How do you reinvent yourself?

Madonna has done it numerous times over the years. Her Re-Invention World Tour in 2004 was the highest grossing U.S. tour that year. IBM, Apple, and National Geographic have all reinvented themselves by adapting to the changing times, and embracing new technology. Stagnation and resistance to change can spell trouble for businesses and brands that get too comfortable with their own success, if they don’t take the time to reassess and reevaluate what got them there in the first place.

It can also often stand in the way of our own personal development and growth.

This issue of Positively Aware, “Rethinking HIV,” is about how HIV research and treatment is evolving, and how radical shifts in our perspective are necessary for us to continue to make progress. Researchers and physicians are building upon the successes of the past while tackling new approaches in how we treat HIV, recognizing the possibilities and challenges that lie ahead not only for treatment, but even perhaps a lifelong remission of HIV without antiretroviral therapy.

It’s these kinds of profound new ways of conducting research and business that are shaking up the field of HIV. It was only a few years ago when we were still seeing companies bringing to market “me-too” drugs. Today companies and researchers have become much more focused on only developing drugs that will provide a distinct advantage to patients, or that bring some added benefit on top of what’s currently available, because the old model and way of thinking are no longer feasible.

In her article “Rethinking HIV Treatment,” Melanie Thompson talks about some of the transformations in treatment that we can expect to see in the next 10–15 years. Dr. Thompson looks at not only the kinds of drugs that we’ll see, but also how they are administered and delivered. Long-acting injectables have garnered quite a bit of interest in the last few years, and are gaining momentum as research moves forward. But we’ll have to make sure we have working systems in place, to ensure these new technologies actually get to those who need them.

As someone who takes a lot of pills in addition to my HIV meds (such as vitamins, blood pressure medication, etc.), I’ve often said that an injectable wouldn’t make much difference to someone like me. But as I’ve given it more thought, I’m not so sure. Just as going from twice a day to once a day made a big difference to me in my quality of life, once a week or once a month might actually be quite nice! Of course the shots will have to be given in a provider setting, as they can’t be self-administered. New delivery systems will need to created to help keep down costs (such as office co-pays) and support adherence, which will become even more critical if and when therapy is dosed at less than once daily.

More baby steps are also being taken in the effort to eradicate HIV once and for all, or at least put it into remission. Treatment Action Group’s Richard Jefferys gives a fantastic overview of the current data, some of the obstacles ahead, and the exciting work that’s ongoing in the field.

Also in this issue, leading PrEP advocate and educator Damon Jacobs challenges us to take another look at the reasons behind why people may choose not to use condoms. Our report back from the 19th Conference on Retroviruses and Opportunistic Infections (CROI) looks at different ways of using PrEP that may be more in line with “real-world” use; an investigational drug in a new class that will be useful for those with multi-drug resistance; and a newer version of an older drug that could have the potential to alter the landscape of HIV treatment.

So what does all this mean for you and me? The good news is, there are those out there who are developing innovative and improved treatment options that will help us live longer, healthier lives. But it’s up to us as individuals to continue to work on ourselves, perhaps reinvent our own lives, or change our perspectives and shift our priorities. For me that’s meant another change in my regimen due to side effects, but I’m undetectable as of yesterday! I’ve also gone back into therapy, and rediscovered yoga (which has been amazing). If we don’t take care of ourselves, no treatment is going to save us. Sometimes we are our own worst enemy.

Whether you’re newly diagnosed or a long-term survivor, positive or negative, a healthcare provider or caseworker, we all definitely have one thing in common. We always have a choice. And when it comes to life with or without HIV, we can choose to stay in our comfort zone, or maybe try to think outside the box. Challenge yourself to look forward, instead of holding back.

Take care of yourself, and each other.