In difficult times, I look for hope. And when there’s hope, there is reason for celebration. I find hope in how far we’ve come in HIV prevention and treatment. But I’m also pragmatic.
Information is the key to hope. I like to think that the annual POSITIVELY AWARE HIV Drug Guide is a “book of hope.” In addition to the HIV drug pages (21–61) that provide details on dosing, side effects and drug interactions, what makes these pages unique are the insightful, candid comments about each drug from an HIV specialist, Dr. Melanie Thompson, and a patient advocate, Joey Wynn. Special appreciation to Eric K. Farmer, PharmD, for updating the drug pages and to my colleague, associate editor Enid Vázquez, for her work on them. And a shout out to art director Greg Mytych for making the HIV drug guide user friendly and appealing.
Also inside, contributing writer Larry Buhl’s Guide to long-acting injectables for HIV looks at the different LAIs, outlining who the drug has been approved for—and who it’s not for. “Help is out there” lists all the nonprofit organizations and pharma assistance programs that help people pay for their HIV meds. When it comes to the power dynamics of the doctor-patient relationship, Bridgette Picou asks, “Are clinicians listening?” (click here). Bridgette follows up in her column (READ BEING BRIDGETTE), suggesting that care providers must build trust if patients are to have faith (or hope) in their treatment.
What better city to photograph the HIV drug guide’s cover than in New Orleans, a city that knows how to celebrate?
Let the good times roll, as New Orleans’ motto says, roughly translated from its original Cajun-French, Laissez les bons temps rouler. The city is rich in history, diverse cultures and close-knit communities that have overcome so much.
“I’m a proud resident of the Upper Ninth Ward,” says Jimmy Gale, one of the people living with HIV featured in the Behind the Cover feature. “This historic neighborhood has overcome a lot and survived its share of adversity. Around here, we take care of each other like family—after surviving hurricanes, tornadoes and floods together, family doesn’t even begin to do it justice.”
But it’s not all good times.
According to the quarterly report of the Louisiana Department of Health’s Office of Public Health STD, HIV and Hepatitis Program, as of this past March 31, there were 23,126 people were living with HIV in the state—10,969 (47%) of them were diagnosed with late-stage HIV, sometimes referred to as AIDS.
Of the 875 Louisianans who were newly diagnosed in 2023, Black people accounted for 68% of the HIV diagnoses and 69% of the late-stage (or AIDS) diagnoses. Louisiana’s overall population is 32% Black. Among the most vulnerable groups, 60% of new HIV diagnoses last year were Black men who have sex with men. People ages 25–34 comprised 34% of new diagnoses; 24% were ages 13–24.
This, in a state that still has a 1987 law criminalizing HIV. If convicted under the law, a person can face up to 10 years in prison and registration as a sex offender for up to 15 years.
It’s a long, slow process, but efforts are underway to modernize the law. In late 2023, the Louisiana Coalition on Criminalization and Health conducted a study that in part measured public attitudes today about HIV. The opinion survey found that 93.5% of respondents believed the law needs updating; 87% agreed that the law does not make sense, based on the medical principle of undetectable equals untransmittable (U=U)—a person who is on HIV treatment and whose viral load is undetectable by most tests, is incapable of passing on the virus to their sex partner.
There’s reason for hope.
You are not alone.
P.S. As I write this, the National AIDS Manual and its website, aidsmap.org, announced they will cease operations this summer after 37 years. Based in London, they have been one of the world’s leading independent community-based sources of accurate and trusted HIV information. With heartfelt loss, PA’s staff salutes our colleagues at aidsmap.
A friend asked if this meant that HIV was no longer a serious thing. No, I said. It means that funding sources for HIV information are drying up. HIV is still here. We were starting to think that HIV was little more than a “chronic condition” that could simply be managed by taking one pill a day or a shot or two every couple of months or so, and that that was all we needed to know. But we keep discovering there are long-term effects of HIV, inflammation related to HIV and that co-existing conditions and aging are exacerbated. No, I said. We need our sources of HIV information as much as ever.