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About 9% of men and 11% of women in the U.S. have faced fertility issues. These challenges may feel overwhelming, but there are a variety of treatment options for both male and female infertility to support your family building journey.

Here’s an overview of the causes and symptoms of male and female infertility and common fertility treatments.

Infertility, Explained

About 9% of men and 11% of women in the U.S. have faced fertility issues. These challenges may feel overwhelming, but there are a variety of treatment options for both male and female infertility to support your family building journey.

Here’s an overview of the causes and symptoms of male and female infertility and common fertility treatments.

Infertility, defined as the inability to get pregnant after twelve months or more of unprotected sex, is a health condition that affects both men and women. Approximately one-third of infertility cases stem from a female reproductive factor, one-third stem from a male reproductive factor, and one-third stem from a combination of both or unknown causes.

These are some common causes of female infertility.

The majority of female infertility cases are caused by problems with ovulation, the release of a mature egg from the ovaries. There are several causes of ovulation disorders, including the following.

Polycystic ovary syndrome (PCOS), a condition characterized by a hormone imbalance that impacts ovulation. It is the leading cause of female infertility.

Excessive exercise, eating disorders, or stress, each of which can result in hormonal imbalances

Primary ovarian insufficiency, sometimes referred to as premature ovarian failure

Fallopian tube damage or blockage can prevent sperm from reaching an egg, or fertilized eggs from attaching to the uterus. Common causes of fallopian tube damage or blockage include pelvic inflammatory disease — an infection of the uterus and fallopian tubes from chlamydia, gonorrhea, or other sexually transmitted infections — or a prior surgery in the abdomen or pelvis, including surgery for ectopic pregnancy.

Uterine or cervical issues such as the following can disrupt the implantation of an egg into the uterus or increase a woman’s risk for miscarriage.

Benign polyps or fibroids may block fallopian tubes or interfere with the implantation of an embryo. However, many women with these growths are able to conceive.

Structural issues with the uterus that are present at birth

Cervical stenosis, a narrowing of the cervix

Endometriosis is a condition in which tissue that should only grow in the uterus implants and grows elsewhere. The abnormal tissue growth — as well as surgical procedures to remove it — can block the fallopian tubes, preventing the fertilization of an egg. In some cases, endometriosis may interfere with implantation of the fertilized egg, or embryo.

Male infertility is most often an issue of sperm production — including the quantity and quality of sperm produced — or of sperm mobility, which affects the sperm’s ability to find and fertilize an egg. A blockage in the testicle or damage to the reproductive organs can also contribute to male infertility.

Age is a factor in both male and female fertility issues. The quality and quantity of a woman’s eggs begin to decline as she enters her mid-thirties, and age factors into the success rates of in vitro fertilization (IVF).

Many individuals and couples first learn of a fertility issue after trying to conceive without success, and the primary symptom of infertility is the inability to get pregnant. There aren’t always noticeable symptoms, but the following may indicate an underlying fertility problem.

A menstrual cycle that’s irregular, absent, longer than 35 days, or less than 21 days

Unusually light or heavy bleeding during menstrual cycles

Erectile dysfunction or low sex drive in men

The timeline for seeking fertility treatment depends on your age. If you are under the age of 35, most health experts suggest consulting a reproductive specialist after a year of trying to conceive. If you are between 35 and 40, you may want to pursue testing or treatment after six months of trying to become pregnant. And if you are over 40, you may want to pursue testing or treatment before you start trying to conceive.

An evaluation for fertility issues and potential treatment begins with a conversation about your health history. Several tests may be used during the diagnostic process, including the following.

An hysterosalpingogram (HSG), an x-ray taken to examine issues within the uterus and fallopian tubes

Blood tests to measure hormone levels related to fertility and reproduction

Ovarian reserve testing, which evaluates the number of viable eggs in your ovarian reserve. These are typically used for women over 35 or those at risk of a low egg count for other reasons.

A semen test is used to diagnose most cases of male infertility. This identifies how many sperm you produce and whether the sperm are normal in shape and movement — healthy sperm have an oval head and long tail. In some cases, additional blood tests and/or genital ultrasounds may be used to rule out other health conditions.

Fertility problems do not mean that you won’t be able to have children biologically. There are many treatment options that can help increase your chances of conception. The most effective course of treatment depends on the underlying cause of your or your partner’s fertility issues. These are among the most common fertility treatments.

Forms of assisted reproductive technology (ART) including in vitro fertilization (IVF), a process in which eggs and sperm are fertilized in a laboratory and then placed into the uterus with the potential outcome of a pregnancy. In addition to treating female infertility, IVF can also be used when male infertility is a factor.

Intrauterine insemination (IUI), a type of artificial insemination in which sperm that have been washed and concentrated are placed directly into a woman’s uterus during ovulation.

Injectable fertility medications including gonadotropins and oral fertility medications such as Clomid® and Femara® can treat fertility-related hormonal imbalances.

Your doctor may also recommend lifestyle changes or treating a related health condition.

A fertility pharmacy partner you can rely on

Since 2016, Alto has supported more than 50,000 fertility journeys. We understand that fertility treatment is a significant investment — physically, emotionally, and financially — and we see ourselves as a partner in your health.

We offer free, same-day delivery seven days a week and temperature controlled packaging to ensure that your fertility medications always arrive in the right condition. And our fertility-trained pharmacists are available until 9 pm PST (12 midnight EST) on weeknights to offer any support you need.

Reach out any time via phone at 1-800-874-5881, or in-app messaging.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

All third party trademarks (including logos and icons) referenced by Alto Pharmacy remain the property of their respective owners. Unless specifically identified as such, Alto’s use of third party trademarks does not indicate any relationship, sponsorship or endorsement between Alto and the owners of these trademarks.

Resources for Affording HIV Medication

The HIV treatment and prevention landscape continues to evolve, with many effective medications. Antiretroviral therapy (ART), the frontline treatment for HIV since 1997, is a combination of medications that lower the amount of HIV in your bloodstream. When taken as prescribed every day, ART can help individuals with HIV achieve and maintain an undetectable viral load. As a result, more than half of all those living with HIV in the U.S. are not at risk of transmitting the virus to others.

On the prevention front, PrEP, or pre-exposure prophylaxis, can lower risk of sexual transmission of HIV by 99% when taken daily and reduces the risk of getting HIV from intravenous drug use by about 74%.

For many individuals, cost is a barrier to both starting and continuing to take ART and PrEP as prescribed. Fortunately, HIV prevention medication and treatment continue to become more accessible, with generic PrEP options and expanded health insurance coverage of PrEP and ART. In addition, the following resources, including patient assistance programs and copay savings cards from medication manufacturers, can help reduce the cost of HIV treatment and prevention medication.

Read on to learn more about eligibility for these programs, and revisit our previous post on state-funded PrEP drug assistance programs.

Many pharmaceutical companies have patient assistance programs (PAPs) to offset the cost of prescription medications for individuals without insurance or with insufficient insurance coverage. If Alto is your pharmacy partner for HIV treatment or prevention, your medication protocol may include medications manufactured by Gilead, which offers the PAP outlined below.

If your medications are manufactured by a different company, contact them directly to learn about any available financial assistance including PAPs.

Gilead's Advancing Access® Patient Assistance Program

Gilead's Advancing Access Patient Assistance Program provides medication free of charge to individuals without insurance who meet program eligibility criteria. There are several ways to learn if you are eligible:

Call 1-800-226-2056 (Monday-Friday, 9 am to 8 pm EST)

Print the enrollment form and submit it via fax

Copay savings cards from pharmaceutical manufacturers can help offset the cost of prescription medications for individuals with insurance. If Alto is your pharmacy partner for HIV treatment or prevention, your medication protocol may include medications manufactured by Gilead or ViiV Healthcare, which offer the copay savings cards below.

If your medications are manufactured by a different company, contact them directly to learn about any available financial assistance including copay savings cards.

Gilead’s Advancing Access copay savings card

Gilead also offers a copay savings card for individuals with insurance to reduce the cost of copays. Those who are enrolled in any state or federally funded prescription medication program such as Medicare Part D and Medicaid, or who are in the Medicare Part D prescription coverage gap, are not eligible.

Learn more about program eligibility and terms and conditions.

The ViiVConnect Savings Card Program helps eligible individuals with commercial insurance save on copay costs for select ViiV Healthcare medications. Those who are enrolled in any state or federally funded prescription medication program such as Medicare Part D and Medicaid, or who are in the Medicare Part D prescription coverage gap, are not eligible.

If you do not have insurance coverage of prescription medications, contact 1-844-588-3288 to learn about additional financial assistance opportunities from ViiV.

Created to help individuals living with chronic health conditions access the treatment they need, the PAN Foundation offers financial assistance for medication costs, copays, and insurance premiums.

Learn what financial assistance you are eligible for.

The Ready, Set, PrEP program provides PrEP at no cost to eligible individuals without insurance coverage of prescription medications.

Learn more about program eligibility and the application process.

Your financial well-being is our priority

At Alto, we understand how stressful it can be to navigate insurance coverage benefits and savings opportunities. We prioritize your financial wellness, working with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to make ART or PrEP as affordable as possible. In addition to automatically applying coupon savings, we’ll connect you with any outside programs that require you to apply directly.

We also offer free, same-day delivery to make it as easy as possible to stay on track with treatment, and our dedicated HIV support team is here to answer any questions you may have about ART or PrEP. Reach out any time via phone at 1-800-874-5881, or in-app messaging.

Alto’s mission is to improve the quality of life for all who need medicine, building a pharmacy experience that serves people of all backgrounds. As we work toward a more inclusive and accessible healthcare system, we recognize the importance of diversity among physicians, pharmacists, nurses, and other public health figures. In honor of Black History Month, take a moment to learn about five influential Black healthcare leaders past and present — those who paved the way and those who continue to break barriers today

Five Black Healthcare Leaders to Celebrate

Alto’s mission is to improve the quality of life for all who need medicine, building a pharmacy experience that serves people of all backgrounds. As we work toward a more inclusive and accessible healthcare system, we recognize the importance of diversity among physicians, pharmacists, nurses, and other public health figures. In honor of Black History Month, take a moment to learn about five influential Black healthcare leaders past and present — those who paved the way and those who continue to break barriers today. (For additional inspiration, revisit the first post in this series.)

Dr. M. Jocelyn Elders: the first Black U.S. surgeon general

As a Black woman born to farmers in a rural, poverty-stricken area of Arkansas, M. Jocelyn Elders encountered numerous obstacles on her path to becoming the first Black U.S. Surgeon General in 1993. At 16, she met a doctor for the first time, but she didn't consider a profession in healthcare until she connected with Edith Irby Jones, the first Black person to attend the University of Arkansas Medical School, during college.

Throughout her career, Dr. Elders balanced clinical practice and research, increasing the public’s awareness of adolescent health issues. In 1987, Bill Clinton, then the governor of Arkansas, appointed Dr. Elders as head of the state’s Department of Health. The Arkansas state legislature mandated sexual education and substance misuse prevention programs in the K-12 curriculum in 1989 in large part because of Dr. Elders’ advocacy. During her tenure as Surgeon General, Dr. Elders continued to champion progressive policies, advocating for better sexual education programs, distribution of condoms in schools, and abortion rights. She remains active in the field of public health as a professor emeritus at the University of Arkansas School of Medicine.

Bernard J. Tyson: former CEO of Kaiser Permanente

As chairman and CEO of Kaiser Permanente, Bernard Tyson transformed the company’s services to account for social determinants of health like food access and affordable housing as well as the importance of mental health and wellness. He was also instrumental in the development of the Kaiser Permanente School of Medicine, which trains physicians to be not only clinicians, but patient advocates and innovators, too. By shining a spotlight on how social determinants of health contribute to disparities in health outcomes, Tyson leaves behind a legacy that reaches far beyond Kaiser’s services.

Nadine Burke Harris: first surgeon general of California

A physician, researcher, advocate, and California’s first surgeon general, Dr. Nadine Burke Harris has transformed how our society responds to childhood trauma. While running a health clinic in an underserved San Francisco neighborhood, she observed that preventative health practices and quality treatment didn’t resolve her patients’ risk for poor health outcomes. Drawing upon research from the CDC and Kaiser Permanente on adverse childhood experiences (ACEs), which linked early adversity to higher rates of chronic illness later in life, Dr. Burke Harris studied her own patients and found that more than 67% had experienced at least one ACE. She has helped increase public awareness of ACEs and toxic stress, advocating for universal screening of children and adolescents for signs of trauma. Her 2014 TED Talk, “How Childhood Trauma Affects Health Across the Lifetime,” has been viewed more than 7.5 million times, and she published The Deepest Well: Healing the Long-Term Effects of Childhood Adversity in 2018.

Dr. Patrice Harris: first Black female president of the American Medical Association

Despite not knowing any doctors while growing up in West Virginia, Dr. Patrice Harris’ passion for medicine started early. The board-certified psychiatrist initially planned to pursue pediatrics but shifted her focus after discovering an interest in psychiatry during medical school. Her focus on child psychiatry allows her to merge her passion for children with her expertise in mental health. Throughout her career, Dr. Harris has focused on the role of implicit bias within the medical profession and how unconscious biases among healthcare workers influence health disparities.

Dr. Harris’ involvement in the professional healthcare community spans many leadership positions at state and national organizations. She became the first Black woman elected as president of the American Medical Association in 2020. During her tenure, she focused on a variety of health issues, from opioid addiction to COVID-19. She previously chaired the AMA’s Opioid Task Force, providing evidence-based recommendations to clinicians with the goal of ending the opioid epidemic.

Betty Smith Williams: first Black graduate of the Frances Payne Bolton School of Nursing

Betty Smith Williams was the first Black student to earn a nursing degree from Cleveland’s Frances Payne Bolton School of Nursing, in 1954, and the first Black individual to teach at a higher education institution in the state of California, but her individual accomplishments are only a part of her legacy. Williams has helped ensure that today’s aspiring Black healthcare professionals have the opportunities and support to break down barriers of their own. She was instrumental in developing the National Black Nurses Association and the National Coalition of Ethnic Minority Nurse Associations, Inc. — initiatives that have elevated the voices of Black nurses within the profession. In uniting Black nurses, Williams hoped to create better health outcomes among the Black community. In her own words: "We had no voice, but we understood our culture and our unique needs better than anyone else.”

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An HIV diagnosis is the beginning of a lifelong health journey, and it’s understandable to experience many different emotions as you process this information. Remember that HIV is manageable, like many other chronic health conditions, and with treatment, you can live a full and active life. Though it may feel overwhelming to take action right after a diagnosis, getting started on HIV medication as soon as possible is critical to protecting your health and others. Here are the most important steps to take as you move forward.

Next Steps After an HIV Diagnosis

More than half of all individuals living with HIV in the U.S. are not at risk of transmitting the virus to others. This is a testament to the effectiveness of antiretroviral therapy (ART), the frontline treatment for HIV.

ART is a combination of medications that stops the progression of HIV and reduces your viral load — the amount of HIV in your blood — to a very low level. When taken as prescribed every day, these medications can help you maintain an undetectable viral load, which preserves the strength of your immune system and protects the health of your sexual partners. Many people living with HIV are able to achieve an undetectable viral load within six months of starting ART.

Finding a healthcare provider for HIV treatment

There are several ways to find a healthcare provider for HIV treatment. If you already have a primary care provider, they may have the experience and knowledge to treat your HIV. If not, they will likely be able to give you a referral. Similarly, if you were tested for HIV at a clinic, ask if they offer ongoing HIV treatment or can refer you elsewhere. You can also use HIV.gov’s search tool to find HIV treatment services near you.

There’s a lot of information to take in when first starting HIV treatment. Having open conversations with your doctor about your questions and concerns can help you feel empowered about your health. It may help you to prepare a list of questions before your first appointment. Here are some suggestions to use as a starting point.

How will you decide which ART medications are best for me?

How will I know if the medication is working?

What is the frequency of follow-up testing and blood work?

Are there things I cannot do because I am HIV positive?

How does HIV affect my reproductive health? (if relevant)

Learning more about HIV and preventing transmission

Living with HIV often feels more manageable when you’re equipped with facts and confident in your understanding of the condition. In addition to asking questions during doctor’s appointments, explore trusted resources like the CDC's website and HIV.gov to familiarize yourself with the basics of HIV treatment and prevention.

Many individuals are concerned about the risk of potentially transmitting HIV to a partner. There are things you can do to prevent transmission and keep your sexual partners safe. Being consistent with HIV treatment in the long term can virtually eliminate your risk of transmitting HIV to others so long as you maintain an undetectable viral load. This is why one of the most important things you can do, for both your health and others, is to start ART as soon as possible. In addition, your partner or partners may want to speak with their doctors about PrEP, an HIV prevention medication that can lower risk of sexual transmission of HIV by 99% when taken daily. Many individuals who have an HIV-positive partner take PrEP for HIV prevention.

You may be wondering who to tell about your HIV diagnosis. While sharing your HIV status with sexual partners may feel uncomfortable or scary, it will allow them to take steps to protect their health. Some states have laws that require you to share your HIV status with sexual partners. These laws also account for the risk of HIV transmission through intravenous drug use and require you to disclose your HIV status with anyone you share drugs or needles with, if relevant.

Sharing your HIV status with all of your healthcare providers is also important. It will allow them to provide individualized health recommendations, coordinate with the rest of your care team, and take appropriate precautions during blood draws and other procedures.

Many individuals living with HIV find it helpful to share their status with close friends and family as they process their diagnosis. Each person’s experience of HIV is unique, and deciding if and when to tell loved ones about your status is a personal choice. It can be helpful to hear how others decided to share their HIV status. The CDC has a collection of stories about life with HIV, and Positive Spin is another resource highlighting personal experiences of HIV.

The stress of living with any chronic condition can impact your mental and emotional well-being, and those with HIV have a higher chance of developing mental health disorders such as depression.

It’s important to take your mental health as seriously as your physical health and seek any support you need. Use your HIV treatment provider as a resource. They may be able to recommend treatment or prescribe medication, if needed, or refer you to a psychiatrist or psychologist for additional support.

Navigate HIV treatment with Alto by your side

Our pharmacists have deep expertise in HIV treatment and prevention and can help you get started with antiretroviral therapy. We will coordinate with your doctor and your insurance provider, if applicable, to ensure that you’re receiving the best option for your needs at the best price. To learn more, reach out any time through in-app secure messaging or by phone at 1-800-874-5881.

While HIV and AIDS remain urgent public health issues, the prevention and treatment landscape has transformed drastically throughout the past four decades. Breakthroughs in treatment have made it possible to stop the progression of HIV and prevent transmission of the virus to others. Read on to learn more about HIV stages, symptoms, treatment, and prevention.

All About HIV: Stages, Symptoms and Treatment

More than 40 years have passed since AIDS, the disease caused by HIV, was first identified in the United States. While HIV and AIDS remain urgent public health issues, the prevention and treatment landscape has transformed drastically throughout the past four decades. Breakthroughs in treatment have made it possible to stop the progression of HIV and prevent transmission of the virus to others. Read on to learn more about HIV stages, symptoms, treatment, and prevention.

HIV (human immunodeficiency virus) is a virus that attacks your immune system, making you more vulnerable to other illnesses. It is transmitted through contact with the blood, semen, or vaginal fluids of someone who has HIV.

If untreated, HIV can lead to AIDS (acquired immunodeficiency syndrome), which is also considered the last stage of HIV. When HIV progresses into AIDS, your immune system has been significantly weakened by the virus.

Currently, there is no cure for HIV, but taking HIV medicine called antiretroviral therapy (ART) as prescribed stops the progression of the disease. As a result, most people living with HIV in the U.S. do not develop AIDS. There are also HIV prevention medications, PrEP and PEP, which are effective at preventing the transmission of HIV through sex or intravenous drug use.

As the HIV epidemic emerged in the U.S. in the 1980s and 90s, gay and bisexual men were disproportionately affected — in part because the virus transmits more easily through anal sex than vaginal sex — and subsequently stigmatized as carriers of the virus. However, the medical community soon discovered that anyone can contract HIV regardless of gender identity or sexual orientation, as the virus can be transmitted through anal sex, vaginal sex, or the sharing intravenous drug equipment such as needles or syringes.

In recent years, there has been significant progress toward reducing the annual HIV infection rate, and new cases of HIV among gay and bisexual men ages 13-24 dropped by 33% between 2015-2019. Still, gay and bisexual men accounted for 69% of all new HIV diagnoses in the U.S. in 2019. And in recent years, Black and Latinx individuals have been disproportionately affected by HIV. Racial and ethnic discrimination and disparities in healthcare access — which can discourage people from seeking HIV prevention services and testing — factor into HIV’s outsized impact on these communities.

There are three primary stages of HIV: acute HIV infection, chronic HIV infection, and stage 3 HIV, or AIDS.

Acute HIV infection, the first stage of HIV, may develop within two to four weeks of contracting the virus. During this stage of HIV, the virus multiplies rapidly and there is a high amount of HIV in your bloodstream (also known as your viral load). While the virus replicates and spreads, it destroys your CD4 cells, a type of white blood cell that plays a role in your immune system.

Some people with acute HIV infection quickly experience flu-like symptoms including fever, chills, rash, night sweats, muscle aches, sore throat, fatigue, swollen lymph nodes, and mouth ulcers. The only way to know your HIV status is by getting tested. If you have any of these symptoms and believe you may have been exposed to HIV, seek prompt medical care and take an HIV test. Find a free and confidential HIV testing site near you..

Experiencing these symptoms does not necessarily mean that you have HIV, as they overlap with symptoms of the flu and other illnesses. And some individuals with HIV develop these symptoms later, while others never develop them at all, which is why it’s critical to get tested for HIV on a regular basis — ideally every three months. You can still transmit the virus to others even if you do not have noticeable symptoms of HIV.

During the chronic HIV infection stage, the virus replicates less rapidly than it did in the acute stage, but it continues to damage your CD4 cells and weaken your immune system.

Many people experience no symptoms or mild symptoms during this latent period, which is also sometimes referred to as asymptomatic HIV infection or clinical latency. However, just like during the acute HIV infection stage, you can still transmit the virus to others even if you are not experiencing symptoms.

Without effective treatment, your viral load will increase and your CD4 cell count will decrease as this stage of HIV progresses. You are more likely to experience symptoms of HIV when your viral load is high and your CD4 cell count is low. Taking HIV medication as prescribed can help you maintain a low or even undetectable viral load and prevent your HIV from progressing into AIDS.

AIDS is the third and most advanced stage of HIV. In this stage, your immune system is severely weakened, your viral load continues to increase, and your CD4 cell count continues to decrease. 

HIV progresses into AIDS when you have a CD4 cell count of less than 200 cells per cubic milliliter or when you develop an opportunistic infection (OI), an illness that occurs more frequently in individuals with HIV because of their weakened immune systems.

Opportunistic infections experienced by individuals with HIV include kaposi’s sarcoma, a type of cancer that develops in your blood and lymph vessels; pneumocystis pneumonia (PCP), and mycobacterium avium complex (MAC), tuberculosis-related bacteria. However, OIs continue to occur less frequently as HIV treatment becomes more effective.

There are many effective HIV treatment options that can keep you healthy and help you maintain a low viral load. The primary treatment for HIV is called antiretroviral therapy (ART), a combination of medications that lower the amount of HIV in your bloodstream.

If you take your HIV medication every day as prescribed, you can maintain an undetectable viral load. This will preserve the strength of your own immune system and prevent you from transmitting the virus to others.

Starting ART as soon as possible after you receive an HIV diagnosis is critical to lowering your risk of developing AIDS and preventing you from transmitting the virus to others. If you have tested positive for HIV, reach out to your healthcare provider right away to begin treatment.

If you have tested negative for HIV, there are important HIV prevention medications that can help you continue to protect your health: PrEP and PEP.

PrEP, or pre-exposure prophylaxis, can lower risk of sexual transmission of HIV by 99% when taken daily and reduces the risk of getting HIV from intravenous drug use by about 74%. PrEP may be right for you if you have a partner who is HIV-positive or unsure of their HIV status, or if you have multiple partners. Pharmacists in a growing number of states can now prescribe PrEP.

PEP, or post-exposure prophylaxis, is a medication taken within 72 hours of potential exposure to HIV to lower your chances of contracting the virus. It can be prescribed by a healthcare provider at emergency rooms, sexual health clinics, community-based health centers, and, in some states, pharmacies. PEP is only for emergencies and accidental exposures. If you anticipate ongoing risk of exposure to HIV, speak with your doctor about potentially taking PrEP for long-term protection.

We’re here to help you navigate HIV treatment and prevention therapies

Our pharmacists have deep expertise in HIV treatment and prevention and can help you get started with antiretroviral therapy, PrEP, or PEP. We will coordinate with your doctor and your insurance provider to ensure that you’re receiving the best option for your needs at the best price. 

Reach out any time through in-app secure messaging or by phone at 1-800-874-5881.

Editor’s Note: This post was originally published in December 2021 and has been updated for accuracy and completeness.

World AIDS Day, observed on December 1st every year, is an important reminder that progress in the global fight against AIDS requires action and awareness from each individual around the world.

Take Action for World AIDS Day 2021

World AIDS Day, observed on December 1st every year since 1988, is an important reminder that progress in the global fight against AIDS requires action and awareness from each individual around the world.

AIDS (acquired immunodeficiency syndrome) was heavily stigmatized from the beginning of the epidemic in the 1980s. Four years passed between the first cases of AIDS in the U.S. in 1981 and the Reagan administration’s first public mention of the disease. There were many misconceptions about how HIV (human immunodeficiency virus) — the virus that causes AIDS — can be transmitted and who is at risk of contracting it.

The stigma and lack of information about transmission and prevention led to many preventable cases of HIV/AIDS in the U.S. At the peak of the epidemic in 1995, complications from the disease were the leading cause of death for adults ages 25-44, and to date, more than 700,000 people in the U.S. have died from an HIV-related illness.

The HIV and AIDS landscape looks dramatically different today than it did back when World AIDS Day was first established. With greater awareness of HIV and AIDS, and more government funding of research, new HIV infections in the U.S. decreased by 73% between 1984 and 2019. Still, the fight to end AIDS isn’t over, with more than 1.2 million people living with HIV in the U.S.

In honor of World AIDS Day 2021, take a look at what has already been accomplished in the fight against AIDS and learn about what is needed next.

There were 34,800 new HIV infections in 2019

13% of those living with HIV don’t know it

57% of those living with HIV are virally suppressed (meaning they are not at risk of transmitting the virus to others)

Milestones in the history of HIV and AIDS

AIDS first emerged in the U.S. in 1981, but researchers did not learn that HIV caused AIDS until three years later in 1984. The history of HIV medication dates back to 1986, when clinical trials for azidothymidineor (AZT), the first antiretroviral HIV/AIDS medication, began. AZT was approved to treat HIV a year later.

Highly active antiretroviral therapy, often referred to as antiretroviral therapy (ART), became the frontline treatment for HIV in 1997. ART is a combination of medications that lower your viral load, which is the amount of HIV in your bloodstream. When taken every day as prescribed, these medications can help individuals with HIV maintain an undetectable viral load, virtually eliminating their risk of transmitting the virus to others.

The U.S. Food and Drug Administration (FDA) first approved a PrEP medication in 2012. PrEP, or pre-exposure prophylaxis, can lower the risk of sexual transmission of HIV by 99% when taken daily and reduces the risk of getting HIV from intravenous drug use by about 74%.

With these breakthroughs in HIV treatment and prevention therapies, the U.S. government recently announced a goal to reduce the number of new HIV infections by 75% by 2025 and at least 90% by 2030, preventing an estimated 250,000 additional cases of HIV.

Next steps in the fight against HIV and AIDS

Despite the progress that has been made in the fight against HIV and AIDS, prevention, care, and treatment remain inaccessible for many individuals at risk of contracting HIV — both in the U.S. and around the world. The theme for World AIDS Day 2021 is Ending the HIV Epidemic: Equitable Access, Everyone’s Voice, in recognition of how health inequities contribute to the epidemic.

In the U.S., racial discrimination and deeper inequities in healthcare have contributed to HIV’s disproportionate impact upon people of color. Black and Latinx individuals — particularly gay and bisexual men — are among the groups disproportionately affected by HIV. A variety of factors contribute to these disparities, including income inequality, unequal access to healthcare, and lower use of HIV prevention and treatment services. According to 2016 CDC data, white individuals accounted for 69% of PrEP use, while Latinx and Black individuals accounted for 13% and 11%, respectively.

Fortunately, HIV prevention medication continues to become more accessible, with generic medication options and expanded health insurance coverage of PrEP. And legislation in a handful of states, including California and Colorado, allows pharmacists to prescribe PrEP. There are also a number of organizations working hard to make HIV services more accessible to communities of color, like NMAC and Black AIDS Institute.

Getting an HIV test is one of the most important things you can do for World AIDS Day. Not only will learning your HIV status give you the information you need to take control of your health, it will also help combat the stigma surrounding HIV and AIDS. Each person who makes use of testing and prevention services — and each person who speaks openly about HIV and AIDS, without perpetuating fear or stigma — brings us closer to a future without AIDS.

Search for a free and confidential HIV testing site near you.

View the CDC’s HIV stigma language guide to learn the power of the words you use when discussing HIV and AIDS.

Get support navigating HIV treatment and prevention medication

At Alto, we’re committed to doing our part to make HIV treatment and prevention services as accessible as possible. Our extensive library of HIV-focused content covers the information you need to make informed decisions about your health. And if you take PrEP or ART, our team will coordinate with your doctor’s office and your insurance provider to ensure that you’re receiving the best medication option for your health needs at the lowest price.

To learn more, reach out any time through in-app secure messaging or by phone at 1-800-874-5881.

Editor’s Note: This post was originally published in November 2021 and has been updated for accuracy and completeness.

How to Take Action for World AIDS Day 2021

October 11 marks National Coming Out Day, an opportunity to celebrate all those who have come out as LGBTQ+ and recognize the courage they’ve demonstrated by choosing to be their authentic selves.

Celebrating National Coming Out Day at Alto

October 11 marks National Coming Out Day, an opportunity to celebrate all those who have come out as LGBTQ+ and recognize the courage they’ve demonstrated by choosing to be their authentic selves. In honor of this annual celebration, we sat down with two Alto team members — Ben Romero (he/they), Business Operations Manager for Health Plans and Travis White (he/him), Senior Software Engineer — who generously shared their experiences of coming out as bisexual/queer. Here are their stories, in their own words.

Ben: Like a lot of folks, I avoided coming out for most of my life. I grew up knowing that I wasn’t exactly straight and later recognized that I’m bisexual. I remember my entire experience around my sexuality being wrapped in shame. I would reluctantly conform to heteronormativity just to avoid the fear of being outed or questioned. It wasn't until college that I first felt like I could open myself up to the experience and validation that I deserved. By the time I graduated from college, I had a refreshed sense of my place in the world, but I was still hiding my sexuality from my family.

Five years after college, I was finally ready to be open with my family about being bisexual, and it was the first time I felt as if I had to “come out.” At the time I was engaged to my non-binary/queer partner. My family knew my partner as a woman, but my partner was also beginning to validate their nonbinary gender experience. All I could think about was how much of a disservice it would be to our identities as a queer couple if we started our marriage having to assume more invalidating heteronormative assumptions. I first told my closest family members — my younger brother and parents — who supported me unconditionally and showed me so much love. Not every family member was as accepting of my sexuality, which was really disappointing, but I had more than enough support from my chosen family to finally overcome the fear that I had held on to for so long. 

Travis: I realized I wasn’t completely straight at some point in high school. Growing up Catholic, I was always taught that men are attracted to women and that being gay was a sin. So when I found myself attracted to both girls and guys during high school, I wondered what was wrong with me. I brushed it off and ignored that aspect of my sexuality for a long time, which I would later come to regret since it definitely fed into ongoing anxiety and depression in college.

I first came out to my closest friends during my junior year of college. By that point, I had fully accepted that I wasn’t straight, but I had never acted on my bisexuality. I had only dated girls, so my friends saw me as completely straight. I couldn’t quite figure out how to tell them, and it ended up happening organically while hanging out on a Friday night. We were playing a game around the table that required everyone to share something no one else knew about them. Something came over me and I decided to throw caution to the wind with a, “by the way… I’m bi.”  

I came out to my parents several years later when I was working my first engineering job out of college, living in Silicon Valley and loving life. I knew that if they chose not to accept me, it was going to be their loss. After a night out (and an amazing prime rib dinner) when they were in town, I told them that there was something I wanted to tell them about myself - that I am bisexual. My dad’s first response was, “What does that mean?” I informed them that it means I am attracted to both men and women, though more recently, I’ve come to think of myself as being attracted to interesting people regardless of the gender they identify as. My parents were very supportive, but truthfully I had reached a point where I could be accepting of the worst-case scenario. 

Ben: I was most grateful for the sense of relief I experienced. Despite facing criticism and homophobia from some of my siblings after coming out, I couldn’t shake the sense of pride I felt from allowing myself to be unapologetically queer and visible. I’m finally allowing this part of me to flourish and grow. It’s liberating to be radically honest with yourself and others, regardless of what anyone else may think. I’ve now come to identify with the term queer in addition to bisexual. Part of the growth I’ve experienced involves unlearning so much of what I’ve been socialized to believe about the gender binary, and I’m just now starting to understand where I exist outside of it.  

Travis: When I came out to my friends during college, we stayed up talking until very late into the night. I left feeling a huge weight lifted off of my shoulders — and so full of love and support from some of the people I was closest to.

And later when I came out to my parents, they accepted me with open loving arms, for which I’m grateful, but I was also prepared to move forward with my life even if they did not accept me as my true authentic self.

What resources, support groups, or communities did you rely on when coming out? 

Ben: The isolation of being in the closet can sometimes lead to stories or expectations of yourself that aren’t necessarily helpful, or true. For me, as a bisexual, some of those expectations sounded like “I’m not queer enough,” “I don’t fit into the queer community,” or “people won’t believe I’m bi/queer.” I looked to my queer friends and even to LGBTQ+ advocates on social media and was relieved to find that they had many of the same fears about coming out as I did. I found that learning from other people’s experiences could help validate my own feelings, even if we had a different orientation or gender. As a queer Latinx, I also sought validation from people who shared similar intersections around my identity, which helped me navigate the concerns I had about coming out to my family.

Travis: My friends were very supportive so I was really able to lean on them. It was also helpful to just search online for other people’s coming out stories. Before I could tell my family, I knew I had to reach a point where I would be secure in my identity regardless of the outcome of that conversation. Part of the reason it’s so important to share coming out stories is because hearing other people’s experiences helps inspire you to do the same.

What advice would you give to others considering coming out? 

Ben: Above all, put your safety first. Try your best to not take on the burden of guilt for not being your authentic self — that is not a reflection of you, but a reflection of how our environment can fail to provide the validation we deserve. Take your time and build your comfort with folks who will validate your experience. There’s a whole community of people who will back you up and care for you if someone you come out to is hurtful or invalidating. 

Travis: Do it if, and when, you’re ready. You can never control how others will react, so just accept that other people’s responses have nothing to do with you. It took me years to reach that point with my family. It can be incredibly tough, and you can never know in advance how anyone will respond, but if they cannot accept you for your true authentic self, there are plenty others out there who will.

Do you have any suggestions for allies? 

Ben: I would stress the importance of familiarizing yourself with queer history and how our struggle for acceptence has evolved over the years. The LGBTQ+ community and allies have so much to be proud of today, like the repeal of “Don’t ask, don’t tell” (a former U.S. policy that directed military applicants to not disclose their sexual orientation), the legalization of gay marriage, and more queer representation on our screens — just to name a few.

At the same time, while all of those are certainly celebratory milestones, I ask that allies also recognize that our pride comes from so much more than a handful of legislative victories over the last decade. Our pride comes from the queer folks who came before us and fought for our visibility by rallying voices to speak out against injustice. Allies can research events such as the Compton’s Cafeteria riot, the Stonewall uprising, or the works of the Combahee River Collective. Understanding this historical context is important for also understanding the intersectional nature of the LGBTQ+ struggle for acceptance and restorative justice. Even though we have much to celebrate, our struggle continues as we fight for those who are still excluded or marginalized. 

Travis: Listen. The number one thing you can do is to listen and accept what someone in the LGBTQ+ community is telling you as their truth. It may change in the future — and that’s okay! Sexuality and gender are not a binary, and both can be incredibly fluid.

For parents: how you discuss sexual orientations and gender identities at home can leave a lasting impact on your children. I remember asking my mother about her thoughts on gay marriage, and she shared a more traditional view of marriage as a union between a man and a woman. That stuck with me for a long time and is a key reason I waited so long to tell them who I truly am. Read your toddler a book about a gay couple that gets married, teach your teens about prominent members of the LGBTQ+ community (and why they’re important), and if your LGBTQ+ child asks you to drive them to gay prom, treat the scenario as completely normal — because it is.

Why is it important for you to work at a company that values diversity in all forms? 

Ben: For me it’s a requirement that a company I work for prioritizes diversity and inclusion. I appreciate that Alto provides visibility into the progress that we’ve made towards building a diverse team that reflects the diversity of the patients we build solutions for. We also hold space to identify the work that still needs to be done. It’s really validating to have your background recognized at company celebrations and events or in spaces like employee resource groups (ERGs)*. It’s also important that we do all we can in our everyday actions to foster a collaborative and inclusive environment — one where people feel comfortable enough to be their authentic selves and not like they have to mask their gender, race, neurodivergence, or any other part of their identity. 

Travis: The U.S. — and the world — is made up of so many different people. There’s diversity of thought and beliefs, educational experiences, socioeconomic status, gender, race, A homogenous company that doesn’t mirror that diversity  will never be able to serve the entire population, and will miss out on a lot of opportunities. Alto’s mission is to fulfill medicine's true purpose — to improve quality of life — for everyone who needs it. The key word to me is everyone, and to truly fulfill the promise of that mission, we need a company as diverse as our customers. I personally find it rewarding to work at a company that values diversity and has strong representation of many identities, because that’s how the best ideas come to fruition and ultimately how the most positive impact is achieved.

At Alto, we believe in a world where every perspective matters. Diversity fosters creativity and creates innovation, and we welcome candidates of all backgrounds, skill sets, and experiences. To learn more, read Why We Prioritize Diversity at Alto. 

For more information on how to make your workplace safe and equitable for LGBTQ+ team members, read 11 Simple Ways You (Yes, You!) Can Make Your Workplace More LGBTQ Inclusive. 

If you or someone you know is considering coming out, we encourage you to review these resources:

Parents, Families, and Friends of Lesbians and Gays (PFLAG) Recommended Reading: Coming Out

*ERGs are meant to empower community groups within an organization by directly linking decision makers and implementing policies that support the group’s specific needs. The groups often center around a shared identity or experience and focus on building community, providing support, and contributing to its members’ personal and professional well-being. By creating an open forum for employees to come together, discuss challenges and opportunities, and foster a sense of belonging, ERGs help both individuals and organizations thrive.

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