By Edwina Eyre | WASHINGTON – While HIV was once considered a death sentence, major medical breakthroughs coupled with advancements in HIV prevention education and stigma reduction have transformed the virus from a once-fatal disease to a chronic condition that can allow individuals to live long and healthy lives. 

Today, more than half of the adults living with HIV in the U.S. are over 50 years old. By 2030, that number will jump to 70% – a number that was unimaginable 30 years ago. While this transformation is a tremendous step forward, it has ushered in its own set of challenges when supporting this new, aging population that has distinct care and treatment needs.

On September 18, healthcare providers, advocacy organizations, and communities across the country will commemorate National HIV/AIDS and Aging Awareness Day (NHAAD) to raise awareness of the impact of HIV/AIDS on older Americans, and the urgent need to expand testing, treatment and care services for individuals over 50.

By 2030, more than 80% of people living with HIV will have at least one age-related medical condition, such as cancer or heart disease. Individuals living with HIV may also contend with various comorbidities that intersect with their diagnoses, such as diabetes, liver disease, anemia and high blood pressure. They may also face a different set of psychological and mental struggles than their peers. 

However, few dedicated resources exist to address the diverse needs of the growing population of older individuals living with HIV. “HIV services and aging services have historically been very siloed,” says Prescott Chow, Director and Co-Principal Investigator for the Training and Health Equity (T.H.E.) Collaborative at the University of California, San Francisco. “While there have been some touchpoints, there have also been a lot of missed opportunities in terms of figuring out how to develop services that are inclusive of folks who are aging with HIV.” 

The lack of attention and funding for the rapidly increasing population of individuals over 50 living with HIV prompted Gilead Sciences to launch HIV Age Positively® in 2018, an initiative aimed at supporting programs focused on improving the quality of life and health for those who are aging. Since its launch, the program has awarded more than $35.8 million in grants to support 42 organizations — from healthcare organizations to advocacy groups working to address the interrelated challenges within the healthcare system and the general HIV community — addressing stigma, loneliness and better coordination of care.

HIV Age Positively centers on three pillars: (1) improving care coordination, (2) increasing resources for better well-being and (3) educating and informing policy related to aging with HIV. Grantees work to provide resources such as mental health services and community support and make sure people aging with HIV receive the care they need by training and educating healthcare professionals with additional literacy around HIV and comorbidities. 

T.H.E. Collaborative, an HIV Age Positively grantee, provides capacity building, technical assistance and training services to other grantees across a 13 state region in the Western U.S. In addition to HIV Age Positively grantees, T.H.E. Collaborative frequently works with other HIV advocacy programs in the Western U.S., providing a platform for peer-to-peer support and training.

“We are currently in this new era in aging, where we are really looking at the whole person and focusing on intergenerational and intercommunal care,” remarks JB Del Rosario, the Care and Wellbeing Center Project Manager at T.H.E. Collaborative. “So much of this work is about paying it back, but also paying it forward – recognizing the work that people who have come before us have done, but also passing on that effort to the coming generation as well and taking the lessons that we’ve learned to create a better world and a better system.” 

One of the ways T.H.E. Collaborative is centering intercommunal HIV and aging care is through their Collaboration in Care Conference. On September 18 and 19, an interdisciplinary network of more than 200 providers from both the aging and HIV space will come together in Sacramento, California, to share best practices from their work and different resources available in their fields. Participants will cover topics as varied as financial health, mental health, community building and the psychosocial aspects of aging with HIV. 

Del Rosario and Chow were thrilled to have T.H.E. Collaborative’s work, including the Collaboration in Care Conference, supported by Gilead through HIV Age Positively and emphasized the need for continued focus on wraparound care to address the health needs of those aging with HIV.

“It feels like a gift right now to think about how to look at HIV differently,” says Chow. “Where we are now is amazing in terms of the biomedical interventions we have available to help people aging with HIV have healthy long lives, but with that comes the responsibility to consider the other issues that impact a person’s life and to ensure that individuals are not just surviving but thriving as they age with HIV.”

Gilead: More than Medicine is part of a paid year-long collaboration between Gilead Sciences and the Los Angeles Blade

By Donovan Harris | WASHINGTON – There is something powerful about embracing our shared humanity. 

For leaders and activists in HIV care and prevention, that is the message they are working hard to spread in the fight against HIV-related stigma.

“I’m stunned that some of the same stigma that we experienced in the early days of the epidemic continues to persist and are so pervasive across society,” said José Zuniga, president/CEO of the International Association of Providers of AIDS Care (IAPAC). 

Zuniga was open about his experiences as a Gay, Latino man, sharing that he is no stranger to the deep-rooted stigma millions of others in the LGBTQ+ community experience. 

“I clearly understand the stigma that comes with people judging us based on our sexual orientation,” he said. “There’s a self-stigma, the self-labeling and the [fear] of feeling unworthy or being othered.”

Zuniga expressed that he is disheartened that HIV-related stigma extends to some healthcare settings, causing many people to delay essential, life-saving care. “It only takes one person within the healthcare system to stigmatize you before you hesitate to do what should be done to mitigate your risk, either becoming HIV positive or progressing to AIDS if you’re newly diagnosed with HIV,” he said. 

According to UNAIDS, people living with HIV who perceive high levels of HIV-related stigma are 2.4 times more likely to delay enrollment in care until they are very ill. 

However, there has been progress globally to reduce stigma and provide greater access to HIV care. In a recent UNAIDS report, researchers found there is a clear path to ending AIDS by 2030. Botswana, Eswatini, Rwanda, the United Republic of Tanzania and Zimbabwe have already achieved the “95-95-95” targets. 

The goal is for 95% of all people living with HIV to know their HIV status, 95% of people diagnosed with HIV infection to receive antiretroviral treatment and 95% of people who are being treated are virally suppressed by 2025.  

While we have seen notable strides over the years, Zuniga said more work must be done to reduce HIV-related stigma globally. 

That is why he is proud of the work done to launch the inaugural Zero HIV Stigma Day on July 21, 2023. The day was chosen to honor Prudence Nobantu Mabele, the first South African woman to disclose her HIV status in 1992. 

“There was no awareness day singularly focused on stigma,” Zuniga said. “There certainly is one [day] around discrimination, but discrimination is really an outcome of stigma.”

Zero HIV Stigma Day was announced in 2022 as a collaboration between the IAPAC, a UK-based sexual health charity called NAZ, the Global HIV Collaborative and the Fast-Track Cities Institute. 

Gilead Sciences also stepped in to amplify the important work Zuniga and his team are doing to end stigma on Zero HIV Stigma Day and throughout the year. 

Through a grant from Gilead, Zuniga said his organization was able to implement one of the first medical education programs for primary care providers around “Undetectable=Untransmittable” which means a person cannot pass HIV through sex when they have undetectable levels of HIV.

He also said the pharmaceutical company was an early supporter of the Fast-Track Cities Institute and has helped reduce HIV-related stigma by providing resources and education through their COMPASS Initiative®, a 10 year, more than $100 million commitment to end the HIV/AIDS epidemic across the U.S. South.

“This is serious work and not something that any entity takes lightly,” Zuniga said. 

This year’s Zero HIV Stigma Day theme is “Human First” to emphasize the humanity of people living with and affected by HIV. 

“Pushing this human first message to us is critical because of course, the H in HIV stands for human,” Zuniga said. “I think we can repair the very frayed level of connectivity between us because we share a common humanity.”

Gilead: More than Medicine is part of a paid year-long collaboration between Gilead Sciences and the Los Angeles Blade