What connects the commonplace experience of hunting for jobs (Taking the plunge) with the rarefied world of gene therapy (HIV gene therapy)? One factor is our improving physical health.

As Matt Sharp explains in his account of being a guinea pig, he was in the HIV generation that only just scraped through: damaged as much by early tries at therapy as by HIV itself, it’s been a long journey for Matt and others to re-establish a properly functioning immune system, and it required some pretty whizz-bang technology.

For Matt’s and my generation, being able to return to work, if we haven’t already, is a real piece of good news. Being a contributor to the economy rather than just a beneficiary may start with improvements in physical health, but it may end in big boosts to mental health and self-esteem.  

We AIDS dinosaurs are only a minority of the community of people with HIV. But, as Sue Murphy and both of the people interviewed for their stories show, more recent HIV diagnosis can spur you to re-evaluate your career and to bring your work nearer into line with what you’d really like to do.   

Others don’t have such a choice. Modern medicine may enable people with HIV to return to work but coming to terms with diagnosis, especially if it’s associated with illness, may make it very difficult to struggle on when already working.

Returning to work and needing, if only temporarily, to stop both occur within a bleak current economy and a squeeze on public funds, documented in recent pieces on cutbacks in HIV services (The whether forecast, HTU 202) and benefits (What’s happening to benefits?, HTU 203).

People with HIV, alongside many disadvantaged others, are being pressurised to return to work at the same time as jobs are scarce and services that could help them are being withdrawn. In next month’s HTU we’ll investigate some innovative social care models that try to get round this squeeze on HIV-specific services.

The global and local squeeze on finance threatens scientific research like gene therapy too. This doesn’t just apply to ways of curing HIV, but to new ways of preventing it.

Although this month we saw a setback in the shape of the non-result of the FEM-PrEP trial, the positive results from the iPrEx trial of oral Truvada in gay men and the CAPRISA 004 trial of tenofovir vaginal gel in women continue to stimulate new thinking about HIV prevention.

In The new prevention? we unveil a proposal by the Health Protection Agency for a radical reshaping of gay men’s sexual health services, including a trial of PrEP. At the moment, however, this is just a proposal, with absolutely no funding secured. An idea like this will need the backing of a strong coalition of researchers, clinicians and advocates if it is to become a reality within our cut-to-the-bone NHS.

This is not the only radical new idea in prevention around at present, and HTU will keep you updated on this rapidly changing field.