Time to read
As a gay man who came out over 35 years ago, now as Chair of the British HIV Association (BHIVA) and someone who has been living with HIV for more than two decades, I see LGBTQ+ History Month as an important moment to remind people that the story of HIV is deeply intertwined with LGBTQ+ history, resilience, and progress.
HIV remains a health issue with disproportionate impact on LGBTQ+ communities globally. For many years, stigma and misunderstanding shaped public perception long before science could transform outcomes. LGBTQ+ History Month offers a platform to honour those who fought for rights, dignity, and access to care, and to ensure that understanding keeps pace with progress.
It is impossible to talk honestly about HIV, science, and progress without addressing the increasingly toxic environment facing trans people.
Trans communities experience disproportionate levels of violence, discrimination, and exclusion – all of which are well-established drivers of poor health outcomes, including increased vulnerability to HIV. While science has continued to advance, social and political hostility has intensified, creating barriers to healthcare access, trust, and safety.
Standing with trans people is not optional or symbolic; it is essential to any credible public health response to HIV. This LGBTQ+ History Month – and beyond – we must be clear that innovation in medicine must be matched by solidarity in society, and that trans people deserve protection, dignity, and equitable access to HIV prevention, care, and support, alongside the unwavering commitment of allies.
Science and Innovation: From Crisis to Control
This year’s theme – Science and Innovation – feels especially resonant. The narrative of HIV over the past four decades is a story of scientific achievement: from the first antiretroviral therapies that transformed HIV from a fatal diagnosis to a manageable condition, to the development and rollout of pre-exposure prophylaxis (PrEP) and long-acting prevention tools.
Science has fundamentally reshaped the lived reality of HIV:
• Antiretroviral therapy (ART) has enabled people living with HIV to lead long, healthy lives with undetectable viral loads, which means HIV cannot be sexually transmitted – a critical breakthrough encapsulated in the U=U (Undetectable = Untransmissible) message.
• Prevention science has expanded options, including daily and long-acting PrEP, offering people choice and control over their sexual health.
• Recent innovations in long-acting injectable agents for prevention such as cabotegravir and lenacapavir signify another leap forward in prevention – evidence that investment in science continues to change the landscape of HIV care.
Yet we know many will not be prescribed these prevention technologies, and their impact will depend not only on discovery but on equitable implementation, education, awareness, and access.
Personal Journeys and Professional Reflections
In my clinical and academic career, from HIV research to establishing the dedicated Sage Clinic for people ageing with HIV, I’ve seen the real-world impact of scientific progress.
I was working at the Royal Free Hospital in 1996 when clinicians returned from the Vancouver World AIDS Conference, and had moved to London 4 years previously, finding my feet in a gay scene still reeling from the devastating losses due to AIDS in the 1980s. I remember the relief and hope that swept through clinics and communities when effective treatment became widely available, and later when PrEP was approved on the NHS. Those milestones meant more than clinical change – they represented dignity, autonomy, and hope for futures once clouded by fear.
But progress is uneven. Too many still face barriers to care: late diagnosis, social stigma, and structural inequities that science alone can’t solve.
Community Champions and Historical Impact
Across the years, remarkable people and organisations have shaped the course of both LGBTQ+ and HIV history. From grassroots activists demanding research and treatment access in the early years, to national and global NGOs advocating for rights and equity, to clinicians and scientists pushing the boundaries of what’s possible – the field is richer for all of them.
Closer to home, community advocates and organisations, including the National AIDS Trust, have been integral partners in BHIVA’s work, whether through policy influence, peer support, or public-facing education. Their contributions remind us that science and community action go hand in hand.
Persistent Gaps in Public Understanding
Despite transformational science, there are still gaps in public understanding. Many people remain unaware that:
• Individuals with an undetectable viral load cannot transmit HIV sexually.
• PrEP is a highly effective prevention option.
• Life expectancy for someone with HIV on treatment can mirror that of the general population.
Stigma persists – not because science has failed, but because culture, narratives, and education have not kept pace. Addressing this requires intentional public engagement, community leadership, and ongoing investment in health literacy.
Innovations Worth Celebrating
In addition to prevention there are new frontiers in HIV science worth highlighting:
• Simplified, less frequent treatment regimens that enhance quality of life.
• Continued development of vaccines and cure-directed research.
• Advances in understanding comorbidities and ageing with HIV, improving holistic care across the lifespan.
These innovations point to a future where HIV may one day be preventable and curable – but realising that future depends on science and society working together.
A Message for 2026 and Beyond
If there’s one message I want people to take away in 2026, it’s that whilst HIV is no longer the crisis it once was – thanks to science – the work isn’t done until every person benefits from that science without fear, stigma, or inequity.
Let’s use LGBTQ+ History Month as a lens to celebrate progress, acknowledge struggle, and recommit to a future where HIV is fully understood, fully prevented, and where everyone affected has access to the care and respect they deserve.