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Q&A with Dr. Anthony Fauci

Researcher talks about state of AIDS on eve of conference

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Anthony Fauci, NIH, HIV/AIDS, gay news, Washington Blade

Dr. Anthony Fauci of the NIH has been involved in the fight against AIDS since the onset of the epidemic. (Photo courtesy NIH)

Dr. Anthony Fauci has been one of the key leaders of the U.S. government’s fight against AIDS for nearly 30 years. Since 1984, Fauci has served as director of the National Institute of Allergy and Infectious Diseases, which is an arm of the National Institutes of Health.

Although his work covers research into other infectious diseases, Fauci serves as one of the lead advisers to the White House and the Department of Health and Human Services on domestic and global AIDS issues, according to biographical information released by the NIH.

He has been credited with developing effective strategies for the treatment of people with HIV/AIDS as well as for the continuing effort to develop an AIDS vaccine.

Fauci spoke to the Blade this week about his hopes and expectations for the 19th International AIDS Conference scheduled for July 22-27 in Washington. About 30,000 people, including scientists, AIDS researchers, government officials, and AIDS activists from the U.S. and abroad are expected to attend the conference.

 

Washington Blade: Can you say something about what important scientific advances and research findings will emerge from International AIDS Conference in Washington next week?

Dr. Fauci: As in most international meetings of this size it is unusual for there to be a scientific breakthrough of pure scientific nature that hasn’t already been seen, discussed, and vetted out in the press. It is very unusual that a major league breakthrough would all of a sudden be totally timed for discussion at the meeting. So that’s not a negative comment or a positive comment. It just is what it is. Meetings like this have themes and they kind of crystallize and galvanize people around a particular theme.

The Vancouver [International AIDS Conference] in 1996 – the theme of that was the first time that we began discussing in earnest the issue of having a combination of drugs that would get the virus below a detectable level and what impact would that have on the longevity and the lifestyle and functionality of people. That was the big theme of that meeting.

The 2000 [International AIDS Conference] in Durban was can we start getting drugs that we know work in the developed world to the developing world when there were demonstrations in Durban, South Africa.

So rather than there being meetings where there are three or four scientific breakthroughs there really is a sort of consolidation or galvanization around a theme. So the theme of this meeting, as you know, is Turning the Tide Together. They’ve asked me to lead off the opening plenary session on Monday, July 23, with a particular approach to the meeting. In other words, to kind of set the scientific tone of the meeting. And that’s exactly what it is because the title of my talk is “Ending the AIDS Epidemic From Scientific Advances to Public Health Implementation.”

And what you’re going to hear throughout the meeting is various iterations in different regions, in different populations, different demographic groups about the challenges – the biological, behavioral and other challenges – of getting that done. So I’m going to talk about how we went from fundamental scientific discoveries to interventions that you could actually use to help people – mostly treatments and prevention – to how we began to implement them, first in the developed world and then in the developing world.

And now what the science-based possibilities are for actually ultimately ending the AIDS pandemic. Then you are going to hear in rapid succession after that either major talks or just minor presentations of details of that. Like Phill Wilson is going to talk about the perspective from the African-American community. Others will talk about it from different countries – Southern African countries, the Caribbean, Europe, Asia, etc. So that’s going to be the prevailing theme. And then obviously there are going to be other approaches about individual specific, more granular scientific issues like the challenges of an HIV vaccine. We don’t have a vaccine. Where have we come from? Where are we now and where do we hope to go? There are going to be a lot of discussions and panels on that.

There’s a satellite session before the meeting starts on toward an HIV cure. You know, what do we mean by a cure? How does a cure relate to the rest of the things that are going on? What are the scientific challenges of a cure?

So we have a bunch of things that are at the stage of having been developed and they just need to be implemented. So you’re going to hear a lot about implementing programs. And then there are a couple of still existing major scientific challenges, one of which is a vaccine and the other of which is a cure.

 

Blade: Can you say where we stand on both of those things?

Fauci: Well, with a vaccine we are probably closer than we are to a cure. A cure is still in the very, very formative stages of discovery because we’re not even sure if it’s possible and, if so, how we might go about doing that because of the very special characteristics of this virus. With regard to a vaccine, I still can’t predict when we’ll have one so it’s futile to even put a number on it. But we’ve already had one modestly successful vaccine trial a few years ago in Thailand in what was called RV 144. It’s a trial that showed there was about a 31 percent efficacy in the vaccinated people protecting them. Now that’s not good enough for prime time but since that time — and you’ll be hearing a lot about it at the meeting — there have been a number of projects that have tried to probe into what are the potential correlates of immunity. In other words, what did that vaccine induce in the people who were protected that you might build upon for the next generation of vaccines?

And there will be discussion about identification of certain types of anti-bodies in infected individuals which are called broadly neutralizing anti-bodies that might point us in the right direction of what we would be asking a vaccine to do. So those are some of the things that are going to be discussed vis-a-vis a vaccine.

The cure thing is going to be very basic, like understanding the nature of the HIV reservoir. Are there ways that we can eradicate that reservoir? If we can’t eradicate it are there ways we can either boost up the immune system or modify the host so that their cells are not susceptible to being infected?

 

Blade: Isn’t that what some of the current treatments do but not to a complete extent?

Fauci: Well they don’t cure it. The current treatments are absolutely sensational in their ability to essentially block the virus’s ability to replicate without eradicating it, but to the point where when people are staying on their medications there’s virtually an undetectable level of virus in the blood of those people.

 

Blade: Has that been progressing in the last several years?

Fauci: Oh yes, absolutely. The results of treatment and its effect – right now you can essentially mathematically predict a normal life span in individuals who get treated early enough in their infections so that their immune system isn’t completely damaged and they stay on therapy and continue to decrease the viral load. When I was seeing patients every day in the very early 80s — 1981, ’82, ’83 — the median survival of the patients was about six to eight months. Now if someone who’s 25 years old comes into the clinic with relatively recently acquired HIV infection, within the last six months or so, and you put them on appropriate therapy you can predict to that individual that they would likely live an additional 50 plus years.

That’s a spectacular advance in the translation of basic research into a scientific and clinical result.

 

Blade: Could you say a little about the announcement yesterday that the Food and Drug Administration has approved the use of the AIDS drug Truvada as a prevention drug for people who are HIV negative?

Fauci: I think you need to put the Truvada thing into the proper context. And the proper context is that Truvada has been proven by scientifically based evidence that it works in preventing infection in uninfected individuals if properly used. The one thing you need to make sure you emphasize — it is part now, since it’s been approved by the FDA, of a comprehensive combination package of prevention modalities. It is not to be used as a substitute for standard prevention like avoiding multiple sexual partners, avoiding risky behavior, the proper and consistent use of condoms. This is an additive approach. It’s a very important one because it’s the first time that the FDA has actually approved an anti-HIV drug for prevention rather than just for treatment.

 

Blade: Has the NIH looked into the use of Truvada as a treatment and how well it works?

Fauci: Oh, it’s been used as one of the best parts – you see, it isn’t the full combination but Truvada is probably the most frequently used component as part of a combination with another drug for the treatment of people who are already infected. So there is a wealth of experience with Truvada.

 

Blade: Are the side effects generally acceptable?

Fauci: They are generally mild, quite mild. If you look at the spectrum of approximately 30 drugs that are used for the treatment of infected individuals Truvada is way down on the list of minimal side effects. They’re not absent. No drug in the world has no side effects. But they’re generally rather mild – nausea, some abdominal discomfort, some diarrhea, perhaps some weight loss, an occasional headache. And only very rarely do you get toxicity like kidney toxicity. But in general if you rank it they’re relatively non-toxic drugs.

 

Blade: While most AIDS advocacy organizations appear to support the FDA decision on Truvada, some have raised strong objections. They say it could give the wrong impression that —

Fauci: Well that’s the reason why they say it’s not for everyone. It’s for people in high-risk categories who don’t seem to be responding to the other available prevention modalities. It’s not saying, OK, everybody out there that’s been trying to avoid infection — no sweat, go onto this drug and you can do whatever you want. That’s absolutely not what this means.

 

Blade: You’ve been involved in the fight against AIDS from the beginning. What is your sense of how our country has adjusted to AIDS over the past 30 years?

Fauci: I think that certainly the stigma that has been associated with this is much, much less than it was back in the early years. There’s no doubt about that. But in certain demographic groups it still lingers, particularly and unfortunately in the African-American population, where being gay and certainly being gay and infected carries much more stigma than you see in the white population. There’s no doubt about that and that’s probably one of the reasons why it’s difficult to get African-American people, men and women, into testing and counseling programs because of the fear of stigma or a variety of other societal factors – socio-economic conditions, etc.

So on the whole we’re doing much, much better but there are still certain subgroups of people that suffer disproportionately. Twelve to 13 percent of the population is African American. More than 50 percent of the new infections occur among African-American men and women, mostly of men who have sex with men.

 

Blade: What is your sense, then, in comparing all the risk groups that we know now, where does the category of men who have sex with men fit in today?

Fauci: That’s still the major demographic group in this country. Internationally it’s very heavily weighted toward heterosexual. In the United States, men who have sex with men is still the largest category of people who get infected.

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Housewives head to Capitol Hill to promote PrEP coverage

Bravo’s Real Housewives stars to lobby lawmakers for expanded PrEP access.

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(Washington Blade photo by Michael Key)

Stars from Bravo’s hit franchise “The Real Housewives” are heading to Capitol Hill next week to advocate for expanded access to HIV prevention and treatment.

On March 18, several well-known cast members — including NeNe Leakes, Phaedra Parks, Candiace Dillard Bassett, Erika Jayne, Luann de Lesseps, Melissa Gorga, and Marysol Patton — will travel to D.C. to participate in an advocacy event aimed at increasing awareness and coverage for pre-exposure prophylaxis, commonly known as PrEP.

The event, dubbed “Housewives on the Hill,” is being organized by MISTR, the nation’s largest telehealth platform focused on sexual health. The group’s founder and CEO, Tristan Schukraft, will join the reality television stars as they meet with lawmakers and legislative staff to discuss the importance of maintaining and expanding access to HIV prevention tools.

PrEP is a medication regimen that can, if taken properly, reduce the risk of contracting HIV through sex by up to 99 percent according to public health officials. Advocates say wider access to the medication — including through insurance coverage and telehealth services — is critical to reducing new HIV infections across the United States.

During their day on Capitol Hill, the Housewives are expected to meet with members of Congress and participate in conversations about federal policies affecting HIV prevention and treatment. Organizers say the reality stars will also share personal reflections about the continued impact of HIV on communities across the country and the importance of keeping prevention resources accessible.

The “Housewives on the Hill” event aims to use the cultural influence of the Bravo stars to spotlight HIV prevention efforts and encourage lawmakers to protect and expand access to lifesaving medication and treatment options. Organizers say the goal is simple: ensure that more Americans can access the tools they need to prevent HIV and maintain their sexual health.

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Too afraid to leave home: ICE’s toll on Latino HIV care

Heightened immigration enforcement in Minneapolis is disrupting treatment

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(Photo by Liam James Doyle for Uncloseted Media and Rewire News Group.)

Uncloseted Media published this article on March 3.

This story was produced in collaboration with Rewire News Group, a nonprofit publication reporting on reproductive and sexual health, rights and justice.

This story was produced with the support of MISTR, a telehealth platform offering free online access to PrEP, DoxyPEP, STI testing, Hepatitis C testing and treatment and long-term HIV care across the U.S. MISTR did not have any editorial input into the content of this story.

By SAM DONNDELINGER and CAMERON OAKES | For two weeks, Albé Sanchez didn’t leave their house in South Minneapolis.

“[I was] forced into survival mode,” Sanchez told Uncloseted Media and Rewire News Group (RNG). “I felt like there was an invisible wall [to the outside world] that I couldn’t cross unless I really wanted to put myself in a place where there was a chance that I might not be able to come back.”

Queer and Mexican American, Sanchez was afraid of being targeted by the Immigration and Customs Enforcement presence in their neighborhood, even though they are a U.S. citizen.

“Every day is a risk,” they say, adding that even if they have paperwork, if they fit the profile, they are a target, making it scary to go even to work or the grocery store.

Sanchez, a 30-year-old sexual health care educator, has been taking oral PrEP, the daily preventive medication for HIV, for over a decade. But the mounting stress of ICE raids has made it harder to keep up with dosing.

“A missed dose here and there pushed me to make the appointment [for something more sustainable],” they say.

Sanchez says they felt like somebody would have their back at their local clinic. It was only a 10-minute drive from where they worked, they knew its staff from previous visits and community outreach, and they could count on finding Spanish-speaking staff and providers of Latino heritage. But not everybody has had that same experience accessing care.

Since ICE’s Operation Metro Surge began in early December, an increasing number of Latino patients in Minnesota are delaying or canceling what can be lifesaving care for the prevention and treatment of HIV.

These findings are particularly alarming for Latino communities, who, as of 2023, are 72 percent more likely than the general U.S. population to be diagnosed with HIV. And while overall infections have decreased, cases among Latinos increased by 24 percent between 2010 and 2022.

“I’m very concerned that there is going to be a sharp uptick in transmission,” says Alex Palacios, a community health specialist in the Minneapolis area.

In a January 2026 declaration as part of a lawsuit seeking to end Operation Metro Surge in the days following Renee Nicole Good’s killing, the commissioner of the Minnesota Department of Health said HIV testing among Latino populations has “dropped dramatically” and that “although grantee staff continue to go into the community to promote and provide testing, people are not showing up.”

Local clinics are reporting the same thing. The Aliveness Project, a community wellness center in Minneapolis specializing in HIV care, told Uncloseted Media and RNG they have seen more than a 50 percent decrease in new clients. The clinic serves a large number of Latino and undocumented clients, and while it usually sees 750 people walk through their door each week, according to providers, it reported seeing 100 fewer people each week since December.

Red Door, Minnesota’s largest STI and HIV clinic, has had a “modest uptick” in no-shows and missed appointments since December.

What happens when treatment stops

Today, there are multiple medications available that work to prevent HIV and dozens that treat it once a person tests positive. Many people who consistently take their medication have such low levels of the virus that they can’t transmit it through sex. But becoming undetectable requires patients to stay on their medication; otherwise, the virus replicates and mutates, weakening the immune system and increasing the risk of life-threatening infections.

“If patients aren’t on their medicines consistently, HIV can learn about the medication and become resistant to them. When this happens, the medicine will not work for the patient, and the new resistant virus could potentially be passed on to others,” says George Froehle, a physician assistant and provider at Aliveness Project. “Medication adherence is one of the most important aspects of HIV care.”

To maintain care and prevent dangerous, untreatable strains from spreading in Minnesota, providers at Aliveness Project have begun delivering medication to patients when possible, offering telehealth when they can, and pausing routine lab work to limit in-person appointments.

“The most important thing we can do from a public health perspective is to keep people undetectable so they don’t transmit HIV,” Froehle says, adding that providers in other cities targeted by ICE will need to make plans for missed injection visits, pivot to telehealth and prepare their teams for the “trauma that can occur.”

Sanchez understands the risks of inconsistent treatment, which is why they opted for the injectable preventative medication.

“I have a lot of risk [to HIV in my community],” Sanchez says. “With so much uncertainty about the future and whether HIV care will remain stable, I realized I couldn’t let this opportunity pass.”

But injectable HIV treatments are commonly dosed at two weeks to six months apart, and the medication must be administered in a clinic — a setting many patients are avoiding, according to providers.

“They have a two-week window” to get their shots, according to Froehle, who added that because patients are afraid to come in person, they have had to transition people off of their injectable HIV treatments. This has caused patients to return to oral HIV treatments without the testing they would normally receive had ICE not been in Minneapolis. “[Oral treatments] weren’t super successful [for these patients] to begin with and that’s why they were on injectables.”

Oral HIV medications, too, must be taken consistently to work. In response, providers have urged patients to have their pills with them at all times in case they get deported or detained.

The caution is not unfounded. Federal immigration facilities have a history of denying adequate medical care to people living with HIV, despite internal standards that require them to comply. Since 2025, at least two men living with HIV have been denied access to their medication in a Brooklyn jail, according to lawsuits obtained by THE CITY. One man said he was only given his medication after his lips broke open and he developed an open pustule on his leg. And in January 2025, another man died of HIV complications while in ICE custody in Arizona.

Beyond being detained without proper medication, patients are at risk of being deported to countries with limited access to HIV care, like Honduras and Venezuela, experts say.

“A lot of men [from Venezuela] told me they left because it wasn’t safe to be gay there and because they struggled to access HIV care,” says Froehle. “It’s a little heartbreaking to see new folks not only face the threat of deportation, but to places where they didn’t feel safe medically or identity-wise.”

“Some of these patients will die in their home country,” says Anna Person, the chair of the HIV Medicine Association. “It’s a death sentence.”

A ‘cascading disaster’

While ICE’s presence is threatening the infrastructure of HIV care that Minneapolis has built over decades, experts say there has always been a blind spot in HIV care for the city’s Latino community.

Vincent Guilamo-Ramos, executive director of the Institute for Policy Solutions at the Johns Hopkins University of Nursing, describes HIV in Latino communities as a “cascading disaster,” the result of years of compounding inequities.

“There’s been an invisible crisis among Latinos that hasn’t gotten traction,” he says. “The numbers have consistently gone up in terms of new infections, while nationally they’ve gone down. … That should be a big alarm.”

Numbers are rising because structural barriers and stigma are preventing Latinos from receiving care. A 2022 report from the Centers for Disease Control and Prevention found that between 2018 and 2020, nearly 1 in 4 Hispanic people living with HIV reported experiencing discrimination in health care settings. Lack of representation among providers, language barriers and deep-rooted medical mistrust further complicate access to care, according to Guilamo-Ramos.

Beyond the medical system, stigma within Latino communities can be equally damaging. According to Human Rights Campaign data, more than 78 percent of Latino LGBTQ youth reported experiencing homophobia or transphobia within the Latino community in 2024.

Sanchez agrees that stigma and bias are already massive barriers to care, citing the strict gender norms and Catholic beliefs many Latino communities hold. They say ICE’s presence is threatening already delicate access to HIV care.

“This has caused so much damage to people,” Sanchez says. “Not being able to access your health care appointments is such a stab in the side. … Being able to navigate any of these things in normal circumstances already has so much difficulty to it.”

Palacios, who is Afro-Latine and living with HIV, says the heightened ICE presence is worsening barriers that have long undermined the Latino community’s access to HIV care.

“The horizon has always been stark and dim,” they say. “And this just feels like one more thing to address and to fight back against.”

Sliding backwards

Navigating HIV care is becoming more difficult across the board, as the federal government has decimated HIV funding, compromising decades of progress made in the fight against the virus since Donald Trump retook office just over a year ago.

In February 2026, three months into Operation Metro Surge, the Trump-Vance administration proposed slashing $600 million in HIV-related grants, targeting four blue states, including $42 million for Minnesota programs. A federal judge has temporarily blocked the cuts.

“This would completely decimate and gut all of our HIV prevention,” says Dylan Boyer, director of development at Aliveness Project. “That’s the reality that we live in.”

“We have all the tools, and yet we are staring down this rollback of infrastructure and research dollars, prevention efforts, treatment efforts, that are going to put us squarely back in the 1980s,” says Person, a national HIV expert who grew up in Minnesota. “[There] seems to be no other rationale for that besides cruelty, to be quite frank, since there’s no scientific reason for it.”

Repair and representation

Jenny Harding, director of advancement at a Minneapolis-area supportive housing program for people living with HIV, says that while ICE’s presence is lessening in the Twin Cities, the “damage is done.”

Person says that this mending will take time, especially between the medical community and patients, since HIV providers can have a “very fragile” relationship with their clients.

“It takes, sometimes, years to build that level of trust. And I do worry that folks are just going to say, ‘I don’t feel safe here anymore. The system does not have my best interest at heart, and I’m not coming back,’” she says. “This is not something that you can flip a switch and everything will go back to normal.”

“We need to hold our federal government accountable, particularly HHS, [and] we need to ensure that HIV funding remains intact,” Guilamo-Ramos says, adding that in order to lower rates of HIV in the Latino community, there should be more specialized efforts: such as bilingual and culturally aligned health care providers, community-based outreach programs co-located where risk is highest, trust-building initiatives to address medical mistrust, mobile clinics, and targeted programs to re-engage patients who have fallen out of care.

Aliveness Project’s patient numbers have increased in the last few weeks as the ICE operation has waned, but the clinic staff is keeping “a watchful eye” and is having “difficulty reaching folks who are understandably scared.”

“Our biggest focus right now is reconnecting with people through our outreach so no one has a lapse in their HIV medications or prevention care,” Boyer, of Aliveness Project, says.

For Sanchez, seeing providers who speak Spanish and are of Latin heritage at Aliveness Project built enough trust for them to reach out and make an appointment despite the risks. Sanchez feels optimistic about their new injectable prevention strategy with the support of their clinic.

“There’s many places where you can receive care here in the Twin Cities where you might not see your skin tone. … There’s still a lot of health care professionals that unfortunately carry bias. … Aliveness is the opposite of that,” they say. “Seeing that representation and knowing someone has that cultural context of how to meet you in moments of sensitivity, it’s crucial.”

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Trans activists arrested outside HHS headquarters in D.C.

Protesters demonstrated directive against gender-affirming care

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(Photo by Alexa B. Wilkinson)

Authorities on Tuesday arrested 24 activists outside the U.S. Department of Health and Human Services headquarters in D.C.

The Gender Liberation Movement, a national organization that uses direct action, media engagement, and policy advocacy to defend bodily autonomy and self-determination, organized the protest in which more than 50 activists participated. Organizers said the action was a response to changes in federal policy mandated by Executive Order 14187, titled “Protecting Children from Chemical and Surgical Mutilation.”

The order directs federal agencies and programs to work toward “significantly limiting youth access to gender-affirming care nationwide,” according to KFF, a nonpartisan, nonprofit organization that provides independent, fact-based information on national health issues. The executive order also includes claims about gender-affirming care and transgender youth that critics have described as misinformation.

Members of ACT UP NY and ACT UP Pittsburgh also participated in the demonstration, which took place on the final day of the public comment period for proposed federal rules that would restrict access to gender-affirming care.

Demonstrators blocked the building’s main entrance, holding a banner reading “HANDS OFF OUR ‘MONES,” while chanting, “HHS—RFK—TRANS YOUTH ARE NO DEBATE” and “NO HATE—NO FEAR—TRANS YOUTH ARE WELCOME HERE.”

“We want trans youth and their loving families to know that we see them, we cherish them, and we won’t let these attacks go on without a fight,” said GLM co-founder Raquel Willis. “We also want all Americans to understand that Trump, RFK, and their HHS won’t stop at trying to block care for trans youth — they’re coming for trans adults, for those who need treatment from insulin to SSRIs, and all those already failed by a broken health insurance system.”

“It is shameful and intentional that this administration is pitting communities against one another by weaponizing Medicaid funding to strip care from trans youth. This has nothing to do with protecting health and everything to do with political distraction,” added GLM co-founder Eliel Cruz. “They are targeting young people to deflect from their failure to deliver for working families across the country. Instead of restricting care, we should be expanding it. Healthcare is a human right, and it must be accessible to every person — without cost or exception.”

(Photo by Cole Witter)

Despite HHS’s efforts to restrict gender-affirming care for trans youth, major medical associations — including the American Medical Association, the American Academy of Pediatrics, and the Endocrine Society — continue to regard such care as evidence-based treatment. Gender-affirming care can include psychotherapy, social support, and, when clinically appropriate, puberty blockers and hormone therapy.

The protest comes amid broader shifts in access to care nationwide. 

NYU Langone Health recently announced it will stop providing transition-related medical care to minors and will no longer accept new patients into its Transgender Youth Health Program following President Donald Trump’s January 2025 executive order targeting trans healthcare. 

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