Forty-four years ago, in June 1981, the first cases of HIV/AIDS were reported in the United States. So began an epidemic that’s killed more than 39 million people around the world and 500,000 people in the U.S., according to the Centers for Disease Control and Prevention. Today, about 1.1 million Americans live with HIV/AIDs, and 38,000 new cases are diagnosed in this country each year.

HIV/AIDS is transmitted through sexual contact, drug injections and, in people with hemophilia, through blood products from donors with HIV.  In its early days, the disease was widely thought to be limited to gay men. However, when doctors discovered it could be transmitted to infants through the blood and to people with hemophilia, panic ensued, setting off a major federal prevention effort.

Today, the disease can be well-managed with medication, but prevention and education remain the best strategies to avoid contracting the infection.

Dr. Tanya Schreibman, 55, Community Aids Network’s (CAN) chief medical officer and an infectious disease specialist, joined CAN in 2008 and has focused her career on HIV/AIDs research, treatment and prevention. She discussed the changes she’s seen over the course of her career, the challenges federal funding cuts are posing to doctors and patients, and the stigma that still lingers around HIV/AIDS. This interview has been edited for length and clarity.

Why did you choose to specialize in HIV/AIDS?

“My background is in infectious diseases. I went to Cornell for undergrad and medical school and did my internship and residency at Yale and, during that time, we were starting to learn more about HIV/AIDS. Patients were getting so sick and dying—it was very different than it is today, and it piqued my interest [as a physician].

“I moved to Sarasota in 2008 and joined CAN when it was a tiny standalone clinic. It’s since grown into 30-plus clinics across the country as the care for patients has advanced. I’ve learned so much as research continues to progress, and it continues to be my passion, and something I care fervently about.”

What challenges are you facing right now?

“CAN is about empowering wellness within a specific community—those affected by HIV/AIDS, hepatitis C and sexually transmitted infections. We take care of a vulnerable community of LGBTQ+, Black and Brown people, and people in rural areas where there are already barriers to health care. In addition to the longstanding challenge of ending the HIV/AIDS epidemic, we’re facing budget cuts to state and federal funding—particularly around prevention services. That’s a huge concern for us that’s grown over the years, but particularly over the last few months.”

Why are prevention services being cut?

“I don’t know. The lifetime cost of treating one person with HIV is estimated at about $500,000. Prevention programs would cost less and would reduce long-term healthcare spending. We’re asking the same questions.”

What do prevention services look like?

“Essentially, we serve as a primary care clinic for all of our patients with HIV, hepatitis C and sexually transmitted infections. When we’re talking about prevention in terms of budget cuts, that’s specifically related to programs and medications like Pre-Exposure Prophylaxis (PrEP), which are for people who don’t have HIV/AIDS, but who are at high risk. A lot of people assume PrEP is just for gay men, but we recommend it for anyone at risk, including women, heterosexual people or people who inject drugs. It’s not only medication; it’s also a public health tool to save lives and reduce healthcare costs.”

What does the trend in HIV/AIDS diagnoses look like today? How is it different from when you began practicing medicine?

“It varies a lot, and generally speaking—in terms of cases of newly diagnosed HIV—the South and Florida are the highest, and those increases have been in the heterosexual population and more vulnerable communities. We don’t know why, but possibly because there’s less education and awareness around HIV/AIDs and access to PrEP.”

Has the stigma around HIV/AIDS changed?

“I wish I could say it’s changed more. The stigma is one of the biggest barriers to ending the epidemic. At CAN, we think of HIV/AIDS as a chronic illness that’s not any different than being diagnosed with hypertension or diabetes. But the reality is that an HIV diagnosis carries so much more weight with regard to its impact on the social and personal lives of our patients.

“There are a lot of people who don’t realize that people they know are living with HIV. And I have patients who have not told a single person, except for the people at our clinic, that they’re HIV-positive.

“I don’t know if you’ve heard the phrase ‘u = u,’ but it means ‘undetectable equals untransmittable.’ If you’re living with HIV and on treatment and have an undetectable viral load, you cannot transmit the virus sexually. It’s a powerful fact that we want people to understand—many don’t realize that. They’re still afraid to hug someone or shake their hand or drink water from their glass.”

So education is a huge part of prevention, too—and it sounds like there’s still a lot that needs to be done.

“I feel that way. It’s a big part of our mission. And even though I’m a doctor and that’s my job, I have all my [CAN-branded] canvas bags when I go to
the supermarket, and a lot of times I’ll be checking out at Publix and someone will say, ‘What does CAN stand for?’ They don’t even realize [HIV/AIDS] is a thing anymore. I think that’s largely for a good reason, because the disease is so much more controlled. The lifespan of someone with HIV who takes their medications is no different than someone who doesn’t have the illness. But because of that, it’s fallen out of the public eye.”

How did the pandemic affect your patients?

“A lot of people told us it felt almost like having PTSD. Early on with Covid, we didn’t know what was happening, we were afraid to touch anyone, we were wearing masks and washing our packages before we brought them inside, there was uncertainty as to who was at risk and we were all isolated at home. That’s how the gay community felt at the beginning of the HIV/AIDS epidemic, and the Covid pandemic reminded them of that time.”

How did it affect CAN?

“We ramped up telehealth, and it’s been revolutionary, especially for our patients who are in rural or underserved areas. It breaks down other barriers like transportation, childcare, even the stigma. We have certain patients who will only come through our back doors or will wear a wig so they can arrive anonymously and not be seen, and now they can do telehealth. It’s allowed us to meet people where they are.”

What are you looking forward to in your career?

“There’s just so much out there in terms of research and being able to move forward with treatments. CAN is a major clinical research site, and we participate in national and international clinical trials. We recently had a lot of our patients in a huge trial looking at PrEP, in which they were getting an injection every six months instead of taking a pill every day. It was such a big study that we were published in the New England Journal of Medicine in November 2024.

“Research keeps you on the forefront and provides opportunities for patients and staff. It’s the only way we’ll ever move forward with HIV.”

Our interview series “In Their Own Words” is brought to you by Gulf Coast Community Foundation.