Health
FDA approves HIV ‘prevention’ pill
AIDS activists divided over benefit versus risk of Truvada
Gilead Sciences Truvada pill. (Image courtesy of Gilead)
The U.S. Food and Drug Administration on Monday announced it has approved use of the AIDS drug Truvada for reducing the risk of HIV infection among uninfected people considered at high risk for contracting HIV through sexual contact.
The decision to allow Truvada to be taken daily in the form of a pill as part of a prevention regimen known as pre-exposure prophylaxis, or “PrEP,” has drawn mixed reactions among AIDS advocacy organizations, with most supporting the decision.
But others have raised strong objections, saying potentially harmful side effects of Truvada along with the risk of HIV infection through non-adherence to a rigid daily drug regimen, which in turn could lead to drug-resistant strains of HIV, far outweigh the benefits.
“Today’s approval marks an important milestone in our fight against HIV,” said FDA Commissioner Dr. Margaret Hamburg. “Every year, about 50,000 U.S. adults and adolescents are diagnosed with HIV infection, despite the availability of prevention methods and strategies to educate, test, and care for people living with the disease,” she said.
“New treatments as well as prevention methods are needed to fight the HIV epidemic in this country,” Hamburg said.
Truvada, which is manufactured by the pharmaceutical firm Gilead Sciences, was first approved in 2004 by the FDA for use as a treatment for HIV.
In announcing its approval for use as a prevention drug, the FDA pointed to two large placebo-controlled trials of the drug as a prophylaxis that were sponsored by the U.S. National Institutes of Health and the University of Washington.
One of the trials conducted in the U.S. and abroad evaluated the drug in 2,400 HIV-negative men or transgender women who have sex with men and who are prone to “high risk behavior,” such as inconsistent or no condom use during sex, according to a statement released by the FDA.
“Results showed Truvada was effective in reducing the risk of HIV infection by 42 percent compared with [a] placebo in this population,” the FDA statement says.
It says the second trial included 4,759 heterosexual couples where one partner was HIV-infected and the other was HIV negative. Truvada reduced the risk of becoming infected by 75 percent compared to participants taking a placebo, the FDA statement says.
Among those supporting the FDA decision to approve Truvada as a prevention drug is Project Inform, the San Francisco based HIV patient advocacy group that has closely observed prevention and treatment options for people with HIV and AIDS for more than 20 years.
“Project Inform is extremely pleased with a landmark decision by the FDA to approve the first biomedical HIV prevention product in the history of the epidemic,” the group said in a statement.
“Finally, after 30 years, HIV-negative individuals have a new way to protect themselves from becoming infected,” said Project Inform Director Dana Van Gorder. “While PrEP isn’t a tool that will be appropriate for broad use, we are thrilled to have a new option that could offer substantial benefit to those at highest risk for HIV, including gay and bisexual men and transgender women who struggle with consistent condom use, and in heterosexual women living in areas with high HIV rates whose partners refuse to use condoms,” Van Gorder said.
The AIDS Institute, a national AIDS advocacy group with offices in Washington, D.C. and Florida, and the Boston-based Fenway Health and its research arm Fenway Institute also issued statements supporting the FDA action.
Taking the opposite view is the Los Angeles based AIDS Healthcare Foundation, which provides HIV/AIDS treatment programs in the U.S. and in countries throughout the world, including Africa and Asia.
“My initial reaction is that this is a catastrophe for AIDS prevention in the U.S.,” said Michael Weinstein, AHF’s executive director.
Weinstein said global trial studies cited by the FDA involved constant monitoring and encouragement by organizers to ensure that participants adhered to their daily drug regimen as well as engaged in safer sex practices, such as condom use.
“The bottom line is that was under ideal conditions,” he said. “People were tested monthly. They were intensively counseled. They were paid to be in the study. And only about 50 percent took the drug.”
He predicted far fewer people “in the real world” would be compliant in taking their daily drug regimen, especially since the drug, as reported by Gilead Sciences, induces occasional side effects in healthy people such as headache, stomach discomfort and weight loss.
Weinstein said that in addition to opening the way for users to lower their guard and stop using condoms, even though the FDA approval calls for continued use of safer sex practices along with Truvada, the drug is highly dangerous for people who become HIV positive without knowing it.
In its published drug warnings, Gilead says use of Truvada alone is harmful to people with HIV unless they use it in combination with other antiretroviral drugs. Weinstein said he fears that people using Truvada as a prevention pill and become HIV positive after failing to take the drug every day could be at high risk – both for becoming ill and developing a drug resistant strain of HIV.
Dr. Debra Brinkrant, an FDA official who has monitored the Truvada studies, said an analysis of the trial studies showed that those who used Truvada used condoms more frequently and did not discontinue condom use.
“Everyone has to work together to make sure this works,” she said. “We must see that adherence is maintained. This is a first step to cut the infection rate,” a rate she said has not decreased in spite of years of other HIV prevention and education programs.
Justin Goforth, director of medical adherence and head of the Sexually Transmitted Disease Clinic at D.C.’s Whitman-Walker Health, said Whitman-Walker has already been prescribing Truvada as a prevention pill as part of a small study program. He said Whitman-Walker will likely expand the number of people it approves for use of the drug as a prevention medication now that the FDA has issued its approval.
“A lot of gay men are coming in and begging us to get this,” he said. “This is clearly not for everyone. The issue is finding the right people. They have to be people at high risk,” he said, adding that men who have sex with men who themselves or their partners have trouble being complaint with condom use, or those with multiple sex partners, would be among those considered for Truvada as a prevention pill.
Goforth acknowledged that the NIH sponsored trials of Truvada for men who have sex with men and transgender women had an adherence rate of about 50 percent. The fact that they were paid to be in the trials could have been responsible for the low adherence rate, with many choosing to join the program for the purpose of taking the money rather than the pills, Goforth said.
But he said Whitman-Walker has found through its limited Truvada trial program for HIV negative people that those seeking out the drug have followed the daily pill regimen.
“I feel people who come forward now to take this have a greater incentive for compliance,” he said.
And Goforth pointed to studies showing that Truvada’s effectiveness in preventing HIV infection is greater than 90 percent among those who take the pill every day.
Health
United States Conference on HIV/AIDS grapples with federal budget cuts
Annual gathering is largest of its kind in the country
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.
Health
AIDS Healthcare Foundation announces 3 million people globally in its care
Los Angeles-based group lauded ‘historic milestone’
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].
Cannabis Culture
LGBTQ people, weed, and mental health: what you need to know
Community uses marijuana at much higher rates than general population
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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