PrEP: Why aren’t you on it?


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Josh Kilby, activist and healthcare worker
Josh Kilby, activist and healthcare worker

I’m a healthcare worker, Queer activist, and consider myself to be pretty well-informed and connected and yet if you had asked me about PrEP as recently as September, I would have wondered what you are talking about. I’m up here today because I feel that the word PrEP needs to be on the lips of every sexually active person and the people they love.

PrEP which stands for Pre-Exposure Prophylaxis is a once a day dose of an anti-retrovirus drug called, Truvada; which is also used for people who are HIV Positive to help keep viral loads low, but in people who are negative, if exposed to HIV, kills the virus before it has the chance to infect you. Numerous studies have shown it to be pretty darn effective.

Being newly single, and sexually active, this naturally piqued my interest; if a one a day pill can help prevent an unwanted condition, why wouldn’t I be on it?

But for good measure, I took to social media to see if anyone in my extended networks had any thoughts or experiences with it. The results were somewhat unsurprising, but worth breaking down:

Two people reached out to me privately to tell me their stories, which were well-received and appreciated, but I wondered why they didn’t feel safe to say publically they were PrEP users. Until I saw some of the other public responses (most of which were positive), but there were a strong current of people who were telling me that I weren’t being “sleazy” I wouldn’t have to worry about this or that they felt that this pill will encourage “bad” behavior.

Kilby and Dr. Amy Nunn
Kilby and Dr. Amy Nunn

This line of thought is nothing new…54 years after the Birth-control Pill hit the market and 41 years after safe and legal abortion was won, people are still saying that contraception will encourage “bad” behavior.

Well I’ve got news for them. “Bad” behavior does not need encouragement. At all. And furthermore, there is nothing bad, dirty, or shameful about sex. We owe it to ourselves, our partners, and the people we love to first and foremost, enjoy ourselves, but also to do everything we can to protect ourselves and other.

We as a society need to come to grips with the fact that sex-positive and queer-inclusive sex education not being a part of our public school curriculum is nothing short of a public health crisis; creating a layer of young people with lots of misinformation and questions who are afraid to seek out answers for fear of judgment. This is dangerous. Silence, in this case, literally equals death.

I, along with my Doctor, Dr, Chan, did decide that going on PrEP was the right decision for the type of life I lead. I was very fortunate to thus far not experience and of the side effects (nausea, vomiting etc.). And if you’re wondering, it didn’t encourage and more or less “bad” behavior.

To conclude, I would be remiss if I didn’t discuss how equally important access to this drug is to it’s availability. I am lucky in that I have a good job with good health insurance, so access to PrEP was no issue for me. But there are so many people in vulnerable demographics (I think of sex-workers and IV drug users especially) may not be as lucky and cannot afford to pay the over $1500 out-of-pocket cost of a monthly supply of Truvada. PrEP has the potential to make new HIV infections a thing of the past, but it cannot do that if no one’s heard of it and people who need it the most cannot access it.

These are the facts, but our challenge as healthcare providers, law-makers, activists, and people who want to see a world without HIV/AIDS is to overcome them. We have come so far already; research in tandem with activism has taken HIV for a death sentence to a chronic, but mostly manageable condition, and now we have the capability to prevent it in the first place. We need to be screaming about this from rooftops, flyering every gay bar, I also liked Dr. Nunn’s idea about using sites like grindr and scruff as tools for outreach, and also making the phrase “ask your doctor about PrEP” as recognizable a slogan as “get tested” and “know your status” is now!

Online hookup sites key to combatting AIDS in Rhode Island


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Dr. Amy Nunn
Dr. Amy Nunn

Too many of us think of AIDS as something that occurred in the past, and see it as a manageable, if unfortunate disease that is well on its way to being eradicated.

The truth is that as of 2012, over 1591 Rhode Islanders has died because of this epidemic. Though the rate of new infections has decreased over the last 30 years, there were 74 new cases of AIDS in RI in 2013. This is an increase of over 17%, according to Dr. Amy Nunn of Brown University who spoke at the State House yesterday for World AIDS Day. She was joined by Governor Linc Chafee and US Rep. David Cicilline and many public health advocates.

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“Today, over half of the new infections are among men, in Rhode Island, and we know from Dr. Philip Chan’s study that a lot of these people are meeting on line, on the Internet,” says Dr. Nunn, “The problem is that our preventative response hasn’t been as quick as those websites which are making money hand over fist and helping people hook up online.”

Dr. Nunn would like to avoid stigmatizing high risk lifestyles and instead concentrate on education as a means of protection.

The answer is “to get our preventive response aligned with how people are getting infected.” Dr. Nunn sees the answer as partnering with these online hook up sites like Grindr, “I would posit that they do a much better job of reaching the highest risk people than we have done in the public health community, and it’s time for a revolution.”

“I would like to challenge every one in the room that we really need to think about how we can enhance our prevention strategies by working with these companies online and also shaming them into corporate social responsibility. Why aren’t they doing more?”

Dr. Nunn would also like to implement AIDS screening as part of our regular checkups, as routine as blood pressure and temperature checks.

If we do this, says Dr. Nunn, we have a good chance of getting our AIDS infection rates down to zero.



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How to improve sexual health for teens


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game on 2013Birds do it, bees do it. And according to the 2011 Youth Risk Behavior Survey, nearly a third of all Rhode Island teenagers do it too. But what do they know about what they are doing, and what are we teaching them about it?

A conference Friday at Rhode Island College will “help improve the sexual health of Rhode Island’s youth,” according to the Sojourner House blog.

“Curious about what’s going on in regards to sexual health and RI youth?” reads their post. “Does the topic make you feel awkward, and you want to learn more about making those conversations go smoothly?”

Well then you might want to read on:

This conference is intended for any providers, educators, and other community leaders in Rhode Island to help them gain insights and improve their skills related to interacting with youth about sexual health issues. The morning sessions will include a mix of presentations from local experts, as well as a special session where young people from Rhode Island will share their thoughts and ideas about sexual health. The afternoon break-out sessions include hands-on training and skills building. A special emphasis of the conference/training is to learn about current and emerging issues in sexual health, and the roles of culture and technology in young people’s lives.

With a keynote by Teri Aronowitz, NP, PhD, an afternoon of workshops from organizations like Youth Pride, Rhode Island for Community & Justice, the YWCA of Northern RI, Planned Parenthood, and more, this is an event you don’t want to miss!

There’s more information on the Facebook page here.