Calls to action as CROI opens under cloud of uncertainty

The annual Conference on Retroviruses and Opportunistic Infections (CROI 2025) opened in San Francisco on Sunday (9 March) under a cloud of uncertainty related to the Trump administration’s suspension of government funding and attacks on health and science.

“We are facing a cataclysmic and cruel precipitous disruption of HIV services,” said conference chair Diane Havlir, MD, of the University of California San Francisco. “We condemn the censoring of science, the targeting of scientists, their institutions and the communities they serve, the withdrawal of funding for research and the abrupt withdrawal of programs based on evidence-based advances that we have made in science for both [HIV] treatment and prevention.”

The CROI Foundation and program committee echoed the message in a media statement.

“We recognize that this year’s meeting is taking place in a time of tremendous apprehension and uncertainty as a result of recent actions by the U.S. government. We stand united with our colleagues and partners in this country and around the world as together we navigate these difficult times,” they wrote. “Indeed, in times like this, it is more crucial than ever for the scientific and advocacy communities to come together to support research and forge a path that enhances the lives of people around the world.”

Havlir and others stressed that investments in HIV research have laid the foundation for advances in other fields, including vaccines, gene therapy, cancer immunotherapy and hepatitis B and C.

“HIV science has advanced our understanding and treatment of myriad other conditions,” said Katharine Bar, MD, of the University of Pennsylvania. “As we gather together to celebrate science, we must acknowledge that science and humane medical care are under attack. One component of our collective response must be to protect, to advocate for and to redouble our efforts to communicate to the general public the immense benefits of HIV science to people with HIV, to people with other conditions, and to society in general.”

This year’s CROI brings together more than 3,700 participants, including 40% from outside the United States. Several presentations—especially those addressing the diversity of people living with HIV—were withdrawn from the program, but more than 90% of selected abstracts will be presented. The conference will allow virtual presentation for delegates from the Centers for Disease Control and Prevention, the National Institutes of Health, and other federal agencies who are unable to attend due to funding cuts and travel restrictions.

Unlike some past conferences, this year’s CROI is not expected to feature major breakthroughs, such as twice-yearly PrEP or doxyPEP, but many sessions will focus on implementation of recent advances and efforts to make them available to those who need them most worldwide.

Do Not Crumble in Despair

Introducing CROI’s Martin Delaney Presentation, long-time advocate Dawn Averitt paid homage to Delaney, the founder of Project Inform, who died of liver cancer in 2009. “Marty was an ally,” she said. “He was not HIV positive himself, and I think that’s important right now, because this is a moment in time when we’re realizing how critically important being an ally really is.”

The annual lecture was given by Rebecca Denison, who was diagnosed with HIV days before the 1990 International AIDS Conference in San Francisco. Inspired by the week of protests surrounding the conference, she joined ACT UP and went on to found WORLD (Women Organized to Respond to Life-threatening Diseases), an education and support group for women with HIV, that initially operated out of her living room in Oakland.

Denison, who was a long-term non-progressor before the advent of effective combination antiretroviral therapy (ART) in the mid-1990s, decided to pursue her long-time dream of starting a family. She had twin girls, one of whom was at the talk days ahead of her 29th birthday, along with Dennison’s HIV-negative husband of 40 years.

“The HIV positive people you interact with need to know that they can have—and deserve to have—healthy, long, loving relationships, and that their partners can remain HIV negative and that they can have families,” she said.

“A lot has happened since my diagnosis 35 years ago. HIV has gone from a death sentence to what should be a chronic, manageable disease. Today, we have so many drugs that work, I can no longer name them all,” Denison continued. “It’s easy and dangerous to take all the progress for granted. Many of the more recently diagnosed people living with HIV have never known a time without the AIDS Drug Assistance Program, the Ryan White CARE Act or PEPFAR, but as long-time activist Lauren Jones said before she died, somebody fought for you to have that service, and if you don’t fight to protect it, you could lose it.”

“The work our president now threatens to cut as waste and abuse is work that has saved millions of lives,” she said. “Many of us believe they started the assault on democracy by cutting programs that serve Africans, undocumented immigrants and transgender kids because they thought that Americans would let them. Pick on the most vulnerable, and they would get away with it even if they broke the law, which they have many times. This is a coup. We have to fight back, and we have to call it what it is.”

“Because of scientists—including many of you—millions of lives have been saved, but these advances will mean nothing if people can’t access the treatment and care,” Denison told CROI attendees. “What does the world look like when people can’t get ART? I remember what it looked like 30 years ago, and it wasn’t good. We can’t go back. I can still remember the names of opportunistic infections like cryptosporidiosis, pneumocystis, cryptococcal meningitis, because every one of those words brings back the memory of a friend who is no longer here.”

By Liz Highleyman

SEE ALSO:

• Infectious Disease Special Edition: CROI chair calls disruption of HIV services ‘cataclysmic and cruel’
• AJMC: Global status of HIV/AIDS pandemic takes center stage in opening session
• Infectious Disease Special Edition: People with HIV can have lives