Does it smell like… you know…?

We have come so far - something to celebrate - and we still have so much left to do - something to remember.

xxx

But please remember the bigger picture. Where you can, make noise, ask questions, share information and remain as furious about the needless and avoidable suffering at the hands of deliberate policy choices as if it was your loved ones’ lives on the line.

Those of us who have the privilege and means to access to the once-unimaginable array of prevention and treatment options (and information) should absolutely take advantage of them in whatever way is most appropriate for us as individuals.

Beyond the scale of damage these deliberate and avoidable cuts will cause to both quality of life and life expectancy around the world is the immeasurable long term damage of sustained stigma - whose reach goes far beyond the virus itself.

“UNAIDS modelling now suggests that failure to restore prevention efforts could lead to an additional 3.3 million new HIV infections between 2025 and 2030.”

news.un.org/en/story/202...

Despite all of these wonders and advances, here is a far more sobering look at what HIV prevention and treatment looks like outside of the Global North

The UK and USA are among nations making dramatic cuts to HIV funding abroad and there is a real human cost - in lives

www.un.org/en/observanc...

This year, London’s HIV Prevention Programme published this *excellent* report

“Towards Equity Report
- Our report on reimagining HIV prevention for London’s Black Heritage communities”

Essential reading for anyone with even a passing interest in health inequity

doitlondon.org/about/black-...

In 2023, in the UK, new HIV diagnoses in heterosexual people surpassed that of gay, bi and other men who have sex with men (GBMSM) with over half of those cases occurring in Black people with women being further disproportionately affected.

nat.org.uk/about-hiv/hi...

Here is but a snapshot of just a few of the headlines…

Here is the World Health Organisation’s summary of HIV globally from July 2025

www.who.int/news-room/fa...

ALL OF THAT IS TO SAY… That I, too, sometimes miss the forrest for the trees.

While I - and some of you reading this - will be privileged enough to take these wonders for granted, it’s worth reflecting - even if just for today - on the wider picture around the world.

…

I say all of this well aware that I can do so from a place of great privilege. I live in a country where I could access these things - *for FREE*, I have good knowledge and can easily access support, I can be “out”, I benefit from white privilege, etc.

I am fortunate and privileged.

Combination prevention, U=U, and the simple but potent empowerment of choice. When I was a kid, the choices were abstinence, use condoms or die. The reality might’ve been different but that was the messaging.

It’s really easy for me to take for granted, not only PrEP but injectable PrEP and ARVs, single-tablet ARVs, the rapidity and relatively short window periods of testing and the infinitely more fragile and less scary virus that is HIV.

Working sexual health, reproductive health and HIV, I often have to pinch myself and take a fresh, sober look at the astounding leaps and bounds that HIV prevention and care have advanced by since the days of Ryan White (some of my earliest memories of HIV).