When Eric Leonardos was first diagnosed as HIV-positive 11 years ago, it was just a couple of months before his 25th birthday. The Austin, Texas resident was just getting started in his career as a hair and makeup stylist, and the diagnosis knocked him for a loop.
“It really shook me up emotionally, as well as financially,” Leonardos, who last year starred on the Logo reality dating show Finding Prince Charming, says. “At that moment, during that time of my life, I was really fearing for my life as well.”
He sought treatment from his doctor, who monitored his viral load and T-cell count for about six months before recommending antiretrovirals to treat his HIV. But Leonardos felt uncomfortable around his doctor, who did not speak about sexual health in a positive or affirming manner, and made Leonardos feel ashamed about his condition. He decided to seek a second opinion.
Leonardos’ next doctor was much more LGBTQ-affirming, and helped him get into a clinical trial studying the efficacy of Atripla, a pill that’s a combination of three antiretroviral medicines that are used to treat HIV and reduce a person’s viral load to “undetectable” levels — meaning the person is unlikely to transmit the virus to another person. Since then, he has switched to Odefsey, another treatment.
Now living in Los Angeles, Calif., Leonardos credits antiretrovirals — and the efforts of his second doctor — with helping him treat his HIV and be able to achieve his life goals.
“I’m really grateful for that opportunity, because I was able to keep on living my life normally,” he says.
Last year, Leonardos came out publicly as HIV-positive on Finding Prince Charming. His coming out gave him a platform to serve as an advocate for HIV testing, and help others access treatment or prevention methods.
“I think we would be in denial to say that there is still not a lingering stigma around getting tested, and it’s based on fear,” he says of the LGBTQ community’s attitude toward the virus. “The fear of a positive diagnosis is still very scary and daunting for people out there. That’s a wound that’s going to take a little bit of time to heal, but I think we’re on our way.”
With the National Day of HIV Testing having taken place only a few weeks ago, and the Day of Unity, which brings together faith leaders in the black church to combat HIV, slated for July 23, many people are keenly aware of the importance of testing to detect the virus. But fewer are familiar with the various treatments available to fight the virus and prevent further infections.
To that end, the Pharmaceutical Research and Manufacturers of America, or PhRMA, a trade group representing the pharmaceutical industry, recently released a fact sheet detailing the types of treatment available — treatments that have helped turn HIV from a deadly, untreatable disease to a chronic, manageable condition.
Currently, more than 40 medicines to treat HIV have been approved since the start of the AIDS epidemic in the early 1980s. There are also 52 medicines being used in clinical trials or awaiting FDA approval, including 32 antiretrovirals and antivirals, 16 vaccines, and four cell therapies.
Some examples include a medicine that researchers hope will prevent HIV from attaching to new cells and breaking through the cell membrane, and the development of a preventative HIV vaccine, currently in trials, which would recognize HIV and develop antibodies to fight off infection if a person is exposed to the virus.
“I think it’s important to understand how difficult HIV is in general,” says Dr. Mike Ybarra, the deputy vice president at PhRMA and an emergency physician who practices in Washington, D.C. “It’s a highly mutating virus that infects your own immune system. and it hides in our immune system. The virus is able to insert itself into our immune cells, our T-cells. That makes it really hard to treat.
“And so, there’s been a ton of research to look at the various ways we can treat the disease. That includes medicines that can treat the disease. That includes preventing the virus from entering the cells, preventing it from replicating within our own cells, prevent it from leaving our cells and spreading,” Ybarra adds. “There’s also the idea of finding a vaccine, a very difficult task, but one that industry seems very committed to.”
Yet even with 40 treatments for HIV currently on the market, statistics from various health departments, including the District of Columbia, show that a substantial number of those diagnosed as HIV-positive will not achieve viral suppression, largely due to their lack of adherence to medication. That may be due to numerous factors, including concerns over cost or a lack of insurance to pay for the expensive medicines.
Ybarra says the ability to reduce the number of pills people are required to take, by combining multiple medicines into one pill, or developing treatments with longer half-lives that may not require daily adherence, may assist clinicians in getting their hands around the HIV epidemic. That’s why the pharmaceutical industry is currently looking into new means of medicine delivery, such as long-acting injectables.
With regard to cost, the industry supports the development of generic forms of medication, which would create competition and potentially help bring down costs for people with HIV who don’t have to spend as much on brand-name drugs.
Ybarra also notes that some pharmaceutical companies have patient assistance programs that can help provide access to treatment for HIV-positive individuals. Additionally, the Partnership for Prescription Assistance has an online search feature where patients can select which medication they are taking, fill out their income and personal information, and see co-pay or patient assistance programs for which they might be eligible.
“Putting on my clinical hat, we need to be educating patients broadly about the spectrum of possible treatment,” Ybarra says.
That’s a sentiment echoed by Leonardos, who notes that his own life experience, particularly being raised in rural or socially conservative communities, underscores the importance of making information about the virus, testing, and treatment for those who are HIV-positive more widely available.
“If people believe sex is bad, or have a negative though process or belief around sex, they’re not going to be open to talking about testing or any issues around that or other subjects,” he notes. “The more we discuss it, the more we talk about it, it’s a ripple effect.
“HIV is not something to be afraid of, but it is something to be well-informed about and educated on in order to be a responsible, sexually active person.”
Editor’s Note: An earlier version of this story used the wrong residence for Eric Leonardos. He is now living in Los Angeles.
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