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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

United States Conference on HIV/AIDS grapples with federal budget cuts

Annual gathering is largest of its kind in the country

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Bishop Antonio José Gallardo Lucena addresses the United States Conference on HIV/AIDS in Anaheim, Calif., on Sep 17, 2026. (Photo by Caleb Kaufman for the Los Angeles Blade)

Advocates, public health experts, and healthcare providers gathered for the United States Conference on HIV/AIDS on Sept. 17 in Anaheim, Calif.

The conference is the largest of its kind in the nation and came amid a wave of new challenges for HIV research and treatment. Since the beginning of the second Trump-Vance administration, federal spending cuts have targeted HIV/AIDS programs, including the gutting of the U.S. Agency for International Development and proposed cuts to PEPFAR, which supports HIV testing and treatment globally, in 2025. 

Last year, Congress maintained funding for HIV programs after proposed cuts faced opposition from advocacy groups and bipartisan criticism. Yet, this year Congress has proposed similar cuts to many of the same programs, which would cut nearly one billion dollars in HIV funding. The majority of the cuts would impact HIV prevention and outreach, which includes ending nearly all Centers for Disease Control and Prevention HIV prevention activities. 

“If we continue down this path,” said Jeremiah Johnson, the executive director of PrEP4ALL, an advocacy group that supports expanding access to HIV prevention. “We’re going to see more people falling off treatment. We’re going to see more wait lists. That’s going to lead to more people dying from AIDS-related complications.”

Cuts and challenges

The funding cuts loomed over the conference and inspired protest from activists. 

On the first day of USCHA, activists with Save HIV Funding organized a mock funeral outside the convention center. Advocates living with HIV wrote eulogies for themselves, meant to show the consequences of diminished access to treatment. Then activists marched through the conference carrying fake coffins. 

Johnson, who helped organize the protest, said that “the Trump administration has eviscerated global aid … and the fears that many of us are just talking about hypothetically for ourselves at the moment are already happening [internationally]. And so we wanted to place that front and center at this conference.”

The attacks on funding for HIV research and outreach come at a complicated time for the movement to end the AIDS epidemic. While options for prevention and treatment have never been more accessible, such as PrEP and antiretroviral therapy, there have been some concerning upticks in infections, particularly among communities of color.

Southern states account for the majority of new HIV infections in the country, despite making up only 38 percent of the population. And these infections impact disproportionately Black and Latino communities. According to the CDC, even as overall HIV infections decreased from 2018 to 2022, diagnoses of HIV among Latinos grew by 17 percent, with a majority of this increase happening in the South. 

Stigma is still the biggest barrier for people seeking out HIV treatment, said Guillermo Chacón, president of the Latino Commission on AIDS. 

“The progress that we [made] in the past two years has been demolished,” he said. 

Chacón blames the federal government for stigmatizing HIV treatment by using harmful rhetoric about queer people. 

“The level of homophobia and transphobia right now is even higher because it has been used as a political message to create fear and division in our country,” he said. 

Chacón believes that research and outreach must be done to reverse the rising HIV infections among Latinos. However, this is exactly the type of research that the Trump-Vance administration is targeting most intensely. Research into “health disparities” — why some health problems impact certain communities more than others — has been heavily criticized by the White House, along with other research that it considers “woke” and claims is not supported by science. 

Impact felt at conference

The opening plenary for the conference addressed some of the funding challenges the movement was facing but tried to shift the focus to the victories the movement has seen over the years. Speakers highlighted historic successful activist campaigns like ACT UP, and recent improvements in medical care and access to treatment. 

Randevyn Pierre, head of U.S. external affairs at ViiV Healthcare, the sponsor of the plenary, took the stage to celebrate the success of the U = U campaign (undetectable viral load =
untransmittable HIV virus), and ViiV’s investment of $33 million in HIV community organizations across the U.S. This comes as the Trump-Vance administration has made moves to end direct funding of community-based organizations, opting to give the funding to state healthcare agencies. 

The speakers at the conference discussed reducing stigma for those living with HIV and the joy of living authentically. They also emphasized the diverse groups of people that are impacted by HIV and how they can come together to fight for a cure. Longtime AIDS activist Rae Lewis Thorton exclaimed, “When they tell me there’s a cure to HIV, I’m gonna take off my 4-inch heels and put on gold slippers,” to applause from the audience. 

The opening plenary also featured song and dance from a variety of artists, many of whom spoke about how HIV has impacted their own lives and how advocacy has uplifted their spirits. However, the joyous atmosphere at the conference would not last. 

On the final day of USCHA, Geri Donenberg, the associate director of AIDS research at the National Institutes of Health, took the stage to address the conference. 

As she spoke, phones began to buzz around the room with breaking news: the Trump-Vance administration was drafting an executive order to create an external board to oversee NIH grants and screen them for political content. NMAC CEO Harold Philips took the stage after Donenberg to address the crowd. “It’s up to us,” Philips said, “to hold NIH accountable.” He added that HIV advocates “have supporters inside NIH who are struggling and working to do the right thing. We have to have their back.” 

Chants of “stand up, fight back, fight AIDS” erupted from the crowd as Philips spoke. “We do have to fight back. We do have to continue to fight,” Philips replied. 

Caleb Kaufman is a California Local News Fellow placed with the Los Angeles Blade. The California Local News Fellowship is a state-funded initiative to support and strengthen local news reporting. Learn more about it at fellowships.journalism.berkeley.edu/cafellows.

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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.

  • A 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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