HIV advocate Mackenzie Copley is making a big bet in Las Vegas—and he’s confident it’ll pay off. As founder and CEO of Shine, he’s launching a pilot program that offers financial incentives—$1,000 every six months—to folks living with HIV if they stick to their treatment regimen.

The goal for participants is to reach and maintain an undetectable viral load. Doing so translates to better overall health, including longer lifespans and fewer opportunistic infections. Importantly, it also means they don’t transmit HIV to others through sex, a fact commonly referred to as Undetectable Equals Untransmittable (U=U).

“The Shine app is designed to make people’s lives better,” Copley says. “It not only helps people get healthier, but it also relieves some of the financial stress in their lives. And it can help end the epidemic!”

After users download Shine, the app helps them track doctor’s visits and lab test (results can be uploaded). Users who follow their treatment plans—whether it’s daily pills or long-acting injectables—are rewarded up to $2,000 a year. (Those who take their meds regularly but are unable for whatever reason to reach an undetectable viral load are still eligible for the financial incentives.)

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A screenshot of the Shine appCourtesy of Mackenzie Copley

Shine’s long-term goal, Copley says, is to expand to other cities and states. Eventually, the app might also be used to reward HIV-negative folks for taking pre-exposure prophylaxis (PrEP)—another effective tool for lowering new diagnoses and thus ending the epidemic.

Shine is HIPPA compliant, Copley notes, meaning that health care data remain private and secure. And the initiative has been endorsed by the American Academy of HIV Medicine (AAHIVM), the National Alliance of State & Territorial AIDS Directors (NASTAD) and Harvard Law School’s Center for Health Law and Policy Innovation (CHLPI).

Participating clinics in Las Vegas include The Center, an LGBTQ community hub, and the Farabi Wellness Center. Spots in the Shine rollout program have already been filled, but a waiting list is now open, and Copley encourages people to sign up at shineapp.co/waitlist.

Once the pilot program is underway and the data are analyzed, Copley aims to expand the program.

Folks with HIV often face barriers to care and treatment. Similarly, Shine faces challenges in reaching the people who need it most. Laws and regulations concerning incentivized health programs vary from state to state, and people who receive public health coverage—including Medicaid, Medicare and the Ryan White HIV/AIDS Program—are not eligible to participate in Shine. Copley and the Shine team are very aware that many people lack insurance or are underinsured and could benefit from financial rewards. As such, the team has indentified potential pathways to work with state and federal governments to change the eligibility criteria and include people who receive public health coverage as soon as possible.

Watch Copley discuss Shine and his journey in HIV advocacy on the A Shot in the Arm podcast below (also on YouTube, Spotify and other formats):

Las Vegas was chosen as the launching pad for Shine in part because regulations there permitted the pilot to move forward. In addition, the jurisdiction was named under the Ending the Epidemic in the United States initiative as an area that sees disproportionate HIV rates and needs additional support to diagnose, treat and prevent new cases. (Although Trump launched the Ending the Epidemic plan during his first term, the initiative is likely to be gutted under the his administration’s new budget.)

As Copley searched for funding and partnerships, he reached out to pharmaceutical companies, government agencies, such as the National Institutes of Health, and nonprofits. Currently, Copley said, pharma is his favorite party to potentially provide financial backing for Shine because it seems to be the most sustainable long-term partner, especially considering federal budget cuts and the current upheaval in national agencies.

As a college student in Washington, DC, Copley volunteered to do HIV testing in the city’s underserved neighborhoods. That led to him and his college buddy David Schaffer, MD, launching One Tent Health in 2017. The organization teamed up with local health care providers and community groups to provide HIV testing at neighborhood hubs, such as grocery stores. When COVID-19 hit in 2020, they added testing for that virus.   

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Mackenzie Copley is a member of the Presidential Advisory Council on AIDS (PACHA).Courtesy of Mackenzie Copley

He then worked on DC’s 90/90/90/50 plan, which, like similar plans across the globe, aims to get 90% of residents living with HIV to know their status, 90% of people diagnosed with HIV on treatment and 90% of those on treatment to maintain an undetectable viral load. In addition, the plan called for a 50% reduction in new HIV diagnoses.

Along the way, Copley was named to the Presidential Advisory Council on AIDS (PACHA), which afforded him more insights into tackling the epidemic. But it was while working on the 90/90/90/50 plan that Copley realized we already have the tools to end the epidemic—if only we could get folks with HIV on treatment and undetectable. Shine aims to help folks reach that goal.

As he prepared for this year’s launch, Copley has been promoting the potential of Shine and gathering support. The advisory board includes many names familiar to the HIV community, including Alicia Diggs of the University of North Carolina and Jake Glaser of the Elizabeth Glaser Pediatric AIDS Foundation (both of whom are living with HIV and have been featured on the cover of POZ).

At this year’s United States Conference on HIV/AIDS (USCHA), held in early September in DC, Copley proselytized to anyone who would listen—which turned out to be a lot of folks. The interest in Shine, he said, is inspiring. “Many in the HIV field feel like Shine can be a transformative solution,” he told POZ. “Shine directly addresses the social determinants of health and helps people overcome barriers to care.” In doing so, Shine will “maximize national viral suppression, extend life, reduce people’s financial stress and, hopefully, help us all end the HIV epidemic as soon as possible.”