'Absolutely devastating': How Trumpcare would affect the fight against HIV.

Matthew Limpede takes a pill that gives him protection, peace of mind, and a reassuring sense of community.

That pill is the drug Truvada, more commonly referred to as "PrEP" (Pre-exposure Prophylaxis). And it's been a game-changer in the fight against HIV/AIDS.

"I think for the whole [gay] community and for me personally, [PrEP has] lifted us up to a place of being more responsible for our own health," Limpede explains.


If taken as directed, PrEP is 99% effective in stopping the transmission of HIV. It's mostly used by HIV-negative men and women who are more at risk of exposure to the virus.

Photo courtesy of Matthew Limpede.

From Limpede's own experiences, the drug isn't just about personal protection, either — it has encouraged more gay and bisexual men to have important conversations about staying safe with their sexual partners, building a sense of openness and honesty within the LGBTQ community. Those conversations have helped destigmatize those who are HIV-positive, too, he says — people who can live long and healthy lives while being sexually active.

The only way Limpede was able to get on PrEP was because of an insurance plan provided through the Affordable Care Act in 2014.

And he's definitely not the only one.

Jim Pickett, director of prevention advocacy and gay men's health at the AIDS Foundation of Chicago, says about 110,000 people across the U.S. started using PrEP between 2012 and February 2017. The ACA played a big role in making that happen.

"PrEP is quite a robust intervention," he says. "It's not just a niche thing for gay men."

Photo illustration by Justin Sullivan/Getty Images.

Making PrEP more accessible has become an increasingly important component of a broader strategy to prevent HIV among groups most vulnerable to the virus, such as transgender women, gay men — particularly gay men of color — and cisgender (non-transgender) black women, according to Pickett.

While PrEP accessibility has grown significantly in the past few years, it's just the tip of the iceberg, Pickett says. About a million more people living at high risk of HIV exposure are good candidates to go on the drug if we can just keep expanding efforts where they're needed most.

Under the current Congress and administration, however, that's shaping up to be quite the tough task.

If the Affordable Care Act is repealed, access to PrEP would take a blow, causing a major setback in our fight against HIV/AIDS.

Image via iStock.

Without health insurance, the price tag for PrEP is about $1,500 a month. With insurance, most people pay between $0 and $500.

Without significant help from an insurer, most Americans can't afford PrEP. Through the ACA's Medicaid expansion, which mostly helped low-income folks — notably, the same groups most affected by HIV/AIDS — PrEP was made accessible in 31 states plus Washington, D.C. Other patients, like Limpede, found the drug was available for free through their ACA plans.

This progress would be reversed under the American Health Care Act, the GOP's plan to "repeal and replace" the Affordable Care Act (aka Obamacare). In the new proposal — one that would cause an estimated 24 million Americans to lose their health care coverage over the next decade — the ACA's Medicaid expansion would phase out. As a result, thousands of people — again, mostly the at-risk groups who desperately need it — would lose access to PrEP.

Photo by Chip Somodevilla/Getty Images.

New HIV diagnoses fell 19% overall from 2005 to 2014, according to the CDC (although progress has been uneven depending on demographics, with some groups seeing increases). With repealing the ACA, we risk reversing this long-term trend.

"If Trumpcare were to be enacted as written, it would be a devastating blow to all of our HIV efforts, both care and prevention," Pickett says. "It would be absolutely devastating."

"If less people are on PrEP, we'll have more HIV infections," Pickett emphasizes. "HIV is forever — that's a cost forever — and that's an increased burden on a system that's overburdened."

Although living a long and healthy life while being HIV-positive is possible, that's only the case for people with access to ongoing health care and treatments that don't come cheap or easy.

For people like Limpede, who has even contemplated moving from Texas to Massachusetts if it means keeping his health care and PrEP access intact, tossing aside life-changing provisions isn't just politics as usual.

It's deeply personal.

"Repealing something like this — that's going to hurt minorities, that's going to hurt people who are low on the socioeconomic scale. It feels very pointed and purposeful," he says. "That's definitely a concern."

Image via iStock.

The HIV/AIDS advocacy community is getting ready for a battle because this is a fight they can't afford to lose.

"The community's main focus now is making sure that Trumpcare does not see the light of day and stopping these harmful provisions in the bill from happening," Limpede says. "We're fighting tooth and nail."

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Amazon

Shopping sustainably is increasingly important given the severity of the climate crisis, but sometimes it's hard to know where to turn. Thankfully, Amazon is making it a little easier to browse thousands of products that have one or more of 19 sustainability certifications that help preserve the natural world.

The online retailer recently announced Climate Pledge Friendly, a program to make it easier for customers to discover and shop for more sustainable products. To determine the sustainability of a product, the program partnered with third-party certifications, including governmental agencies, nonprofits, and independent labs.

With a selection of items spanning grocery, household, fashion, beauty, and personal electronics, you'll be able to shop more sustainably not just for the holiday season, but throughout the year for your essentials, as well.

You can browse all of the Climate Pledge Friendly products here, labeled with an icon and which certification(s) they meet. To get you on your way to shopping more sustainably, we've rounded up eight of our favorite Climate Pledge Friendly-products that will make great gifts all year long.

Amazon

Jack Wolfskin Women's North York Coat

Give the gift of warmth and style with this coat, available in a variety of colors. Sustainability is built into all Jack Wolfskin products and each item comes with a code that lets you trace back to its origins and understand how it was made.

Bluesign: Bluesign products are responsibly manufactured by using safer chemicals and fewer resources, including less energy, in production.


Amazon

Amazon All-new Echo Dot (4th Gen)

For the tech-obsessed. This Alexa smart speaker, which comes in a sleek, compact design, lets you voice control your entertainment and your smart home as well as connect with others.

Reducing CO2: Products with this certification reduce their carbon footprint year after year. Certified by the Carbon Trust.


Amazon

Burt's Bees Family Jammies Matching Holiday Organic Cotton Pajamas

Get into the holiday spirit with these fun matching PJs for the whole family. Perfect for pictures that even Fido can get in on.

Global Organic Textile Standard: This certifies each step of the organic textile supply chain against strict ecological and social standards. Each product with this certification contains 95%-100% organic content.

Amazon

Naturistick 5-Pack Lip Balm Gift Set

With 100% natural ingredients that are gentle on ultra-sensitive lips, this gift is a great gift for the whole family.

Compact by Design (Certified by Amazon): Products with this certification are packaged without excess air and water, which reduces the carbon footprint of shipping and packaging.


Amazon

Arus Women's GOTS Certified Organic Cotton Hooded Full Length Turkish Bathrobe

For those who love to lounge around, this full-length organic cotton bathrobe is the way to go. Available in five different colors, it has comfortable cuffed sleeves, a hood, pockets, and adjustable belt.

Global Organic Textile Standard: This certifies each step of the organic textile supply chain against strict ecological and social standards. Each product with this certification contains 95%-100% organic content.

Amazon

L'Occitane Extra-Gentle Vegetable Based Soap

This luxe soap, made with moisturizing shea butter and scented with verbena, is perfect for the self-care obsessed.

Compact by Design (Certified by Amazon): Products with this certification are packaged without excess air and water, which reduces the carbon footprint of shipping and packaging.

Amazon

Goodthreads Men's Sweater-Knit Fleece Long-Sleeve Bomber

For the fashionable men in your life, this fashion-forward knit bomber is an excellent choice. The sweater material keeps it cozy and warm, while the bomber jacket-cut, zip front, and rib-trim neck make it look elevated.

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Amazon

All-new Fire TV Stick with Alexa Voice Remote

Make it even easier to access your favorite movies and shows this holiday season. The new Fire TV Stick lets you use your voice to search across apps. Plus it controls the power and volume on your TV, so you'll never need to leave the couch! Except for snacks.

Reducing CO2: Products with this certification reduce their carbon footprint year after year. Certified by the Carbon Trust.

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If the past year has taught us nothing else, it's that sending love out into the world through selfless acts of kindness can have a positive ripple effect on people and communities. People all over the United States seemed to have gotten the message — 71% of those surveyed by the World Giving Index helped a stranger in need in 2020. A nonprofit survey found 90% helped others by running errands, calling, texting and sending care packages. Many people needed a boost last year in one way or another and obliging good neighbors heeded the call over and over again — and continue to make a positive impact through their actions in this new year.

Upworthy and P&G Good Everyday wanted to help keep kindness going strong, so they partnered up to create the Lead with Love Fund. The fund awards do-gooders in communities around the country with grants to help them continue on with their unique missions. Hundreds of nominations came pouring in and five winners were selected based on three criteria: the impact of action, uniqueness, and "Upworthy-ness" of their story.

Here's a look at the five winners:

Edith Ornelas, co-creator of Mariposas Collective in Memphis, Tenn.

Edith Ornelas has a deep-rooted connection to the asylum-seeking immigrant families she brings food and supplies to families in Memphis, Tenn. She was born in Jalisco, Mexico, and immigrated to the United States when she was 7 years old with her parents and sister. Edith grew up in Chicago, then moved to Memphis in 2016, where she quickly realized how few community programs existed for immigrants. Two years later, she helped create Mariposas Collective, which initially aimed to help families who had just been released from detention centers and were seeking asylum. The collective started out small but has since grown to approximately 400 volunteers.