[Interview] HIV nears a cure -- but stigma still holds us back
“We can end HIV epidemic. But before that, we must break down the invisible walls built by fear and misunderstanding.”
Ryan McKeel, Public Affairs Executive Director at Gilead Sciences, assesses that the HIV treatment landscape has moved past an “era of innovation” and has now entered a pivotal point toward eradication.
Indeed, HIV is now a manageable chronic disease with once-daily medication, and pre-exposure prophylaxis (PrEP) has advanced to prevent over 99% of infections. However, unlike technological progress, societal understanding has been slow to advance. The social stigma surrounding people living with HIV remains deeply entrenched.
Since the 1980s, when HIV/AIDS instilled global fear, the disease has transformed over the past 40 years—from a fatal illness to a condition one can live with—thanks to dramatic advancements in medical technology. Gilead has been at the center of this transformation. Yet, while the lives of people living with HIV have changed, societal perception has not evolved as easily.
“While working in the media, I saw, heard, and reported on the early days of HIV/AIDS. At the time, San Francisco had extremely high infection and mortality rates, and many people died without treatment.”
McKeel has been at the heart of change surrounding HIV, having transitioned from a journalist to Head of Communications at the San Francisco AIDS Foundation, and now a Public Affairs Executive Director at a global pharmaceutical company. Through these diverse roles, he has experienced the gap between scientific progress and public perception more profoundly than most.
The reality: treatment exists, but visiting the hospital remains difficult
While treatment is available, many still avoid visiting medical facilities—fearing stigma and discrimination that may arise the moment they are diagnosed. This is also true in South Korea.
“Many people hesitate even to get tested for HIV, and some have vague fears about living alongside someone with HIV. That is why it is essential to recognize HIV/AIDS as a public health issue within our society and begin the process of normalization.”
Normalization refers to creating a societal atmosphere where people living with HIV are viewed no differently than patients with other chronic conditions. However, Korea has yet to reach that stage. In some hospitals, even healthcare professionals are reluctant to treat people living with HIV. Discrimination also frequently occurs in workplaces, schools, and insurance companies after an individual’s HIV status is disclosed.
McKeel identifies “information and education” as the solution to this issue.
“If we share more about what life is really like for people living with HIV—how they are receiving treatment and leading ordinary lives—these barriers can gradually be dismantled.”
He describes HIV-related stigma as the shadow of an infectious disease. While the virus itself can be suppressed with medication, the fear and prejudice engraved in people’s minds are much harder to erase.
How the San Francisco model was realized
McKeel’s experience in San Francisco reflects a city that implemented an integrated model of HIV prevention and treatment. NGOs, healthcare institutions, city government, and communities worked together toward a shared goal.
“San Francisco has made long-term, large-scale investments at the city level in addressing HIV/AIDS. Multiple institutions, including the public health department, moved in a coordinated direction with a unified voice, which made such efforts possible.”
He emphasizes the importance of prevention education. During his time at the AIDS Foundation, he was the first to plan and launch a website providing HIV prevention information. At the time, prevention was not seen as informational but rather a taboo topic. This groundbreaking initiative later spread nationwide, laying the foundation for HIV prevention strategies across the U.S.
“At the time, there were almost no HIV prevention options available, and people had to wait one to two weeks for test results. I still vividly remember trying to create educational content and introduce the concept of prevention in an era with no information.”
Language is part of treatment: how communication changes the reality of stigma
HIV stigma is not straightforward. It can manifest not only as overt discrimination but also through subtle reactions from medical staff or a single word in a media report.
“Stigma exists in many forms and is difficult to clearly define. It can appear in healthcare settings, articles, workplace environments—virtually anywhere.”
McKeel notes that stigma is evolving. While stigma in the past was primarily based on fear and exclusion, today it more often stems from ignorance. For example, individuals may face discrimination despite being non-infectious simply because others do not understand PrEP.
The solution lies in education and communication—but not through one-sided dissemination. It must be interactive communication with the community. The voices of people living with HIV must be heard, and the language used must reflect their preferences.
“It is essential to listen to how community members prefer to be referred to and how they wish to be described. This feedback should be reflected in actual language usage.”
Respect begins with language
McKeel has witnessed firsthand how each expression used in HIV/AIDS reporting can shape public perception of people living with HIV. He continues to place significant weight on the role of language in bridging the HIV community with broader society.
“I have always emphasized how important word choices are. Rather than 'people infected with HIV,' I believe the expression 'people living with HIV' is more accurate and conveys respect for the community.”
He stresses that this kind of language is not merely for political correctness but is a practical tool that can improve access to treatment and support self-expression within the community.
“Refining our language, using respectful terminology, and creating an environment where people can comfortably talk with their families about what they do—this is where change begins.”
He compares efforts to end HIV stigma to combating climate change, believing that everyday attitudes ultimately drive collective transformation.
A preventable infection—yet PrEP Remains Inaccessible
PrEP is a decisive tool in preventing HIV infection. However, in South Korea, access to and information about PrEP remain limited. Institutional support is lacking, and while some government assistance is available, individuals still bear the cost. High-risk groups—such as sexual minorities, youth, and migrants—are especially vulnerable to structural marginalization.
McKeel highlights that the core of the San Francisco model was its convenient accessibility.
“The care pathway was designed so that people could be tested not only for HIV but also for hepatitis B and C, and then easily move on to receiving prescriptions.”
However, this system did not materialize overnight. Considerable time and effort were needed to help communities understand and accept preventive options.
“No matter how effective an innovation may be, it always takes time for people to adopt and become familiar with it.”
For PrEP expansion in Korea, what is needed is not technology, but awareness and policy will. McKeel states:
“Everyone should be able to make informed decisions about their sexual health as a natural part of life.”
The road to a cure -- Gilead’s journey continues
Gilead remains a global leader not only in HIV treatment but also in prevention strategies. However, McKeel emphasizes that what matters most at this moment is not technology, but connection.
“Gilead is not a company that stops with its current achievements. We are going beyond once-daily oral treatments and are developing new forms such as injectables and long-acting formulations.”
As he states, Gilead is investing significant resources into research and development with the goal of curing HIV—a challenge that goes beyond mere disease management.
Gilead was the first company in the world to develop a curative treatment for hepatitis C. The company is now determined to rewrite that history for HIV.
“Gilead was the first company to develop a curative therapy for hepatitis C. We aim to become the first to create a curative therapy for HIV as well.”
However, McKeel continues to stress that it is not just about technology—it is about attitude. Without ensuring access to information, building trust with communities, using respectful language, and addressing institutional discrimination, even the best curative technology cannot reach society.
South Korea has the will to change
During his visit to Korea, he shared that he was deeply impressed by the local HIV community. He said he found hope in the fact that healthcare professionals, activists, and community leaders were not speaking from resignation, but from a belief in the possibility of change.
“Instead of saying 'nothing will ever change,' I saw people actively asking, 'What can we change?' That is truly encouraging.”
Tasks that Korean society can realistically pursue include national insurance coverage for PrEP, expanding anonymous testing, implementing school-based sexual health education, and developing media reporting guidelines on HIV. Now is the time for policy, not just awareness, to lead.
He also spoke directly to Korean journalists—noting that their role is not merely to report incidents, but to help create societal turning points through the power of language. To policymakers, he appealed for a shift in perspective—to view people living with HIV not as subjects of protection, but as equal citizens.
McKeel spoke once again, in a calm and steady voice.
“Anyone may have the desire to make a big change in this field, but I believe it is the accumulation of small, repeated efforts that ultimately leads to meaningful transformation.”
As he suggests, while medication can suppress the virus, fear and prejudice remain in people’s hearts. That is why what is needed now is language that erases stigma, and a social attitude that achieves normalization. The era that dreams not only of a cure, but of liberation from stigma, is now within reach.