I moved to San Diego 10 years ago — just in time for the city’s Pride celebration! The community flooded the sidewalks — LGBTQ folks and our allies — whistled and cheered as each float went by. Todd Gloria (in his pre-mayor days) gave an impassioned speech about the power of LGBTQ people coming together. I have seen that power in my own life, especially when it comes to HIV. I have been involved in the HIV movement for three decades and living with it for 25 years. I am now the executive director of Mpact Global, an international HIV organization being led from right here in the San Diego area.
After 40 years since the beginning of the fight against HIV, gay, bi and queer men continue to be a considerable and disproportionate number of new diagnoses, as well as HIV-related deaths. In 2006, activists from all over the world came together to create Mpact Global to fight against the disastrous under-resourcing in HIV funding for gay and bisexual men. Even where gay men are the overwhelming majority of HIV cases (in some countries as high as 67%), the funding for services, campaigns and organizations is never proportionate. Mpact Global was founded to increase funding and attention to the HIV community.
Now, two decades later, Mpact Global advocates with global health agencies, governments and philanthropic organizations. Whether it’s seeking the inclusion of our community in the United Nations or pushing for funding in the United States President’s Emergency Fund for AIDS Relief (PEPFAR) portfolio for LGBT organizations in the places hardest hit by HIV, Mpact Global has carried the torch.
Some of these places and initiatives have been radically transformed in the past few years. HIV is still a public health emergency, yet many countries and funders do not prioritize it. The fact that gay, bi and queer men continue to be disproportionately impacted by HIV — in terms of new diagnoses, lack of access to prevention and deaths — seems to be of little interest. Are they tired, apathetic, or is it 45 years of homophobia?
There are over 60 countries that criminalize LGBTQ people, with more places being added to that list every year. In addition, in the U.S. alone, the ACLU has tracked 529 anti-gay laws so far this year. These laws encourage violence and discrimination in our everyday lives. It takes away vital support for housing, employment and health services. It forces people to migrate if we can. And there are a limited number of places that will accept LGBTQ migrants.
As governments and funders turn away from HIV and our community, Mpact has met this moment with a recommitment to community. We recognize that when governments ignore our plight, it is our coming together that makes the difference. Regardless of laws and policies that discriminate against us, gay, bi and queer men find each other. There are more and more places passing laws against us, all over the world. As a community, we can create safe places and support each other.
Mpact has accomplished great things with our partners: built support networks, advocated for funding streams and implemented services tailored to the needs of our community. We have pushed countries to be more accepting of us, and this has meant great gains in some places for all LGBTQ people. We have confronted those in power and forced real change in institutions.
In 2026, 20 years in, Mpact Global is more necessary than ever. Gay, bi and queer men are being overlooked in HIV and in wider health concerns. Our health — physical, mental and spiritual — is still contested as if we do not deserve it. But health is a human right. We have a right to vaccines, mental health services, prevention and treatment technologies, and safety in our community and homes. We will not stop fighting for those rights.
The San Diego community has come together. The only way through this moment of brazen anti-gay attacks is by joining together, all of us across the world. HIV is not over; LGBTQ people are not disappearing. Mpact stands strong and proud at 20 and asks if you will stand with us.
Spieldenner is the executive director of Mpact Global Action for Gay Men’s Health and Rights and a North Park resident.