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AIDS groups, activists cautious over ‘prevention’ pill

Anti-retroviral drug reduced HIV infections by 44 percent

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Truvada, gay news, Washington Blade

Gilead Sciences Truvada pill. (Image courtesy of Gilead)

Leaders of AIDS advocacy organizations joined researchers in expressing both optimism and caution over a study released last week showing that the use of a daily anti-retroviral pill significantly lowered the chance of becoming infected by HIV.

The study found that a sample of mostly gay men who were assigned to take a daily tablet of the widely used HIV medication Truvada experienced an average of 43.8 percent fewer HIV infections than participants who received a placebo pill.

Findings of the study were published Nov. 23 in the New England Journal of Medicine.

The study, which began in 2007 and included a total of 2,499 participants in the U.S., Brazil, Ecuador, Peru, South Africa and Thailand, was funded by the National Institutes of Health and the Bill & Melinda Gates Foundation. It was coordinated by the Gladstone Institutes, an arm of the University of California at San Francisco.

Participants were limited to mostly men who have sex with men and a smaller number of transgender women who have sex with men. Researchers conducting the study said the sample was chosen to represent a population group considered at high risk for contracting HIV.

“All study participants received a comprehensive package of prevention services designed to reduce their risk of HIV infection throughout the trial, including HIV testing, intensive safer sex counseling, condoms and treatment and care for sexually transmitted infections,” the Gladstone Institute said in a statement.

NIH official Dr. Anthony Fauci triggered a wave of optimism over the study findings when he told the New York Times last week that the Truvada pill was more than 90 percent effective in preventing HIV infections among a smaller number of study participants who faithfully adhered to the prescribed daily regimen.

The 43.8 percent reduction figure for HIV infections was based on findings from all 1,251 participants who were given the Truvada pill, including many who did not take the daily pill consistently, according to a detailed summary of the study released by the Gladstone Institutes.

The summary says 1,248 participants received a placebo pill as part of what Gladstone officials called a “double blind” study, in which both participants and employees dispensing the pills did not know who received the drug or the placebo.

In addition to interviewing participants to obtain their own accounts of whether they took the pills every day, researchers conducting the study administered regular blood tests of all participants and were able to confirm which ones took the Truvada pill as directed.

Dr. Kenneth Mayor, medical research director of the Fenway Institute in Boston, an HIV treatment facility that was one of two U.S. sites involved in the study, called the findings “a tremendous step forward” in the quest to lower the rate of HIV infection.

“For more than 15 years, the rate of new infections in the U.S. has been stuck at about 56,000 per year,” Mayor said in a statement. “There has been no downward movement in this number, which has meant that we desperately needed a new approach.

“It’s now possible that within the next few years, we can significantly reduce the number of new infections,” he said.

Other AIDS specialists, including Dr. Ray Martins, medical director of D.C.’s Whitman-Walker Clinic, expressed caution over the implications of the study and the widespread use of a prevention pill approach that researchers call “pre-exposure prophylaxis” or “PreP.”

Martins said the average reduction rate in the study for HIV infections of fewer than 44 percent was lower than he expected and shows a tendency of non-compliance by a large percentage of participants.

Similar to other AIDS specialists assessing the study, Martins expressed concern that a lack of adherence to a daily pill regimen of Truvada or other anti-retroviral medications could result in strains of the HIV virus that are resistant to Truvada or other HIV drugs.

The study showed that just a few participants developed resistant viral strains; they were believed to have become infected before they joined the study, with their infections undetectable at the time.

Martins called Truvada “the major backbone to almost all our current HIV regimens” for treating people with HIV and AIDS.

“So if we increase resistance to those meds and people start transmitting more resistant virus, this could be very bad for the HIV community as a whole,” he said. “To me, that was the most worrisome thing.”

He said Whitman-Walker has no immediate plans to dispense Truvada as a prevention pill for D.C.-area residents who might request it. However, he said the Clinic does prescribe Truvada to people who come to the Clinic for “post-exposure prophylaxis” – a short-term drug regimen used for people who seek treatment immediately after engaging in unsafe sex.

“I think more studies have to be done before we would recommend this as a kind of generalized use,” he said.

Martins said the Clinic would welcome the chance to participate in another study that might offer pre-exposure prophylaxis for patients at its sexually transmitted disease clinic program, who are considered to be among the highest risk group for HIV.

Longtime AIDS researcher and physician Dr. Joseph Sonnabend of San Francisco, where the other U.S. site for the prevention pill study was located, said the reduction rate for HIV infections was far too low to make a Truvada prevention pill useful for large populations.

“Daily Truvada reduced new HIV infections by only 44 percent,” he said in a statement. “This is useless, so how on earth can this be construed as a triumph?”

He said the far higher reduction rate for study participants who adhered to the daily pill regimen was meaningless in drawing conclusions for widespread use of a prevention pill “in real world conditions.”

Some AIDS advocacy organizations also expressed concern that the availability of an HIV prevention pill could result in less adherence to condom use and other safer sex practices.

Jose Zuniga, president of the International Association of Physicians in AIDS Care, called the study “an important first step in validating biomedical prevention of HIV in adults.” However, he pointed to a number of potential drawbacks to the use of Truvada as a prophylaxis in addition to the concern over viral resistance to the drug.

Possible side effects to the medication include kidney-related problems with the potential of forcing people to stop taking the medication, Zuniga noted. He said the average cost of $10,000 or more per year for the drug, which likely would not be picked up by health insurance, is also a major concern in considering its widespread use for prevention.

“The bottom line message is that condoms, clean syringes and behavioral interventions must remain our first line of defense against HIV transmission,” Zuniga said.

The study’s organizers at the Gladstone Institutes say the findings show participants increased rather than curtailed safer sex practices during their involvement in the study.

“In fact, self-reported HIV risk behavior decreased among participants in both arms of the study and condom use increased,” Gladstone said in its summary statement.

Among the groups expressing optimism over the study’s findings is Project Inform, a San Francisco-based advocacy organization for the development of effective HIV treatment and prevention options.

“A study showing that a daily pill reduces HIV risk in gay men is reason for great hope,” the group said in a statement. “U.S. agencies should waste no time in assessing the ability of pre-exposure prophylaxis to slow the HIV/AIDS epidemic.”

The group’s four-page analysis of the study is available here.

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Health

AIDS Healthcare Foundation announces 3 million people globally in its care

Los Angeles-based group lauded ‘historic milestone’

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An AIDS Healthcare Foundation float in the Lima Pride parade in Lima, Peru, on July 1, 2023. (Photo courtesy of Jacob Kessler)

The AIDS Healthcare Foundation, a Los Angeles-based nonprofit group founded in 1987 that has become the world’s largest HIV/AIDS organization, has announced it has three million people in care around the world.

In a statement released on May 26, the organization, known worldwide as AHF, said the latest accomplishment reflects its global commitment to HIV prevention, care, and treatment. It says the accomplishment comes at a time when AHF marks the 25th anniversary of its first global programs launched in South Africa and Uganda in early 2001.

The statement says the three million people in care milestone also comes while the group approaches the 40th anniversary of its founding in 1987.

“Today, AHF provides lifesaving services in 50 countries across Africa, the Americas, Asia, and Europe, supporting millions of people living with HIV through a network of 1,056 global clinics, 79 healthcare centers in the U.S., 67 pharmacies, 96 wellness centers, 26 Out of the Closet thrift stores, outreach programs, and community partnerships,” the statement says.   

“This accomplishment is far more than a number — it represents 3 million individuals whose lives have been touched by compassion, commitment, and the belief that healthcare is a human right,” Condessa M. Curley, the AHF board chair, said in a statement. “We extend our deepest gratitude to every member of the AHF team whose dedication made this milestone possible,” Curley said.

The AHF website notes the organization was founded in 1987 in Los Angeles as a network of hospices committed to “fighting for the living and caring for the dying” at a time when there was no effective treatment for HIV/AIDS. A statement on the website says since that time AHF has greatly expanded, converting its hospices into healthcare centers “and building a new paradigm for HIV care both in the United States and around the world.”  

The statement adds, “Under the leadership of president and co-founder Michael Weinstein, AHF has grown from a group of friends dedicated to creating dignified hospice care to the largest AIDS organization in the world.” It says Weinstein “has been at the forefront of creating cutting-edge healthcare and advocacy programs and continues to drive the organization forward with the aim of saving more lives around the world.”

The statement announcing the milestone has also come at a time when more than 40 million people worldwide are living with HIV, “while hundreds of thousands continue to die annually from AIDS-related illnesses despite the availability of effective treatment.”

It says AHF’s response has included an expansion of its prevention and public health programs worldwide. In 2025 alone, according to the statement, AHF and its affiliated programs provided nearly five million free HIV tests globally and distributed more than 54 million free condoms, “underscoring the organization’s continued emphasis on both prevention and treatment.”

In D.C. AHF operates health care centers at 1701 K St., N.W., Ste. 400 [202-293-8680], 650 Pennsylvania Ave., S.E., Ste. 310 [202-350-5000], and 1647 Benning Road, N.E., Ste. 300 [202-350-5000]. 

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Cannabis Culture

LGBTQ people, weed, and mental health: what you need to know

Community uses marijuana at much higher rates than general population

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(Photo courtesy of NORML)

Uncloseted Media published this story on May 7.

By SPENCER MACNAUGHTON | In 2025, the global cannabis market size was valued at nearly $103 billion. By 2034, that number is expected to explode by roughly 1,400 percent to more than $1.43 trillion.

In short, as an increasing number of countries legalize marijuana use, everyone is starting to consume a lot more weed. And LGBTQ people tend to use cannabis at much higher rates than the general population. One study found that 55 percent of lesbian and 45 percent of gay young adults use marijuana, compared to about 33 percent and 37 percent, respectively, of their straight counterparts.

As LGBTQ people face a mental health crisis, the mainstream stereotypes that depict weed as an antidote for anxiety, panic and depression aren’t painting the full picture. And that could be exacerbating the mental health struggles so many queer people, and especially youth, face.

Here’s what the research demonstrates about marijuana and its effects on mental health:

  • Multiple studies suggest a link between marijuana use and an increased risk of mental health disorders, including schizophrenia, depression and anxiety in individuals who are genetically predisposed.
  • One study found that daily marijuana use, especially among younger people, makes some individuals seven times more likely to develop psychosis.

The increase in higher-potency strains of marijuana could pose unknown risks. In 1995, the average content of Tetrahydrocannabinol (THC) in confiscated marijuana was less than 4 percent. In 2022, it was more than 16 percent. Researchers don’t know the full extent of the impact that these higher concentrations can have on mental health and especially on younger people whose brains are still developing.

  • systematic review of studies published between 2013 and 2025 found damning results for the mental health of young cannabis users:

They were 51 percent more likely to experience depression, 58 percent more likely to experience anxiety, between 50 and 65 percent more likely to experience suicidal ideation and 80 to 87 percent more likely to have attempted suicide.

  • While the above stats paint a grim picture, there is also some research that suggests benefits of cannabis use:
    • A 2025 systematic review found that “medicinal” weed showed some efficacy in relieving withdrawal symptoms of opioid use disorder. THC use has been associated with improvement of post-traumatic stress disorder symptoms, bipolar symptoms and sleep quality.
    • Other studies found that THC administered in a controlled setting was associated with a decrease of symptoms and adverse effects for a range of mental health disorders, including schizophrenia, psychotic symptoms, and anorexia nervosa.

Beyond what we pulled from academia, there is an astounding lack of information about the interplay between weed and mental health. As we dive deeper into Mental Health Awareness Month, I hope advocacy organizations, influencers and news outlets ramp up their coverage of this important topic that affects the countless LGBTQ weed smokers, many of whom are already struggling.

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Health

UPDATED: Trans-led HIV clinic in Portsmouth struggles amid funding cuts

As states across the U.S. cut funding for HIV care this small clinic in Va, is still fighting

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Nyonna L. Byers (Photo courtesy of Nyonna L. Byers)

Two years ago, Nyonna Byers, a transgender woman from Portsmouth, Va., founded Ending Transmission of Sexual Infections (ETSI) Health Clinic to support a community she saw struggling with rising HIV rates. Now, as costs continue to climb and funding for HIV healthcare initiatives is being cut across the United States, Byers says her transgender identity has made it harder to secure the financial support her clinic needs to survive.

Portsmouth, with just under 100,000 people, is right across the Elizabeth River from Norfolk.

“We’re an HIV-led organization here in Portsmouth, providing services throughout the Hampton Roads area,” Byers told the Blade. “As a trans-led organization—with me as the founder and executive director—I’ve received a lot of rejection when it comes to funding. That’s one of the main reasons why we’re struggling to keep the clinic open. Without funding, we can’t provide HIV treatment or care, and then we’re just a theoretical organization—we can’t be impactful in the community we serve.”

She said the data clearly shows a need for increased investment in HIV care in Portsmouth, but the response from leadership has not matched the urgency of the crisis.

“Portsmouth is one of the smallest cities with one of the highest HIV rates, and there are very few HIV-led organizations or clinics here. The need is urgent, but the response doesn’t match it. We’re doing the work on the ground, but we’re not getting the support to sustain it. That disconnect is what’s hurting people the most.”

That need, Byers explained, continues to grow as ETSI struggles to meet the financial demands of the life-saving work it provides.

Portsmouth has one of the highest HIV prevalence rates in Virginia, with roughly 736.9 cases per 100,000 people—a rate that exceeds both state and national averages.

“Leaders like the mayor and city council don’t focus on public health or social health. They focus more on development—building the city up physically—rather than investing in the health of the people. I’ve applied for funding multiple times and been denied. Every time I’ve asked for resources, I’ve been turned away.”

When asked why, Byers said the answer felt clear to her.

“I honestly believe I was denied funding because I’m trans. I told the mayor I was going to go public with it, because it’s not fair. We’re on the ground doing the work to end HIV, and we’re still not getting the support we need. That’s not just frustrating—it’s harmful.”

While she said local support has been lacking, Byers noted that the state has stepped in—though the funding still falls short of what is needed to sustain the clinic long term.

ETSI Health Clinic was included as a recipient of funding in the Virginia 2027–2028 Senate budget, receiving $50,000 per year from the Virginia General Fund. Byers specifically credited State Sen. Lillie Louise Lucas with helping secure that funding, which she said did not come from city leadership.

Byers shared that she has given up a lot to keep ETSI afloat, but the costs just keep coming.

“I’ve worked a lot of contracts—jobs paying $30 to $40 an hour—and poured that money into my clinic. But the downside is that I’m struggling personally. I’ve lost cars, I’ve lost a house—I’ve lost a lot to keep this clinic going. This work has cost me almost everything.”

Nyonna L. Byers and HIV/AIDS activist Jeanne White-Ginder (Photo courtesy of Nyonna L. Byers)

She added that the impact of federal policy shifts is also being felt locally. As the Trump-Vance administration continues to roll back what it has described as unnecessary “DEI” spending, Byers said those decisions are affecting clinics like hers.

There was a time when the clinic was able to receive funding from Sentara Cares, the philanthropic program of Sentara Health, a not-for-profit healthcare system based in Virginia and North Carolina, but now they can’t.

“We had funding from Sentara Cares for three years, and it helped keep us going. Then when DEI initiatives started getting rolled back, that funding stopped. I was told directly that because of federal policy changes, they couldn’t fund the clinic. I broke down during that meeting, because it felt like they were really saying they couldn’t support us because of who we are.”

That lack of funding is compounded by broader gaps in healthcare access in the region. Portsmouth—the ninth most populous city in Virginia—does not have a hospital.

“There’s very limited access to care in Portsmouth. We don’t even have a hospital—people have to be transported to Norfolk. We’ve had high rates of syphilis, and the health department is only open a few days a week. A lot of people don’t trust it, and that leaves entire communities without care.”

Byers made it clear that this is more than a passion project for her—it is her life’s calling, and she would do nearly anything to keep it going.

“To be honest, I would go back to sex work before I let my clinic close. This is something I built from the ground up. I built this clinic with money I earned myself. I’m not going to let it disappear without a fight.”

She also pointed to gaps in education and outreach, which she says exacerbate HIV rates despite the availability of preventive measures.

“There’s almost no marketing or education about PrEP in the Hampton Roads area. If you go to places like D.C. or Atlanta, you see billboards and campaigns—but here, you don’t see anything. If people don’t see it, they don’t know about it. That lack of awareness is putting people at risk.”

It is also a deeply personal fight, she explained.

“I’ve lost friends to HIV. People say you can’t die from HIV anymore, but you can if you’re not in care. I’ve seen it firsthand, and that’s what motivates me to keep going. HIV doesn’t have to be a death sentence—but without support, it can become one.”

The Blade reached out to Portsmouth Mayor Shannon E. Glover for comment.

Glover disputed Byers’ claims that her clinic was treated unfairly, including her allegation that her transgender identity played a role in funding decisions.

“There’s no issue with Miss—with her and her organization. We have been in discussion, and quite frankly, the claims that she made as it relates to ‘we’re not treating her equitably and fairly because of her [being] transgender’ that is totally untrue,” Glover told the Blade via phone call. “I’ve talked to Miss Nyonna on a number of occasions, and that is categorically not true.”

Glover added that the city provides funding to various organizations and said he had directed Byers to seek support elsewhere.

“So I’m not understanding what her issues are,” he said. “But in any event, you know, we have funding that we provide to organizations. I’ve recommended other organizations to her. I’ve recommended that she go to the state where they have more flexibility with their budget and they could help her. So that’s what I’m prepared to tell you today. I’m not going to answer any questions. I just wanted to respond that her claim that we are mistreating her, not treating her fair, is totally untrue.”

To donate to ETSI, visit their donation page at ESTIhcvas.org/donate

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