If we were serious about ending HIV, this drug would be free.
But we’re not. We’re serious about profit margins. About shareholders. About protecting the divine right of executives to squeeze blood from the poor—especially queer, racialized, and vulnerable communities who’ve already buried enough bodies to know how this ends.
In June 2025, the FDA approved Lenacapavir, a twice-a-year injection that can prevent HIV transmission with near-total effectiveness. It costs $25 to manufacture. Gilead is charging $28,218 per year. That’s over 1,000x markup—on a drug that could make HIV a historical footnote.
And yet, here we are. Letting a private company with a criminal history of price gouging decide who gets to live and who gets to die.
You can be arrested for charging $40 for a handjob. But apparently, charging $28,000 for prevention? That gets you a board seat and a bonus.
This isn’t a medical breakthrough. It’s a hostage situation.
Lenacapavir is now the most effective PrEP option on the market—and the most unaffordable. It was developed with years of public research. And yet, in 2025, the people most at risk of HIV transmission are still being told: Pay up, or roll the dice.
Let’s be clear: This isn’t about recouping costs. It’s about gatekeeping life itself. It’s about making sure queer bodies remain profitable. Gilead isn’t curing a crisis—they’re prolonging one.
They could end HIV transmission. They chose quarterly profits. That’s not a miracle of science. That’s a failure of humanity.
Gilead didn’t do this alone. And that’s the part they hope we forget.
Because behind every “miracle drug” headline is a graveyard of effort:
- Public grants.
- Government-funded research.
- Tax breaks and lobbying write-offs.
- Donations from exhausted queer people still dancing, running, biking, stripping, and starving themselves on GoFundMe to scrape together funds for someone else’s treatment.
You don’t get to call that innovation. That’s inheritance. And it was never yours to hoard.
Lenacapavir isn’t a gold mine they discovered—it’s a community-built lifeboat they’ve decided to rent out at yacht prices.
Let’s put this in context: We’ve held marathons, sold chocolate bars, thrown underwear parties, shaved heads, staged vigils, sacrificed dignity and years of life expectancy just to keep people alive. And now that the science finally caught up, Gilead wants to act like it was all a startup hustle?
I hope there’s a pandemic of Luigi Mangiones. Not the man, but the moment—that flash where someone finally says, “Enough of this.” When the mask slips and the crowd realizes the emperor isn’t just naked—he’s looting the clinic and selling it back to us by subscription.
There’s a lie we keep telling ourselves—that good things trickle down, that innovation is expensive, that the system will “balance out” if we just give it more time.
No. The system isn’t broken. It was never designed to serve the vulnerable. It exists to convert collective hope into quarterly profit. And HIV—our trauma, our fight, our history—has become their business model.
We’ve been polite. We’ve been grateful. We’ve tried to meet the system halfway. But you cannot reform something that’s functioning exactly as intended.
This isn’t a call to reform. It’s a call to rupture.
Because when life-saving medicine costs $25 to make and $28,000 to access, you’re not looking at healthcare. You’re looking at a hostage situation with a logo.
Footnote
Let’s be clear: When I referenced a “pandemic of Luigi Mangiones,” I wasn’t calling for violence—I was calling for a reckoning.
Luigi Mangione has been labelled a terrorist for allegedly responding to a system that denied the sick their last chance at care—and their right to live and die with dignity. I am not celebrating a broken system. I’m pointing out what it takes for people to finally look up from their shareholder reports and notice the bodies.
Meanwhile, the CEOs and boardrooms responsible for decades of avoidable death are still treated as thought leaders.
My fight—and the fight of others like me—is for truth, for access, and above all, for dignity. Speaking up against institutional cruelty is not terrorism. Demanding that people don’t suffer because they can’t afford survival is not extremism.
If you’re more outraged by my tone than the fact that people are still dying by design—you’re defending the design.
If this makes you uncomfortable? It’s because you’re the problem. It’s you.
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