December 1st marks World AIDS Day, recognized since 1988 as an opportunity for people worldwide to unite in the fight against HIV, to show support for people living with HIV and to commemorate those who have died of an AIDS-related illness. In those early years, it was marked by small local gatherings, with other providers and a few people with AIDS to raise awareness and remember those we lost. Attended mostly by providers, friends, and community members, as most people hid their diagnosis when they could or were too ill to participate in public events. We quietly called out the names of our friends, family members, colleagues, and patients who died of AIDS [horizontal ellipsis] Marion, Rodger, Daniel, Jenny [horizontal ellipsis] so many more. In the early 1990s, the red ribbon started showing up, a visual clue as to who was an ally. The red ribbon, ubiquitous now, was developed as a small grassroots project by a group of artists in New York City. Launched in 1991 as the Red Ribbon Project with the message, "Wear a red ribbon to show your commitment to the fight against AIDS. The red ribbon demonstrates compassion for people with AIDS and their caretakers and support for education and research leading to effective treatment, vaccines and a cure." It was noticed at the Emmy and Tony awards that year and in other places and communities decimated by HIV/AIDS. Within two years, it became an iconic symbol worldwide of solidarity with people living with and affected by HIV/AIDS and as a stand against fear and stigma. It has never been copyrighted nor "owned" but meant as a free, open way to show support and allyship.

It was the first of the awareness ribbons, followed by other colors and causes. For nearly 35 years, a simple red ribbon was part of the logo of ANAC. The current ANAC logo was developed in 2014 to better represent ANAC's dedication to supporting nurses and other members of the health care team involved in the prevention, care, and treatment of HIV and related co-occurring conditions through education, clinical care and research, and policy and advocacy. In the logo, the letter "A" representing the word AIDS features an elongated tail, symbolizing that ANAC's mission extends beyond AIDS care. We provide education and advocacy regarding intersecting health and social conditions that impact individuals and communities affected by HIV/AIDS and recognize that people living with HIV/AIDS are much more than that diagnosis, acknowledging the whole person and community.

Diversity and different health care fields and the interprofessional approach to health care are represented by the various shapes and sizes of several ribbons of color. These bands are then interwoven, forming a strong fabric of community and connectedness-in essence, forming a rich tapestry that reflects ANAC's proud history with unfinished ends that can be endlessly expanded upon. Red is the primary logo color, while commonly signifying urgency, safety, love, and the physical self, for us it also affirms the legacy and significance of the original red ribbon symbol: "compassion for people with AIDS and their caretakers and support for education and research leading to effective treatment, vaccines, and a cure."

In the 35 years since that first World AIDS Day, it has moved from small local events to a larger acknowledgment of the impact of the global HIV/AIDS pandemic. Government, politicians, the health care and other industries, educational settings, and the media acknowledge World AIDS Day. Googling it, the search reveals many commercial outlets that sell things, such as t-shirts, posters, trinkets, and other goods, including premade red ribbons to purchase and give away at events. Reflecting on the original intent of the Red Ribbon Project, we have mixed results. We have made remarkable progress in effective treatment, yet the complicated search for effective vaccines and a cure remains unfinished. Compassion for people living with HIV has increased, yet stigma and disparities in access and outcomes along economic, racial, and geographic lines and threats to the human rights of LGBT individuals and communities thwart efforts to stop new transmissions in the United States and end AIDS worldwide. This year, the World Health Organization announced the theme for World AIDS Day 2023: Let Communities Lead. This is an important message in 2023 as suppressions of LGBTQ rights and crackdowns on the organizations that provide services and support are happening in countries across the globe, likely to obstruct the progress of HIV prevention and treatment services. And here in the United States, although we have the tools to prevent transmission through PrEP and effective treatment (U=U), the communities most in need are not getting it. Community-led education and meaningful input into the design and delivery of services will help. An important element of nursing is listening. Nurses listen, to hear and understand individual and community needs. Just like in the early days of the red ribbon and World AIDS Day, we must act on what we hear and see, and join with community to amplify the call for human rights and equity in access and outcomes in the national and global HIV response.

And while I wear a red ribbon often and use it as an opener to talk about HIV/AIDS whenever possible, I won't be buying one from the online sellers.

Disclosures

The author reports no financial interests or potential conflicts of interest.