For World AIDS Day, December 1, 2025, Lifelong CEO James Shackelford shared this opinion editorial, published by the Everett Herald.
HIV/AIDS isn’t death sentence, but work must continue
New infections are on the decline here, but focus can’t be lost on research, testing and prevention.
Saturday, November 29, 2025 1:30am
By James Shackelford / For The Herald
They say that when you forget history, you’re likely to repeat it. That may be happening when it comes to HIV here in Washington and throughout the United States. On World AIDS Day, Dec. 1, let’s take a moment to remember the past so we can learn from it and continue to make progress.
More than 40 years into the epidemic, misunderstandings about HIV seem to be growing. As the CEO of an organization working with people affected by HIV, I see this often. People’s perceptions fall into one of three categories. Some think HIV is still a death sentence while others assume it has been cured and is no longer a concern. But too many have forgotten the epidemic altogether: its history, its toll, and the challenges that persist.
It’s true that AIDS was once fatal. It’s also true that HIV is now a manageable chronic condition; but only if people have consistent access to treatment and support. For too many, that is not the reality.
Roughly 1.2 million people in the U.S. are living with HIV, with 38,000 new diagnoses each year. An estimated 13 percent of people living with HIV don’t know their status. Nationally, Black and Latino communities, transgender people, people who use drugs, and residents of rural areas carry the heaviest burdens, facing barriers to care including racism, stigma and mistrust of the medical system.
And yet, this is also a moment of extraordinary possibility. Antiretroviral therapy suppresses viral load, restores health and prevents transmission. Tools like PrEP (pre-exposure prophylaxis) reduce the risk of acquiring HIV by more than 90 pecent. New long-acting options — like the recently approved, twice-yearly injectable, Lenacapavir — are transforming treatment for people who struggle with daily medications. And, though we still lack a vaccine, research continues to push toward one.
But progress is not inevitable. Without sustained focus and funding, these efforts will stall.
Here in Washington, we see both how far we’ve come and how far we still have to go. Seattle has been a leader in HIV research and care for decades, and 78 percent of people diagnosed with HIV in our state have achieved sustained viral suppression; well above the national average. Between 2018 and 2022, Washington saw a 20 percent decline in new HIV infections, preventing an estimated 380 infections and saving more than $210 million in lifetime medical costs.
Yet prevention and treatment tools only work when they are delivered equitably. Nearly 15,000 Washingtonians are living with HIV. While 87 percent know their status, nearly 13 percent remain undiagnosed, and communities of color continue to experience lower viral suppression rates than the state average. The inequities seen nationwide are mirrored here at home.
Meanwhile, prevention funding is shrinking, attention is shifting elsewhere, and too many people still face barriers to care.
That’s where community organizations step in. Earlier this year, I joined Lifelong, a Washington-based organization that has spent decades supporting people affected by HIV. We help clients access quality medical care, stable housing, nutritious food and other essential services. This kind of community-led outreach is critical, especially in neighborhoods where stigma is high and the medical system is viewed with skepticism.
Ending HIV as a public health threat requires sustained action at the national, state and local levels. It requires political will, equitable delivery systems, and investment in prevention and care. Most importantly, it requires remembering the past to ensure we do not repeat its mistakes.
Unlike the early days of the epidemic, we now have the tools to stop HIV in its tracks. Our task today is ensuring these tools reach everyone who needs them. This World AIDS Day, let’s commit to not repeating history. Let’s commit to finally ending HIV as a public health threat.
James Shackelford is the CEO of Lifelong, a Seattle-based organization serving people affected by HIV.