In the mid-1980s, at 24, Luke Adams was told he had two years to live. Forty years on, he's a psychologist, ACT UP veteran and recent political refugee from the United States, now living in London.

Luke Adams was 24 and living in Santa Cruz, California, when a test came back positive for what doctors then called HTLV-III. His nurse, Ed, gave him two years to live, then brilliantly made Luke furious enough to act.

Luke channelled that fury into decades of AIDS activism: building safer-sex education programmes with student volunteers, joining ACT UP alongside Larry Kramer, and watching Anthony Fauci go from adversary to convert. He survived the brutal monotherapy era of AZT, a near-fatal AIDS diagnosis in 1996, and the addiction that followed years of grief, before getting sober with help from a friend at the Haight Ashbury Free Clinics.

Now 63, and more troubled by arthritis than HIV, Luke has recently left the United States for London, describing himself as a political refugee after his activism, his marriage to a Latino man and his support for trans rights drew scrutiny from the Trump administration.

The conversation closes with his verdict on today's PEPFAR, USAID and UK foreign-aid cuts, and a moment of remembrance.

• [00:02:04] Becoming a political refugee: why Luke left the United States for London
• [00:08:03] Nurse Ed's blunt delivery of a positive HIV result, and the fury that followed
• [00:11:27] What ACT UP actually was, and why Larry Kramer built it
• [00:14:26] A reunion with Larry Kramer at the NIH — and a young doctor named Anthony Fauci
• [00:21:08] Fighting Lyndon LaRouche's ballot initiative to intern people with HIV
• [00:31:20] Compound S to AZT: inside the toxic monotherapy years
• [00:38:19] A T-cell count of 30, and a summer he wasn't expected to survive
• [00:46:01] Crystal meth, grief and finding sobriety through the Haight Ashbury Free Clinics
• [00:53:33] A moment of remembrance for his friend Doug Rasic

Luke Adams is a psychologist and HIV activist who tested positive in Santa Cruz, California, in the mid-1980s. He helped build early safer-sex education programmes, worked alongside Larry Kramer in ACT UP, and co-wrote community materials on HIV prevention. Now 63 and sober for decades, he recently relocated from the United States to London, describing himself as a political refugee. He continues to practise psychology and campaign against HIV stigma.

• Terrence Higgins Trust – UK support and information for anyone living with or affected by HIV.
• National AIDS Trust – campaigning on HIV stigma, discrimination and the law.
• Sisters of Perpetual Indulgence – the drag activist order Luke references, still fundraising and educating worldwide.
• Diseased Pariah News – background on the zine co-founded by Luke's housemate, Beowulf Thorne.
• ACT UP Historical Archive – records and capsule history of the AIDS Coalition to Unleash Power.

If you've been affected by anything discussed in this episode, support is available through the Terrence Higgins Trust.