the Coming Home Hospice when she visited. After she met with patients, he said, Taylor sat with the handful of staffers in their tiny kitchen and asked them how they were taking care of themselves. “How do you support each other?” she wanted to know.
They averaged three deaths a week in the 15-bed hospice, he said. “Sometimes I would get off my three-to-midnight shift and I would come back the next day, and one or two people might have died during the night,” Vandenberg said, his voice cracking. “The need was so great that the bed would not be empty more than a day at most; sometimes the bed would be filled right away. We didn’t have time to process the volume of death.”
Even amid all the darkness, there was joy. “A majority of our patients, as they were dying, were quite capable of laughter and gallows humor, and to an outsider that often felt really strange or inappropriate. When the hospice was taken over by a more corporate hospital, we got disciplined for too much laughter, and we were eating with the patients and that was not allowed,” Vandenberg said through tears. “She fit right in, she knew that was good. She joked with them. She hugged and kissed every single one of us, the patients and the staff.”
After one of her hospice visits, a patient woke up and said, “I had a vision that Elizabeth Taylor came to me in my sleep!”
“No, she was actually here,” a nurse told him.
Taylor wanted to look perfect for every visit (“I hope I haven’t overdone it!” she’d joke), so she always arrived with full hair and makeup and the famous 33.19-carat Asscher-cut Krupp diamond on her left ring finger. She wanted the patients to see her the way they had imagined her to be.
She told her assistant Jorjett Strumme, who would get emotional, that she could not come into hospices with her because she would start to cry if Strumme cried. She had to keep things light and happy, she said, but she’d get back in the car and she would bury her head in her dog’s soft white fur and be unusually quiet for a while.
Ed Wolf was a counselor in San Francisco General Hospital’s Ward 5B in the 1980s. San Francisco was second only to New York in the number of AIDS cases, and 5B was the world’s first revolutionary inpatient unit for people with AIDS. It was created in 1983 and run by registered nurses who specialized in caring for AIDS patients. In 5B patients were treated with compassion.
In the beginning nurses and doctors wore so much protective gear that they looked like astronauts. Food trays piled up outside of hospital rooms because no one wanted to touch them. But in 5B things were different. Nurses were not allowed to wear protective medical gear, including gowns and masks. They believed that physical touch was an important way to honor each patient’s humanity. They did seemingly little things, like re-creating the decor of patients’ living rooms in their hospital rooms, allowing their pets to visit them, and, of course, allowing their partners to stay with them. They even used Champagne glasses for water.
Antiretroviral therapy, or ART, is a safe and proven way to treat HIV. Your doctor will want you to start right away — usually the same day you’re diagnosed. This is called rapid-start ART. Early and effective treatment can help you live a normal life. It can also lower the chances you’ll pass the virus to someone else.
The sooner you start ART, the better. That’s true even if you feel good.
“There’s no upside to waiting,” says Shannon Galvin, MD, associate professor of medicine and infectious diseases at Northwestern Medicine. “Everyone who has HIV will benefit from being on treatment, no matter what their T-cell count is.”
Effective ART can lower your viral load so much that blood tests won’t be able to find it. That doesn’t just keep you well. It means there’s pretty much no chance that you’ll sexually transmit the virus to someone else. That’s called “undetectable equals untransmittable.” If you reach this state fast, you may feel more in control and hopeful about your condition, says Gregory Huhn, MD, associate professor of medicine and infectious diseases at Rush University Medical Center.
ART can help you stay healthy. But it’s not a cure for HIV. You’ll need to take your medicine every day. If you have questions about your treatment, talk to your doctor before you start. They can help you find a plan that works for you.
How Does ART Treat HIV?
This combo of drugs can lower the amount of HIV in your blood, which is called your viral load. This keeps up your CD4 count. The higher this number, the more T cells you have and the better your immune system works. ART also lowers your HIV-related immune activation. This is inflammation that can hurt your heart, brain, bones, and other organs.
Basically, ART makes it less likely you’ll get sick from HIV. And that helps you live longer.
“If you take a 20-year-old with a CD4 count above 500, who starts ART immediately after diagnosis — and they don’t have hepatitis B, C, or other comorbidities — their life expectancy is about the same as that person without HIV,” Huhn says.
Who Should Start ART Right Away?
In the past, doctors gave rapid-start ART to people with a very low CD4 count. But now, anyone with HIV is likely to get it. “We have hard data that shows everybody (with HIV) lives longer and healthier if they’re on antiretrovirals,” Galvin says.
ART is even more important for certain groups. That includes people who:
Are pregnant. You’re less likely to pass HIV to your baby if you have an undetectable viral load. If you’re already on ART, keeping taking your medicine. But if you’re not, talk to your doctor about how you can start treatment right away.
Have a low CD4 count. People with a CD4 count less than 200 are at high risk for becoming ill. In fact, a CD4 count this low means you have AIDS.
Have an AIDS-defining condition. These are infections and cancers that are especially serious for people with HIV.
Should Anyone Delay ART?
There are very few people who should wait to begin ART, Huhn says. But sometimes you may need to treat certain infections first.
Your doctor may put off your ART if you have:
Your doctor may also want to first treat any serious mental health conditions, Huhn says. Untreated psychological or substance abuse problems can make it harder for you to keep up with treatment.
What If You’re Not Ready?
It’s normal to need some time to take in your diagnosis. It’s still considered rapid start if you begin ART within 7 days. What’s most important is that you’re ready to stay with treatment once you start. “There are a few people who have to think about it, and they should be given that opportunity,” Galvin says. “We just want to make sure that we’re starting something we have a plan to continue.”
