World AIDS Day (December 1st, 2022)

World AIDS Day Promo

December 1st is World AIDS Day

This year’s theme for World AIDS Day is “Putting Ourselves to the Test: Achieving Equity to End HIV.” It encourages people to unite globally to eliminate the disparities and inequities that create barriers to HIV testing, prevention, and access to HIV care. First observed in 1988, World AIDS Day is a day to unite to help end HIV and remember those lost to AIDS-related illnesses.

Four decades into the HIV response, inequalities persist for the most basic services like testing, treatment, and condoms, and even more so for new technologies.

This #WorldAIDSDay, let’s unite to end the inequalities holding back the end of HIV/AIDS.

A Reflection from our Principal Investigators, Prescott Chow, MUP, and Monica Hahn, MD, MPH, MS, AAHIVS

“Each year, World AIDS Day allows us a space to commemorate and honor those we’ve lost to HIV/AIDS, while also affording us an opportunity to reflect on the progress we’ve made, lessons learned and challenges ahead. Forty+ years after the first AIDS cases were identified, we find ourselves in the midst of intersecting pandemics and unacceptable inequities which have persisted for decades. Today we recognize the collective challenges we still face.  No doubt we have made much progress; we have highly effective HIV medications for prevention and treatment.  We’ve made huge strides in medical technology in the last few decades, and that is NOT what’s holding us back in ending the epidemic. Let’s be crystal clear – systemic oppression in the forms of racism, poverty, homophobia, transphobia, stigma, and criminalization are what is holding us back – especially for people who hold multiple oppressed identities.

This year’s theme, ‘Putting Ourselves to the Test: Achieving Equity to End HIV,’ speaks to this truth. This theme resonates deeply with our values and vision for our work at THE Collaborative, including at our Pacific AETC and the Care and Wellbeing Center programs. On this World AIDS Day and every day, we reflect on how we can recognize, disrupt, and repair systems that perpetuate harm and inequity, and how we are centering communities most impacted and most marginalized in our everyday work.  We recognize that anti-oppression and anti-racism are central to our work in the world of HIV prevention, treatment, capacity building, training and education, and it is our duty to interrogate and critique systems of oppression and how they operate to produce and maintain the inequities we see in the HIV landscape. It is with great gratitude and optimism that we engage in our work with a mission-driven team with collective hopes and dreams for future directions to advance and achieve health equity for all.

Everyone deserves access to quality HIV services. Let’s make it happen together.”

Monica Hahn, MD, MPH, MS, AAHIVS and Prescott Chow, MUP
Training & Health Equity (THE) Collaborative Principal Investigators

World AIDS Day Graphic

Our History: Pacific AETC

The Pacific AIDS Education & Training Center (Pacific AETC) is a member of a national AIDS Education & Training Center network of eight regional and two national centers, covering all 50 states as well as US Territories and Jurisdictions.

PAETC logo transparent

In October 1987, the Health Resources and Services Administration (HRSA) Bureau of Health Professions, under the Department of Health and Human Services (DHHS), established the AIDS Education & Training Center (AETC) Program to build the HIV clinical workforce in the United States. In the early days of the AETC, there were two Centers that served the Pacific region: the AETC for Southern California (led by the University of Southern California) and the Western AETC (led by the University of California, Davis). In the mid-90s, with encouragement from HRSA, the two Centers solidified. The University of California, San Francisco (where the Western AETC was housed) would lead the new entity, now known as Pacific AETC.

The AETC program continues to evolve and Pacific AETC continues to be at the forefront of practice and innovation. This includes highlighting emerging science and healthcare innovation, and our commitment to health equity. While the programming has evolved over the 30+ years of the AETC program, much of the work remains ongoing, urgent, and life-saving: ensuring healthcare professionals have the clinical and programmatic knowledge and skills needed to support care for people with or affected by HIV.

35th Anniversary of the AETC Program

Learn about the AETC network’s 35 years of supporting the HIV care community. The following video celebrates the program’s history, accomplishments, and milestones in response to the HIV epidemic since 1987:


HIV affects everyone. This World’s AIDS Day, let’s help #StopHIVStigma. Everyone, everywhere must have access to health and HIV services without fear of stigma, discrimination and criminalization. Access the CDC’s Stigma Language Guide to learn how to talk about HIV in a way that is not stigmatizing.

Stigma infographicHIV affects everyone graphic

To honor this year’s theme of equity, we’ve compiled some of Pacific AETC’s stigma and racial equity trainings.

PrEP Ready! Community of Practice: Building your Community’s HIV Prevention Capacity with a Health Equity Lens (On-Demand)

PrEP Ready! Community of Practice is a peer-to-peer EHE learning community to strengthen equitable PrEP programming at FQHCs. This session was presented by members of the West Region CDC Capacity Building Assistance Providers from California Prevention Training Center, Denver Prevention Training Center, and ​San Francisco Department of Public Health – Center for Learning and Innovation.

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HIV Learning Network – HIV and Harm Reduction: A Cultural Approach (Upcoming)

Description: Harm reduction strategies help to lessen the harms associated with drug use and related behaviors to increase the risk of HIV infection. Harm reduction plays a significant role in preventing drug-related deaths and offering access to treatment, social services, and healthcare. Current narratives around harm reduction and recovery are dominated by a white lens, depicting white communities as the most vulnerable victims of the current opioid crisis. From 2015 – 2020, there was a 213% increase in overdose death rates for Black men – the largest increase experienced by any demographic group (Black Harm Reduction Network). In this session, Dr. Gigi Simmons will explore the history of HIV and harm reduction in the Black community, and examine how the media portrayal of HIV and harm reduction shape our views of how we approach harm reduction with Black people with HIV.

HIV Learning Network – HIV Stigma & LBGT Communities (On-Demand)

Description: LGBT Communities are disproportionately affected by HIV. Men who have sex with men and transgender people experience stigma and discrimination that can negatively affect their engagement and retention in HIV care and prevention services. In this session, Shawn Demmons, MPH, will discuss and define the different types of stigma that affect these communities and the impact that stigma has on these communities, and discuss strategies to reduce stigma on a intrapersonal, communal and organizational level.

Understanding the Impact of the Structural Racism on Clinical Care: Lessons from HIV and COVID-19 (On-Demand)

Description: In order to understand how health inequities in various chronic disease such as HIV and SUD occur, it is necessary to examine their associations with longstanding structural racism.  This on-demand course will provide an overview of structural racism in the context of the clinical care and review what lessons have ben learned from the HIV and COVID-19 pandemics that can inform future work, and help to interrogate systems and structures which perpetuate structural racism in order to take steps to move toward providing services with an anti-oppression and anti-racism lens. Presented by THE Collaborative Principal Investigator, Monica Hahn, MD, MPH, MS, AAHIVS.

HIV Learning Network – Culturally-Based Programs to Improve Engagement and Health Outcomes: Addressing Stigma for Native Hawaiian with HIV (On-Demand)

Presented by Malulani Orton, Native Hawaiian Medical Case Manager, Hawai’i Health & Harm Reduction Center.

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New: PrEP Ready! Community of Practice Past Sessions Available

PrEP Ready! CoP is a peer-to peer EHE learning community to strengthen equitable PrEP programming at FQHCs in the Pacific Region. Sessions are created to help to enhance the various aspects required to offer successful PrEP delivery services with a health equity lens. While PrEP Ready! CoP session are only open to FQHCs in EHE jurisdictions in the Pacific Region, we believe all healthcare organizations offering PrEP can find the materials developed useful.

Below is a list of past session with registration links to view the archived recordings, slides, PrEP implementation tools, and other materials developed for each session. Click on each title to register!

New Resource: Expand your HIV Toolkit: Cabotegravir and Rilpivirine (CAB/RPV) Essentials and Clinical Guide

Cover of the Expand your HIV Toolkit: Cabotegravir and Rilpivirine (CAB/RPV) Essentials and Clinical Guide

Pacific AETC has developed the Expand Your HIV Toolkit: Cabotegravir and Rilpivirine (CAB/RPV) Essentials and Clinical Guide to inform healthcare providers about CAB/RPV, the first FDA-approved long-acting injectable antiretroviral (ARV) medication for patients with HIV. This comprehensive toolkit includes:

  • Recommendations for patient evaluation, screening, and shared decision making when considering prescribing CAB/RPV.
  • Implementation tools such as sample checklists, protocols, and resources available to aid in the implementation of offering CAB/RVP in healthcare settings.  

The toolkit was developed to enhance the content of a 4-part webinar series held January – April, 2022, titled: Expand your HIV Toolkit: CA Statewide Trainings on Extended-Release Injectable Suspensions for HIV Treatment and Prevention.  The series was designed to equip California clinicians, pharmacists, and members of the healthcare team with an in-depth understanding of Cabotegravir/Rilpivirine (Cabenuva). Attendees gained:

  • Real-world patient and provider perspectives.
  • A guide to patient eligibility, clinical considerations, and insurance coverage.
  • Insights to increase equitable access for priority populations. 

Register below to watch the 4-part series and access materials.

Upcoming! Routine Testing in Clinical Setting: A Webinar Series to Showcase Partnerships that Maximize Opt-out HIV Screening

Denver PTC LogoMore than 160,000 Americans are unaware they are living with HIV. Diagnosing HIV is critical to the success of the Ending the HIV Epidemic in America initiative (EHE). How can we assist clinical providers in identifying individuals who would not otherwise receive HIV testing? Research demonstrates large-scale HIV screening in the emergency departments and urgent care settings using existing staff and resources, regardless of patient selection strategy, does not impact care processes or patient flow.

Join the Denver PTC on Wednesday December 14, 2022 as they deliver a webinar on HIV Testing in Emergency Rooms – A Public Health Initiative to Improve Early HIV Detection and Linkage to Care.

No registration is required. Access the Zoom information below:


Meeting ID: 696 210 3759

Passcode: 123321

Learn how your team can maximize opt-out HIV screening!

Early HIV Diagnosis and Treatment Important for Better Long-term Health Outcomes

Cross-posted from NIAID Newsroom

NIAID NewsroomStarting antiretroviral treatment (ART) early in the course of HIV infection when the immune system is stronger results in better long-term health outcomes compared with delaying ART, according to findings presented at the IDWeek Conference in Washington, D.C.

The findings are based on an extended follow-up of participants in the National Institutes of Health-funded Strategic Timing of Antiretroviral Treatment (START) study. In 2015, START demonstrated a 57% reduced risk of AIDS and serious non-AIDS health outcomes among participants who began ART when their CD4+ T-cell counts—a key indicator of immune system health—were greater than 500 cells per cubic millimeter (mm³) compared with those who did not begin ART until either their CD4+ counts fell below 350 cells/mm³ or they developed AIDS. Following the 2015 report of these findings, the participants in the deferred treatment arm were advised to begin ART.

Approximately, 1.2 million people in the United States are living with HIV, and roughly 13% do not know they are infected, according to the Centers for Disease Control and Prevention. When HIV diagnosis and treatment are delayed, HIV continues to replicate. This can negatively impact the infected individual’s health and increase the risk of transmitting the virus to others.

The international START study proved the benefit of early ART initiation, but longer-term follow-up of 4,446 participants was undertaken to determine whether the health benefits of early ART compared with deferred ART increased, remained constant, or declined after the participants in the deferred arm were advised to begin ART. The primary study endpoints included the number of participants who developed AIDS; those who developed serious non-AIDS health conditions, such as major cardiovascular disease, kidney failure, liver disease and cancer; and those who died.

For participants who began ART before the end of 2015, the median CD4+ cell count at the time of ART initiation was 648 cells/mm³ for the immediate arm and 460 cells/mm³ for the deferred arm. The analysis presented [on 10/21/22] compared the primary study endpoints before the end of 2015, with those in the extended follow-up period, from Jan. 1, 2016, to Dec. 31, 2021. In the latter period, most deferred-arm participants were taking ART. During the second period, people initiating ART in the deferred group had rapid and sustained declines in HIV viral load (less than or equal to 200 copies/mL); however, CD4+ cell counts remained, on average, 155 cells lower compared with that of individuals in the immediate ART group. While the risk of serious health outcomes was substantially diminished soon after ART was initiated in the deferred treatment group, some excess risk remained compared with the immediate treatment group. The deferred ART group continued to have a somewhat greater risk (21%) of serious health consequences or death in comparison to the immediate treatment group. Twenty-seven cases of AIDS occurred in the five-year follow-up period in the deferred treatment group compared with 15 cases in the early treatment group. Similarly, 88 cases of serious non-AIDS health issues occurred in the deferred treatment arm compared with 76 cases in the immediate treatment arm. Lastly, there were 57 deaths in the deferred treatment group compared to 47 in the immediate treatment arm.

These findings confirm that ART significantly improves the health of an individual with HIV and reduce the person’s risk of developing AIDS and serious health issues, and that early diagnosis and treatment are key to maximizing these benefits and reducing risk, according to the presenters.

The START study and its extended follow up was conducted by the International Network for Strategic Initiatives in Global HIV Trials (INSIGHT), funded in part by the National Institute of Allergy and Infectious Diseases (NIAID), part of NIH. It was led by principal investigator James D. Neaton, Ph.D., of the University of Minnesota, Minneapolis, and START study co-chairs Abdel Babiker, Ph.D., of the University College London, and Jens Lundgren, M.D., of the University of Copenhagen.

New CDC Articles on Increasing Equity in Monkeypox Vaccine Distribution & Addressing Monkeypox Holistically (

Cross-posted from

New CDC MMWR Articles: Increasing Equity in Monkeypox Vaccine Distribution

Last Friday, CDC published three new Morbidity and Mortality Weekly Report (MMWR) reports on recent developments in monkeypox vaccination in the U.S.:

New CDC MMWR Articles: Increasing Equity in Monkeypox Vaccine Distribution Graphic

The first report shows that progress has been made in increasing the proportion of Black and Hispanic persons vaccinated against monkeypox virus in the U.S. According to the report, by October 10, 2022, 931,155 JYNNEOS vaccine doses were administered in the United States. Among persons who received ≥1 vaccine dose, 51.4% were non-Hispanic White, 12.6% were non-Hispanic Black or African American (Black), and 22.5% were Hispanic persons. The percentages of vaccine recipients who were Black (5.6%) and Hispanic (15.5%) during May 22–June 25 increased to 13.3% and 22.7%, respectively, during July 31–October 10. The Importance of Community Vaccination Events The other reports detail how community vaccination events can help make access to vaccines easier for people most affected by monkeypox. This summer’s Southern Decadence event in Louisiana and the Atlanta Black Gay Pride Festival in Georgia are highlighted. Both events provided the opportunity to increase access to monkeypox vaccination among populations disproportionally affected by the monkeypox outbreak. Community engagement, targeted messaging, and selection of venues catering primarily to racial and ethnic minorities for community vaccination events improved vaccine equity and reduced health disparities. For the latest information on monkeypox in the U.S., visit

Addressing Monkeypox Holistically

Addressing Monkeypox Holistically GraphicFrom day one of the Biden Administration’s response to the Monkeypox outbreak, we have recognized that Monkeypox is not a virus that lives in isolation. It exists as a part of a number of acute and chronic outbreaks and health challenges that interact with each other and can be impacted by social circumstances that worsen disease outcomes. Such interacting epidemics, or “syndemics,” require responses beyond traditional disease-specific healthcare delivery and to also address associated social determinants of health. That’s why we have worked closely—and successfully—within the Administration and with our partners in public health, the LGBTQI+ community, and with community-based organizations—to combat and treat this virus using a holistic approach, that takes all of these factors into consideration.

HIV and Monkeypox are examples of syndemic outbreaks that interact with each other and therefore require specific action for both diseases in order to mitigate the impact of both. Recent epidemiology has shown that people with HIV continue to be over-represented in cases and severe manifestations of Monkeypox disease. In one study published by the CDC, nearly 40% of people diagnosed with Monkeypox had HIV infection, and over 40% had been diagnosed with a sexually transmitted infection (STI) in the year prior to their Monkeypox diagnosis.1

In an even more recent study of 57 people reported to CDC with severe Monkeypox infections, 82% had advanced HIV infection and nearly three-quarters of these individuals had very compromised immune systems with extremely low CD4 cell counts. Under 9% of these patients were taking antiretrovirals at the time of their Monkeypox diagnosis. Some people succumbed to these preventable infections.2

Syndemics are not just about viruses and bacteria; social circumstances like systemic inequities in the health care system and social determinants of health like housing interact with infections to worsen or deepen their impact. In this same report of severe Monkeypox outcomes, nearly 70% of patients were Black and 23% were experiencing homelessness.2

These statistics make it clear the need to continue an aggressive and comprehensive approach to address Monkeypox, HIV, STIs, homelessness, and mental health together. HIV prevention and care mitigates the impact of Monkeypox on the health of individuals living with or at-risk for both infections. And, linkage to HIV care and treatment is critical to protect individuals from a variety of health threats, including Monkeypox.

Throughout our response to the Monkeypox outbreak, the Biden-Harris Administration has taken critical actions toward this effort. We have centered vaccine equity with local and national programs to address disparities in vaccine administration by bringing vaccine closer to the people who could benefit. HRSA’s Ryan White HIV/AIDS ProgramCDCSAMSHA, and HUD have worked with grantees to emphasize the urgent need for syndemic actions to respond to syndemic challenges. These agencies have provided clear messages about the importance of using the HIV, STIs, housing, and behavioral health funding, staff, and infrastructure to help control Monkeypox. It is critical that front line service providers in public health departments, medical clinics, substance abuse and mental health environments, housing providers, and community-based organizations continue to leverage these resources across these syndemics. We can work collaboratively across these interacting infections and social determinants to address the Monkeypox virus as a holistic health challenge, not in isolation. Providers that serve affected communities, particularly those living with HIV, must continue to leverage funding and programmatic flexibilities by:

  • Using HIV care systems to support people with HIV and lead those at-risk for Monkeypox to the testing, prevention, and treatment services required to prevent poor outcomes of both diseases.
  • Using established data-to-care strategies, and out-of-care lists, to reach the people most vulnerable for severe illness because they are not engaged in HIV care and use that outreach to offer them Monkeypox vaccine, behavioral guidance, and linkage to HIV care.
  • Taking the opportunity presented by people seeking Monkeypox prevention to test for HIV and STIs and offer prevention or treatment services to avoid HIV infection or disease progression.
  • Using housing resources to support people living with HIV and others so that they can prioritize their Monkeypox and HIV-related health seeking behaviors.
  • Taking advantage of housing and mental health service encounters to engage people with HIV at-risk for Monkeypox and to link them with resources to identify, prevent, or mitigate Monkeypox and HIV disease progression.
  • Provide HIV and Monkeypox resources and services for people seeking STI diagnosis and treatment.

Because Monkeypox exists as part of the syndemic of HIV, STIs, mental health and homelessness, the Administration is committed to treating it that way. Providers must continue to use all of the tools created by these important, and ground-breaking, funding and programmatic flexibilities. Service providers should use the expanded syndemic toolkit created by these flexibilities including HIV data-to-care, care navigation, housing resources, HIV prevention and care services, and Monkeypox vaccine and education to control this outbreak and support the wellness of people with and at-risk for HIV.


Learn More About Monkeypox: HHS Response to the Monkeypox Outbreak |
Ryan White Monkeypox Resources: Monkeypox Information | Ryan White HIV/AIDS Program (
Prevent Monkeypox: Prevention | Monkeypox | Poxvirus | CDC
Mental Health and Monkeypox: Monkeypox (MPV) | SAMHSA
HUD Monkeypox Resources: Homeless Systems Operational Management During Monkeypox and Talking to People Experiencing Homelessness About MPX (


  1. Curran KG, Eberly K, Russell OO, et al. HIV and Sexually Transmitted Infections Among Persons with Monkeypox — Eight U.S. Jurisdictions, May 17–July 22, 2022. MMWR Morb Mortal Wkly Rep 2022;71:1141–1147. DOI:
  2. Miller MJ, Cash-Goldwasser S, Marx GE, et al. Severe Monkeypox in Hospitalized Patients — United States, August 10–October 10, 2022. MMWR Morb Mortal Wkly Rep. ePub: 26 October 2022. DOI:

Recognizing American Indian/Native American Heritage Month (November 2022)

AIDSVu Infographic AI/NA Heritage Month

Recognizing American Indian/Native American Heritage Month

November is American Indian/Native American Heritage Month. This November, Pacific AETC would like to acknowledge the over 150 indigenous tribes who are traditional stewards of the land that the Pacific region occupies in Arizona, California, Hawai’i, Nevada, and the US-Affiliated Pacific Islands. We are committed to the improvement and expansion of HIV testing, education, and treatment among indigenous populations and honor the longstanding history of those native to the land that we inhabit. 

The number of HIV diagnoses in American Indian/Alaska Native (AI/AN) people has increased over time. View the CDC’s latest data on HIV among AI/AN people and learn about the prevention challenges that some AI/AN people face.

The following is cross-posted from AIDSVu:

In 2020, 190 American Indian/Alaska Natives were diagnosed with HIV.

Among Native communities, HIV impacts certain groups more than others – for example, Gay and Bisexual Men represented 82% of new HIV diagnoses among American Indian/Alaska Natives (AI/AN) men in 2020. In the same year, injection drug use accounted for 43% of new HIV diagnoses among AI/AN women. According to the Centers for Disease Control and Prevention, factors such as high rates of sexually transmitted diseases among AI/AN populations, alcohol and drug use, and cultural stigma result in disproportionate HIV rates among Native communities.

AIDSVu Infographic AI/NA Heritage Month

It is also important to recognize how social determinants of health can negatively impact HIV-related health outcomes for Native communities due to a lack of access to affordable health care and financial insecurity. For example:

  • In 2019, 6.1% of the AI/AN population were unemployed, compared to 3.7% of the U.S. population.
  • In the same year, 15% of the AI/AN population were uninsured, compared to 8% of the U.S. population.

AIDSVu Infographic AI/NA Heritage Month - Regional Impact

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