In recognition of his decades of advocacy on behalf of LGBTQ people and people living with HIV, Paul Aguilar was named the Lifetime Achievement Grand Marshal for San Francisco Pride 2023. The city’s Pride parade was held Sunday, June 25.

“Our Grand Marshals represent a mix of individuals and organizations that have made significant contributions to the lesbian, gay, bisexual, transgender community,” SFpride.org reads. “With the help of community input, Pride selects these groups and individuals in order to honor the work they have put into furthering the causes of LGBTQ+ people.”

Aguilar, who has been living with HIV since late 1988, has dedicated his life to HIV advocacy. In 2022, the annual POZ 100, which that year celebrated Latino advocates, featured Aguilar on its list. Aguilar is currently doing his part to further HUV science as a participant in a University of San Francisco study focused on monthly injections as a replacement for daily antiretroviral pills to treat HIV.

“In August of 1981, my first friend died, and they [my friends] haven’t stopped [dying] for 41 years, which is why I do these studies and I’m part of these—that’s to honor those who haven’t made it this far,” Aguilar said in a CBS profile on him and the study (you can watch the KPIX/CBS video at the top of this page).

For many people, the burden of taking pills every day can be a source of anxiety for numerous reasons. For example, the pills may serve as a constant reminder of people’s status. Some folks may have trouble remembering to take their meds, while and others worry that people may discover their meds and, therefore, learn of their HIV status. Monthly injections have proved to help alleviate these stressors.

Aguilar told CBS that he has watched HIV treatments evolve since his diagnosis. In addition to monthly injections, he receives two supplemental injections every six months to maintain his treatment and keep his viral load low. “It’s a godsend. I mean, it really is one less thing off my mind,” he said. “This is a game changer, I think, for a lot of people.”  

The study Aguilar is involved is examining whether monthly injections can help people who struggle taking pills every day. Monica Gandhi, MD, MPH, the medical director at Ward 86, UCSF’s HIV and AIDS clinic, where the study is being conducted, told CBS that about 10% to 20% of patients struggle with oral therapies.

On the day of the Pride parade, Gandhi tweeted support of Aguilar—and Ward 86—along with photos. "Very proud of #PaulAguilar as one of the #GrandMarshals of the San Francisco PRIDE Parade,” she wrote, adding “#Ward86 has a special place in the city’s history in terms of PRIDE being the oldest HIV clinic serving publicly-insured patients-we have a float each year”

The treatment used in the study, sold under the name Cabenuva (cabotegravir/rilpivirine), was approved by the Food and Drug Administration in 2021 and marked the nation’s first complete long-acting injectable HIV treatment.

“I actually think this is pretty huge. I really think it could change the trajectory of HIV,” Ghandi said. “It really changes your life if you don’t have to take a pill every day.” 

Aguilar hopes the study will lead researchers to better understand and treat people aging with HIV, adding that the burden of daily pill treatment particularly affects people who don’t have housing or who aren’t comfortable taking medication around others.

“Forty years ago, when AIDS first hit, Ward 86, Ward 5B, San Francisco, changed the way the medical community treats patients, it was worldwide, it was universal,” Aguilar said. “There’s a lot of unmet needs out there, but we’re still working on it.”

The 2022 POZ 100 profile on Aguilar reads in part:

A published writer, videographer and artist, Paul Aguilar is a third-generation San Franciscan of Mexican descent who was diagnosed with HIV in 1988 at age 25. He has long been a committed HIV and AIDS advocate and service worker. He volunteered at the Shanti Project for many years and is a member of the HIV Advocacy Network and chair of the HIV Caucus of the Harvey Milk LGBTQ Democratic Club. He’s also a resident and board member of Marty’s Place, the only self-governing affordable housing cooperative for people living with HIV and AIDS in the United States.

In related news, see the POZ feature “Going Long: Long-acting therapies are the future of HIV treatment and prevention,” which is from the latest issue. Also check out the March 2023 feature “Ward 86 at 40: The San Francisco HIV clinic has pioneered innovations that have been adopted worldwide.”