Peter Staley: HIV Progress, PrEP Access & Resistance

The fight to preserve decades of progress against HIV is far from over, a message delivered with urgency by veteran activist Peter Staley at the Conference on Retroviruses and Opportunistic Infections (CROI 2026) in Denver. Staley’s call to action comes amid what he describes as a systematic rollback of public health advancements, particularly under the current administration, raising concerns about access to vital treatments like PrEP – pre-exposure prophylaxis – and the future of HIV prevention efforts. His remarks, reported by AIDSmap and AJMC, highlight a growing anxiety within the HIV community about the fragility of hard-won gains.

A History of Activism and the Current Landscape

Peter Staley, born January 9, 1961, is a central figure in the history of HIV/AIDS activism. As an early member of ACT UP New York, he co-founded the Treatment Action Group (TAG) and AIDSmeds.com, platforms instrumental in advocating for research, treatment access, and informed patient care. His story, documented in the Oscar-nominated film How to Survive a Plague, exemplifies the power of community organizing in the face of a devastating epidemic. (Wikipedia)

Now, decades later, Staley is sounding the alarm again. He points to a series of concerning developments in 2025, which he termed an “annus horribilis” for global health. These include the dismantling of USAID programs, widespread cancellations of research grants, and the appointment of individuals questioning established scientific consensus to key positions, including Robert F. Kennedy Jr. As Secretary of Health. The impact has been felt acutely through staff reductions within federal agencies, disproportionately affecting women and people of color in leadership roles, and through stop-operate orders on PEPFAR, halting HIV treatment and prevention services across Africa.

Echoes of the Past: A Parallel to Early AIDS Crisis

Staley drew a stark parallel between the current situation and the early days of the AIDS epidemic, when effective treatments were unavailable and individuals were left to face the disease with limited support. He expressed concern that the recent disruptions could lead to a similar scenario for people currently relying on HIV prevention and treatment programs, “suddenly robbed of the hopeful futures they were looking forward to.” This echoes the desperation and fear experienced by those living with HIV in the 1980s and early 1990s, before the advent of combination therapy.

The Response from the Scientific Community

Staley’s assessment of the scientific community’s response has been mixed. He criticized some researchers for modifying grant applications to remove language related to diversity and equity – a tactic employed to increase the chances of funding approval in a climate of political scrutiny. While acknowledging the pragmatic reasoning behind this approach, he labeled it as “acquiescence.” He also expressed disappointment with those who believe maintaining political neutrality is a viable strategy during a crisis.

Still, Staley also highlighted instances of resistance and advocacy within the scientific community. He praised the American Public Health Association for taking the National Institutes of Health (NIH) to court over cancelled grants, and acknowledged the nearly 500 NIH employees who signed the Bethesda Declaration, committing to academic freedom and evidence-based health policy. Several prominent officials have also resigned in protest, demonstrating a willingness to take a stand against what they perceive as an assault on science.

PrEP Access and the Broader Implications

While Staley’s address encompassed a broad range of concerns, the issue of PrEP access is particularly critical. PrEP, a daily pill or injection, is highly effective in preventing HIV infection when taken as prescribed. Widespread access to PrEP is a cornerstone of the “Ending the HIV Epidemic” initiative, a national strategy aimed at reducing new HIV infections in the United States. Disruptions to PrEP programs, whether through funding cuts or political interference, could have significant consequences for public health.

The concerns extend beyond the United States. PEPFAR, the U.S. President’s Emergency Plan for AIDS Relief, is the largest global health program to combat HIV/AIDS. Stop-work orders impacting PEPFAR have the potential to reverse decades of progress in preventing and treating HIV in Africa and other regions. The potential consequences are devastating, potentially leading to a resurgence of the epidemic in areas where significant gains have been made.

What Comes Next: A Call for Sustained Resistance

Staley’s message is not one of despair, but of urgent action. He urged the HIV community – clinicians, researchers, advocates, and people living with HIV – to resist what he described as a deliberate dismantling of public health infrastructure and scientific integrity. This resistance can take many forms, from quiet advocacy within institutions to public demonstrations and political engagement.

The situation demands vigilance and a sustained commitment to defending the progress made in the fight against HIV. It requires a willingness to challenge policies that undermine public health, to advocate for continued funding for research and treatment programs, and to ensure that evidence-based science remains at the forefront of decision-making. The lessons learned from the early days of the AIDS epidemic – the importance of community organizing, the power of advocacy, and the necessity of challenging the status quo – remain as relevant today as they were decades ago.

Ongoing monitoring of federal funding allocations, research grant approvals, and policy changes related to HIV prevention and treatment will be crucial. Individuals concerned about these issues can contact their elected officials, support organizations working to protect public health, and stay informed about developments in the field. The fight to end the HIV epidemic is far from over, and requires the continued dedication and engagement of all stakeholders.