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Everything You Ever Wanted to Know About …

Everything You Ever Wanted to Know About DoxyPEP

Words by Daniel Hirsch


A hefty dose of antibiotics. A big syringe in the derrière. Getting treated for an STI is not fun — to say nothing of the symptoms and risks involved with contracting one like syphilis, gonorrhea, or chlamydia. With the CDC reporting rising numbers — gonorrhea is up 11% over the last five years, syphilis is up 79% — risk of infection is on the rise.


However, clinicians around the country, spurred by recently released guidance from the CDC, are recommending the antibiotic doxycycline as a means of post-exposure prophylaxis (DoxyPEP for short) to prevent the spread of STIs. I spoke with DAP Health Chief of Community Health C.J. Tobe about this prevention strategy.


Let’s start with the basics. What is DoxyPEP?

DoxyPEP, or doxycycline, is a 200 milligram pill that can be taken within 24 to 72 hours after sex. It reduces a person’s chance of contracting either chlamydia, gonorrhea, or syphilis by up to 70%. Doxycycline has been around for quite some time and is used to treat STIs and acne.


How sexually active do you need to be to justify a prescription?

It’s going to look different depending on a person’s lifestyle and the conversation with their provider. For example, if you have sex Friday, Saturday, and Sunday, you can take DoxyPEP that Monday morning and you’re good. Let’s say you’re having sex five times a week, then you should probably talk to your doctor about switching to DoxyPrEP.


And what’s DoxyPrEP?

DoxyPrEP would be taking 100 milligrams of doxycycline daily as a preventative measure. That’s typically for people who either want to make sure they’re protected, or they’re having frequent sex, or they may be a sex worker.


Are there side effects? Isn’t doxy tough on the GI tract?

A lot of the side effects that get reported are GI issues. So we recommend people take the medication with food or a carbonated drink. When people take a higher dose of doxycycline, like 200 milligrams twice a day, the side effects increase. If you go on DoxyPrEP, that’s just 100 milligrams once a day. And I can tell you it’s such a low dose that the majority of folks don’t have side effects.


One of my worst nightmares, and it’s one shared by the World Health Organization, is that an STI becomes resistant to antibiotics. Is that a concern with people regularly taking doxy?

Part of the medical community is hesitant to embrace this strategy because they don’t know what could happen in terms of drug resistance. The other half are saying, “We need to get people on it right now because it’s an important preventative tool.” There’s always going to be a risk of drug resistance when people don’t follow the dosing recommendation of a doctor. As a public health person seeing the rise in STIs, I think a patient who is having sex should have that conversation with their doctor and see if DoxyPEP is right for them. Personally, I’ve been on doxy since 2020 and it’s been a lifesaver.

March is Colorectal Cancer Awareness Mon …

March is Colorectal Cancer Awareness Month

Here’s the 101 so that you can keep yourself and those you love safe.

Words by David Russo


“Colon cancer is the battle we can win with early detection and regular screening.”

                                                                                                               — Unknown

DAP Health’s Associate Chief Medical Officer Dr. Silas Gyimah is fond of that inspiring citation of unknown derivation. As the founder of the Palm Springs-based, queer-led nonprofit Cheeky Charity — whose mission is to facilitate colorectal and anal cancer prevention, early detection, and support, with a focus on the young and LGBTQ+ populations — so am I.

“At every visit, we verify records to see if a patient is due for a screening,” Gyimah says. “If they are, we schedule them, focusing on FIT [fecal immunochemical test] and colonoscopies as our primary screening methods. This is a true implementation of the quote above.” 

Let’s delve more deeply into this largely preventable and curable disease.


Colorectal Health: Understanding and Prevention

Colorectal cancer (CRC), once predominantly a concern for older adults, is now increasingly affecting younger individuals. This shift necessitates a renewed focus. Understanding the nuances of colorectal health is vital for individuals of all ages.


Understanding Colorectal Cancer

CRC originates in the colon or rectum, part of the digestive system. It usually begins as small, noncancerous (benign) clumps of cells called polyps that form on the inside of the colon. Over time, some of these polyps can become colon cancers.


Symptoms To Be Aware Of

CRC might not cause symptoms right away, but if they occur, they may include changes in bowel habits, rectal bleeding or blood in the stool, persistent abdominal discomfort, a feeling that the bowel doesn’t empty completely, weakness or fatigue, and unexplained weight loss. It’s important to consult a health care provider if any of these symptoms are experienced.


Risk Factors

Certain factors increase the risk of developing CRC. These include older age, a personal or family history of CRC or colorectal polyps, inflammatory intestinal conditions, a low-fiber/high-fat diet, a sedentary lifestyle, diabetes, obesity, smoking, and alcohol use. Genetics also play a role, with some inherited genes increasing the risk.


Prevention Strategies

Prevention of CRC starts with lifestyle changes. A diet rich in fruits, vegetables, and whole grains — and low in red and processed meats — can reduce risk. Regular physical activity is crucial. Maintaining a healthy weight, avoiding smoking, and moderating alcohol consumption are also recommended.


The Importance of Screening

Screening for CRC is one of the most powerful weapons for preventing the disease. It’s generally recommended to begin screening at age 45. Screening can find precancerous polyps, which can be removed before they turn into cancer. For people at higher risk, such as those with a family history, screening may be recommended earlier.


Navigating the Rising Trend in Young Adults

The rising incidence of CRC among young adults is a complex issue that involves a combination of genetic, environmental, and lifestyle factors. It’s important for young adults to:

  • Be aware of their family history.
  • Minimize known risks.
  • Incorporate healthy preventative habits into their lifestyle.
  • Regularly check for symptoms.
  • Discuss screenings with their health care providers if they have risk factors.



As our understanding of colorectal health evolves, it becomes clear that CRC is not just a concern for the elderly. The increase in cases among younger adults emphasizes the importance of awareness and proactive health measures across all age groups. Through lifestyle modifications, regular screening, and early detection, the impact of CRC can be significantly reduced.



Colorectal Cancer Alliance, colorectalcancer.org

American Cancer Society, cancer.org/cancer/types/colon-rectal-cancer

Centers for Disease Control and Prevention, cdc.gov/cancer/colorectal

Cheeky Charity, cheekycharity.org


In a partnership between DAP Health and Cheeky Charity — and in honor of Colorectal Cancer Awareness Month — 50 eye-catching banners will be flown throughout downtown Palm Springs during March to help raise awareness and reduce stigma.

Where Did All This Peanut Allergy Come F …

Where Did All This Peanut Allergy Come From?

Words by Ellen Bluestein


According to the American College of Allergy, Asthma & Immunology, as of 2017, 2.5% of children in the United States have peanut allergy. While that percentage may seem small, it translates to more than 1.8 million kids with a potentially fatal condition. 


“Probably about 20 years ago, it was clear that this was not only a growing problem, but it had already become a public health problem in the United States and around the world,” says Dr. Andrew Liu, a pediatric allergist at the University of Colorado. “I don’t know that we’re sure why or how peanut allergy has become so prevalent. But I think it’s pretty clear that it’s real.”


Researchers have been exploring several possible hypotheses. One — the hygiene theory — explores the idea that with the advent of germ-killing cleaning products, our environments no longer provide the exposure to microbes that the immune system recognizes and learns to fight off.


“What is a microbe-rich environment? One where we’re living around a lot of animals,” says Dr. Liu. “There have been a lot of studies where it looks like allergies are less common in kids growing up in farming environments or in developing nations where people live very closely to their animals. Some people think … that the immune system doesn’t see enough of those microbial exposures early because we’ve gone and cleaned up our environment.”


Early exposure to peanuts — between four and six months of age — may be one way to reduce the allergy. “The original observation was in Israel, where they had this teething cracker called Bamba which has peanut in it,” says Dr. Liu. “And they observed that within communities where this was a common cultural practice, the prevalence of peanut allergy in the kids was really low compared to what they were seeing in other communities.”


This led to more research and ultimately a definitive study on prevention. Children were given Bamba or a derivative, and then followed. Those who received the cracker were unlikely to develop peanut allergy compared to those who didn’t get it. “It looked like early exposure … when our bodies are learning about what is safe … is an essential time period,” says Dr. Liu. “If the immune system learns that the peanut is not something to be concerned about, then that stays.”


While there is still much to be discovered, Dr. Liu is optimistic that there will be remedies for those who suffer from the life-threatening condition. “There’s work going on to develop treatments to either reduce or prevent the severe reactions to those who are peanut allergic,” he says. “There continues to be investment in a lot of research … to try to get to that place where there are treatments that can be helpful for people and young kids who are allergic.”

The Science of Positivity

The Science of Positivity

“Never say never because limits, like fears, are often just an illusion.” — Michael Jordan

Words by Kay Kudukis


In the 1990s, a recurring skit on SNL called “Daily Affirmations with Stuart Smalley” had Al Franken portraying an insecure, support group-addicted, self-help schlub in a cardigan. He was the antithesis of the popular, flashy, mindset gurus like Tony Robbins. Stuart would frequently look at himself in the mirror and say, “I’m good enough, I’m smart enough and, doggone it, people like me.”

Although Franken was poking fun at the new fad, it wasn’t very new. Over 3,000 years ago, the Greeks were writing meditations and guidelines touting the best ways to live. The idea is actually 5,000 years old, but back then there was no alphabet, which made writing hard.

By the 1800s, poets and renowned authors were onto it, but scientists didn’t take notice until the 1970s, when they asked, “Is there anything to this?” It took a few decades, and a lot of studies, but the answer is — in wildly unscientific terms — it’s definitely a thing. Turns out, there’s true power in the science of positivity!

Yes, science. The University of Chapel Hill conducts a Positive Emotions and Psychophysiology Laboratory studying “how positive emotions affect people’s thinking patterns, social behavior, health, and physiological reactions.” Johns Hopkins and the Mayo Clinic promote positive thinking to lower blood sugar and high blood pressure, and to reduce the risk of heart attacks and strokes by lowering cortisol.

The human brain is the most complex thing in the known universe, and yours is fueled by your thoughts. Ever heard that if you repeat a lie long enough it becomes the truth? If your brain is filled with negative self-chatter, it will come to believe it. If your inner monologue is positive, the brain responds, and your stress levels decrease along with your blood pressure.

There is another tool called “reframing” that makes you more productive. It’s where “I hate doing the dishes” becomes “I can’t wait to get these dishes done and have a nice clean sink.” Such positivity releases dopamine and serotonin into your system, and if you add a smile? Well, a study at the University of Kansas concluded that smiling is such a powerful source of endorphins that your stress levels go down even when you fake a smile. So now you’ve got a buzzy cocktail of dopamine, serotonin, and endorphins in you, and the dishes are done.

If you need a little extra help, DAP Health is here for you. Its medical professionals won’t do your dishes, but they do have some unique Wellness Services, including a Zoom group based on positivity and related to achieving goals.

Michael Jordan didn’t get to be the GOAT by talent alone. In fact, he attributes his success to positive thinking. He never told himself he couldn’t. “I can accept failure,” he famously said. “Everyone fails at something. But I can’t accept not trying.”

So be like Michael. Flip that switch. It’s not going to make you a great basketball player, but you’ll absolutely, positively, win at this game we call life.

Know Your PrEP Options

PrEP: So Many Options

As seen in GED Magazine

The HIV prevention world has changed dramatically in the more than 10 years since the U.S. Food and Drug Administration (FDA) approved Gilead Sciences’ Truvada as pre-exposure prophylaxis (PrEP) in July 2012.

Following the discovery that Truvada can pose renal and bone density problems in some individuals (which, thankfully, go away after the medication is discontinued), the FDA approved Gilead’s more kidney-and-bone-friendly Descovy as PrEP in October 2019. While Truvada is currently available as a generic equivalent, Descovy is still under patent.

More than a year ago — on December 20, 2021 — the FDA approved GSK’s Apretude, the first and only long-acting injectable form of PrEP, which requires a new dose every two months.

According to the Centers for Disease Control (CDC), when taken as prescribed, PrEP reduces the risk of HIV infection from sexual activity by more than 99%, and by at least 74% for those who use intravenous drugs. You should be on PrEP for HIV protection if you are 18 years or older, are sexually active (or soon planning to be), and are HIV negative.

“The great news with injectable PrEP is that it is a wonderful alternative for people who have issues with adherence and may forget to take their daily pill,” says DAP Health Clinical Supervisor of Sexual Wellness, Nurse Practitioner Trent Broadus. “It’s also very helpful for unhoused people who may have nowhere to store their meds, or who may be concerned that they’ll be stolen. Even more exciting, longer-lasting forms of injectable PrEP are currently being studied. Data are promising on one injection that would last a full six months.”

Before starting PrEP — whether orally or by injection — you’ll need to get tested for HIV, STIs, kidney function, and Hepatitis B and C.

Some people experience gas, nausea, or headache when beginning PrEP. These side effects typically go away within the first week. Note that it takes at least one week on PrEP before you’re protected for anal sex, and three weeks for vaginal sex.

Most insurance plans cover oral PrEP for HIV. Injectable PrEP is covered by Medi-Cal, but some Medicare and private insurance plans may require you to go through your primary care provider.

All forms of PrEP require regular follow-up HIV, STI, and kidney function testing. Every three months for oral PrEP; every two months for injectable PrEP.

You should talk to your doctor before stopping any medication. And if you stop taking PrEP, talk to a health care provider about using other HIV prevention strategies.

If you’re interested in PrEP, contact a DAP Health PrEP navigator at 760.656.8400. You can also talk to any nurse or nurse practitioner during your visit if you want to discuss which PrEP may be right for you.

If you don’t have health care insurance, or if you need financial assistance, a PrEP navigator can also explain your options, help you get access, and answer questions about finding a doctor or working with your pharmacy.

And remember: All PrEP visits and lab work done at DAP Health’s sexual wellness clinics in Palm Springs and Indio are always free of charge to all patients.

Anthony Velasco Elected Director-At-Larg …

Velasco Elected Director-at-Large for Association of Nurses in AIDS Care 

Anthony Velasco was reluctant to accept when the Association of Nurses in AIDS Care (ANAC) approached him about joining its board of directors. Even though he is a founder and current president of the Palm Springs chapter, he wondered if he had impostor syndrome. His colleagues knew better, as they elected Anthony Director-At-Large with the Association of Nurses in AIDS Care (ANAC).   

ANAC is made up of more than 40 chapters located around the world with over 2,200 members from 60 countries. Members include social workers, pharmacists, physician assistants, lawyers, and doctors from around the world committed to HIV/AIDS nursing.  

“ANAC is such a great venue to really connect with other people and see what they’re doing and compare what we’re doing,” Anthony says. “It’s so awesome to hear about the research being done on the national level and to see how it could potentially be applied at DAP Health.” 

Anthony, who chairs DAP Health’s Transgender Health Program, says the synergy helps both organizations.  

“I’ve told ANAC about the work we do at DAP Health and the great interdisciplinary culture we have here, including social work, community health, medical, and mental health,” he says.  

DAP Health provides holistic, compassionate, and comprehensive care.  

Anthony believes that DAP Health’s approach to care should be the model everywhere. This includes culturally competent care for transgender patients he serves, and more opportunities for nurses of color.  

While Filipinos make up about 20 percent of the nursing population in California, Anthony wants them to reach into leadership, research, and academia. (U.S. Census Bureau) 

He remembers noticing that there were never Filipino professors teaching his nursing classes as he completed his undergraduate and graduate school degrees in California. 

“Representation is one of the motivations I have,” Anthony says. “If a young Filipino nurse entering the field sees someone who looks like them in a leadership position, they will know that they can be in that position someday.”   

He provides compassionate care to people living with and without HIV. Caring about people who need special care does not stop there for Anthony.  

He provides comprehensive gender-affirming care and works to create more access to safe and gender-affirming spaces for all. At DAP Health and elsewhere, he has improved the health care experiences of many transgender patients in the Inland Empire.   

He belongs to the World Professional Association for Transgender Health (WPATH).  

Anthony is passionate about global health equity and has served on medical missions in Haiti and Honduras. Annually he gives his time and talent in the Philippines with Global Health Force, a non-profit organization providing access to free health care in underserved communities around the world.   

A Nurse Practitioner and credentialed HIV Specialist at DAP Health, Anthony has been working in HIV care since 2010. He is pursuing his doctorate in nursing at the University of Colorado. 

Aging Positively — Reunion Project 202 …

HIV and Aging Conference Header Image

Contact: Steven Henke                                 
Director of Brand Marketing 
(612) 310-3047 
[email protected] 


August 5 2021  

Local Organizations Collaborate on HIV & Aging Conference  

Aging Positively — Reunion Project Set September 18, 2021  

Aging Positively — Reunion Project, the annual Coachella Valley conference aimed at providing practical information and inspiration for those aging with HIV, will bring together community leaders to improve the lives of older adults living with HIV for a virtual conference on Sept. 18, 2021. The conference will feature an HIV research panel of top experts discussing HIV and aging issues in our community.   

September 18 is National HIV/AIDS and Aging Awareness Day — a day to call attention to the growing number of people living long and full lives with HIV and to aging-related challenges of HIV prevention, testing, treatment, and care.    

The virtual conference is free to attendees and open to the public. Presented by Eisenhower Health, this year's event is the result of a unique collaboration among local service providers and organizations focused on improving the shared experience of older adults living with HIV.  

People with HIV are living longer lives, thanks to advancements in scientific research and medical treatments; today, about half of HIV positive individuals in the U.S. are age 50 and above. Aging persons living with HIV have experienced tremendous loss, stigma, and discrimination throughout their lifetime and within the healthcare system.  In comparison to similar HIV-negative populations, individuals aging with HIV may experience an early onset of aging complications such as neurocognitive decline, impaired physical function, frailty, and falls.    

Karl Schmid, the entertainment reporter for ABC7 LA will speak on HIV and the media. The ABC reporter, who came out as HIV Positive in 2018, uses his multimedia platform, +Life, to educate and combat HIV stigma.  

At ABC7, Karl has been a regular contributor since 2013, joining the team as a correspondent and producer on the then-weekly and syndicated "On The Red Carpet." 

A passionate activist in the fight against HIV stigma, Schmid launched +Life (www.pluslifemedia.com) in 2019 online to help foster a new conversation around what it means for people living with HIV and to tackle the stigma still associated with the virus. +Life is also part of Localish TV on the newly launched Localish TV network. 

"HIV is not killing people but stigma is, and this is what needs to change," Schmid said in a statement. "We need to talk more about HIV and its advancements, about what U=U means, and we should not be stigmatized by society. 

"We need to have more information on mainstream media about how you contract HIV, prevention and treatments available so that people stop stigmatizing those that are positive and realize that anyone can have HIV and live a completely normal and healthy life."  

Since coming out as HIV-positive, Schmid has used his platform to educate and fight bias.  

Keynote speaker Andy Bell of Erasure fame will share his personal story. Bell is a founding member of Erasure.  Formed in 1985, when former Depeche Mode and Yazoo member Clarke advertised for a new singer. The duo quickly became enormously successful in the U.K., U.S., and several other countries with hits like “Chains of Love,” “A Little Respect,” and “Oh L’amour.” Now, three decades into their career, they are considered one of the most adored and influential synthpop bands selling more than 25 million records. In 2019, Erasure released their 18th studio album, The Neon. 

Bell has become an icon within the LGBTQ+ community for his honesty, compassion and support. Among his support of various LGBTQ+ causes, Bell has served as an ambassador for New York’s Hetrick-Martin Institute, and he is currently a patron of the Cambridge, England-based charity Diverse and of Above The Stag, London’s only LGBTQ+ theater. 

Topics and speakers:  

  •  Keynote speaker: Andy Bell from Erasure 
  • “Honoring Our Experience” with Gregg Cassin 
  • “KeeLee Meditation” with Dr. Daniel Lee, from the University of California, San Diego's Owen Clinic 
  • “HIV & The Media”: Karl Schmid is the entertainment reporter for ABC7 LA. He recently revealed his HIV status and has been an advocate for U=U as well as breaking down HIV stigma. 
  • HIV research update panel: 
    • Borrego Health: Valerio Iovino, i-Care 
    • DAP Health: Dr. Tulika Singh 
    • Eisenhower Health: Dr. Ken Lichtenstein 
    • Palmtree: Dr. Carlos Martinez 
    • HIV+ Aging Research Project-Palm Springs (HARP-PS): Jeff Taylor  
    • Caregiving with Perry Wiggins from The Center, end-of-life doula Alex Snell, and Richard Bass from PALS (Planning Ahead for LGBTQ Seniors)
    •  “Let’s Kick ASS”: Brian DeVries speaks about sustaining and making new friendships late in life 

What: The Aging Positively — Reunion Project 6th annual HIV conference is a collaboration between the HIV+ Aging Research Project—Palm Springs and other nonprofit community partners. It will be a virtual conference consisting of a mix of facilitated discussions, panels, and presentations led by key researchers, advocates, and long-term survivors of HIV/AIDS.  

When:  The 6th Annual Aging Positively — Reunion Project virtual conference will be held 9 a.m. to 2 p.m. on Sept. 18, 2021. 

Where:  Attendees can attend the conference from the digital device of their choice.  In-person elements may be announced later.  

How: Registration is free and open on Eventbrite: https://www.eventbrite.com/e/hiv-aging-virtual-conference-tickets-162082616469  

Collaborating Organizations:  


The Association of Nurses in AIDS Care (ANAC) is the leading health care organization responding to HIV/AIDS. Since its founding in 1987, ANAC has been meeting the needs of nurses and other healthcare professionals in HIV/AIDS care, research, prevention, and policy.  

 ANAC aims to promote the health and welfare of people affected by HIV/AIDS by:  

  • Creating an effective, engaged network of nurses in AIDS care. 
  • Studying, researching and exchanging information, experiences and ideas leading to improved care and prevention. 
  • Providing leadership to the nursing community in matters related to HIV/AIDS infection and its co-morbidities. 
  • Advocating for effective public policies and quality care for people living with HIV. 
  • Promoting social awareness concerning issues related to HIV/AIDS. 

Borrego Health   

Borrego Health provides high-quality, comprehensive, compassionate primary health care to the people in our communities, regardless of their ability to pay. They serve these communities and adjoining regions with respect, dignity, and cultural sensitivity as a medical home and safety net for essential health care and social services. Borrego Health is a non-profit 501(c)(3) Federally Qualified Health Center (FQHC) and a Federal Tort Claims Act Deemed (FTCA) facility.  

DAP Health   

At DAP Health, no one wonders if they belong — they just feel it. People can rely on culturally competent and stigma-free care at DAP Health.    

DAP Health offers medical and mental healthcare tailored to patients and clients by clinicians who listen to them. DAP Health has been meeting the diverse needs or its community since 1984, and it offers culturally competent care with no stigma about a person’s race, being LGBTQ+, or living with HIV. By actively listening, we can offer people care and services that meet their unique needs.     

  • Sexual wellness — DAP Health’s Orange Clinic offers STI testing and treatment, Pre-Exposure Prophylaxis (PrEP), Post-Exposure Prophylaxis (PEP), and HIV and hepatitis C testing.
  •  Thriving with HIV and ending the epidemic — DAP Health helps patients living with HIV thrive by staying healthy, undetectable and untransmittable to others. They become part of DAP Health's family beginning with testing, linkage into care, and then being enrolled in medical and mental healthcare, dentistry, social services, and prescription access. 
  • Mental health services — DAP Health offers individual and group therapy and has a substance abuse program that emphasizes recovery and relapse prevention. Mental health is health — no stigma, no shame. It just takes seeing a person truly where he/she/they are in their personal journey. 
  • Ongoing primary care — Join more than 9,700 patients who enjoy culturally competent care from clinicians and care teams who become like family. DAP Health's team works with patients to coordinate their care and ensure they have everything they need to stay healthy.  

Eisenhower Health  

Eisenhower HIV Clinic: Recognizing the complex health care needs of the LGBTQ patient population, Eisenhower Medical Center offers a comprehensive range of clinical, research and education resources — starting with a team of dedicated primary care doctors who have exceptional experience and expertise.  

Eisenhower HIV Clinic Primary Care Services: Providing state-of-the-art care for HIV patients requires knowledge of the latest treatments and best practices in the detection and treatment of HIV. Eisenhower's HIV Primary Care program is focused on the overall health of each patient, including:  

  • Appropriate utilization of advances in HIV care to sustain the best possible quality of life, including appropriate STD and cancer screening as well as healthy aging  
  • Best practices to prevent the spread of HIV  
  •  Compassionate access to new medicines for highly drug-resistant patients  
  • Our team includes HIV primary care doctors Board Certified in Internal Medicine or Family Medicine, with an additional certification as an HIV specialist with the American Academy of HIV Medicine (AAHIVM).  
  • Eisenhower Health is proud to collaborate with many nonprofit organizations here in the Coachella Valley providing HIV and related healthcare services, through partnership connectivity of services, referrals, and education.  


The HIV+ Aging Research Project-Palm Springs is a grassroots community non-profit that conducts research and provides education to improve the quality of life for long-term HIV survivors in the Coachella Valley. They collaborate with academic partners throughout Southern California and nationally to conduct socio-behavioral research on issues like resiliency and COVID-19 affecting HIV survivors. They hold monthly provider events to provide education on HIV Treatment issues, and they held monthly COVID Rounds during the peak of the COVID-19 pandemic. They also provide the monthly Positive Life HIV education series with topics and speakers tailored to the unique needs of their HIV survivor community. They created the annual Reunion Project daylong regional seminar to bring together the HIV and aging community in Southern California. Last year they combined forces with DAP Health and other community partners on the Aging Positively-Reunion Project event, which is held each year on or around HIV and Aging Awareness Day on September 18.    

Jewish Family Service of the Desert 

Since its inception as part of the Jewish Federation of Palm Springs and Desert Area in 1982, JFS has grown—not just in size, but in its ability to serve the people of the Coachella Valley. Beginning as a small group of volunteers who checked in on seniors and disabled people who lived alone, JFS Desert has evolved into an organization of professionals and volunteers that provide a broad range of support and services to thousands of Coachella Valley residents each year.  

JFS Desert’s experienced case managers can assist in exploring potential resources. They will assess clients’ eligibility for services and programs and can help facilitate the application process to obtain benefits and support. JFS case managers are a resource for the Coachella Valley, providing emergency financial assistance to prevent homelessness. JFS also works with local and county organizations to advocate for the rights of seniors in the valley. The JFS case management team takes a holistic service approach, collaborating with internal departments to ensure clients’ needs are addressed. We are dedicated to making sure that mental health issues and affordable housing stay front and center for our valley citizens.   

Let’s Kick ASS Palm Springs 

Let’s Kick ASS Palm Springs is an inclusive social group seeking to reduce the stresses of AIDS Survivor Syndrome. They welcome members regardless of HIV status, race, gender, age, or sexuality, believing that the individual is the best judge of the impact of HIV on their life. LKAPS organizes social functions providing opportunities to develop friendships and community.  

They support education and advocacy to raise awareness of AIDS Survivor Syndrome, long-term survivors, and the challenges they face.  

People feel better when engaged in social activity. LKAPS helps long-term survivors overcome isolation by creating social opportunities. From their popular monthly potlucks, twice-monthly coffee socials, bowling team, and movie nights, to now-established annual events such as June 5's Long-term Survivors Day reception and the Thanksgiving Day feast, LKAPS benefits its members through engagement with their local community of HIV survivors.  


PALS (Planning Ahead for LGBTQ Seniors) is a volunteer-led community initiative based in Palm Springs that helps LGBTQ+ adults and friends plan ahead before a health or other life-altering situation arises.   

Having a plan in place mitigates stress and anxiety, ensures that LGBTQ+ adults are in control of their future care and legacy, and relieves the burden on family and friends.  

The Center   

At The Center, they like to say they create vibrant community by helping LGBTQ+ people along their way, wherever they might be in life’s journey. Even better, The Center likes to live it, breathe it, and do it. If someone is looking to meet new friends, get resources, or enrich their life and their place in community, they have come to the right place.  

Based in the Coachella Valley, The Center serves people of all ages, totaling more than 70,000 visits annually. How do they attract so many people? They do it with meaningful, relevant and mission-focused programming that addresses three strategic initiatives:  

  •   Ending isolation and loneliness  
  •   Connecting people to resources and community  
  •   Enriching individual and collective experiences 

About DAP Health 

DAP Health is an advocacy-based health center in Palm Springs, Calif., serving more than 10,000 patients, offering medical and mental healthcare, STI testing and treatment, dentistry, pharmacy, and lab services. A variety of wraparound services enable patients to experience optimal health, including social services, support groups, alternative therapies, and other wellness services. Excellent HIV care is provided by the largest team of specialized clinicians in the area.      

DAP Health opened one of California’s first COVID clinics and hotlines to offer screening, testing, and treatment. DAP Health also is working to address the social determinants of health that are causing negative health outcomes during this pandemic, like food and housing insecurity, joblessness, isolation, and access to ongoing healthcare.  

DAP Health’s sexual health clinic offers STI testing and treatment, pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP), and HIV and hepatitis C (HCV) testing. DAP Health has earned Charity Navigator’s highest rating for the twelfth consecutive year — landing DAP in the top 6% of nonprofits rated. The distinction recognizes that DAP Health exceeds industry standards in terms of financial health, accountability, and transparency.      

Visit www.daphealth.org to learn more.     


Dr. Tulika Singh co-authors major HIV cl …

Dr. Tulika Singh co-authors major HIV clinical research study

By Robert Hopwood

Published: June 18, 2021

DAP Health is gaining recognition from the clinical research trials underway at the health center.

The results from a clinical research trial that DAP Health conducted were published online in early June by the medical journal AIDS. Additionally, the results will be published in the printed journal.

Dr. Tulika Singh, associate chief medical officer and director of research at DAP Health, co-authored the published manuscript that reports the study's findings.

The ViiV Healthcare STAT Study researched if the antiretroviral drug Dovato could be used in a rapid start setting, said Greg Jackson, the clinical research manager at DAP Health. Study participants began the medication within 14 days of their HIV diagnosis.

ViiV Healthcare is a London-based pharmaceutical company. Its U.S. headquarters is located in North Carolina’s Research Triangle Park.

"We've now become a preferred site for ViiV Healthcare's research because of our successes," Jackson said.

The FDA will look at the data from the STAT study and decide if doctors can prescribe Dovato to people within days of an HIV diagnosis.

DAP Health recruited 14 adults for the STAT study, Jackson said. That was the third-highest number of participants recruited among the organizations conducting the study. In total, the study had 131 participants.

"It has been an exciting honor to be part of the STAT study and being able to contribute to the science and the success of the rapid start treatment regimen for Dovato," Singh said.

The STAT study, which concluded in 2020, will be presented at the 11th IAS Conference on HIV Science in July. It was one of several studies underway at DAP Health.

Currently, there are three active clinical research trials at the health center. DAP Health is studying whether patients can switch their current antiretroviral therapy drug for another, if a long-lasting injectable treatment for HIV can supplant a daily pill, and if screening and treatment of precancerous cells can prevent anal cancer.

The most recent study launched by DAP Health was the Biktarvy SWITCH Study, which began in May 2021. Singh and Jackson co-authored the study.

Participants in the study, which is open to HIV-positive patients aged 65 or older, will be switched from their current antiretroviral therapy to Biktarvy, which combines three HIV medicines into one pill.

"With the advent of successful treatment regimens, more than 25% of people with HIV will be over the age of 65 by the year 2030," Singh said. "We are studying HIV regimens, such as Biktarvy, to determine the benefits to quality of life in patients 65 and older."

Gilead Sciences Inc., a Bay Area biopharmaceutical company, is collaborating with DAP Health in the SWITCH study.

DAP Health wants to enroll 50 patients in the study. So far, the health center has enrolled two people in the clinical research trial.

"It is a lot of work to find these patients," Jackson said.

DAP Health also is in the course of the GSK/ViiV SOLAR Study and the ANCHOR Study.

The SOLAR study, a global clinical research trial, also is being done in collaboration with ViiV Healthcare. Recruitment for the study ended in June 2021.

Patients in the SOLAR study will switch their HIV medication for a long-acting injection, according to ViiV Healthcare. The goal is to develop an HIV treatment that offers patients more convenience; a treatment that is easier to adhere to; and an increased quality of life.

"The treatment of HIV has evolved tremendously over the past three decades to a point where patients can now get long-acting treatments rather than take a pill once a day," Singh said. "We are evaluating exciting regimens at DAP for safety and efficacy in where patients can get an injection once every two months to control their HIV."

The ANCHOR study, which is still accepting patients, is probing the best way to prevent anal cancer among people living with HIV. The National Cancer Institute of the National Institutes of Health is funding the collaborative study.

More clinical research studies are in the planning process, but unfortunately, Jackson could not go into details.

Anyone who wants more information about any of DAP Health's research should contact Greg Jackson at (760) 992-0445 or [email protected]. 

Vaccinations: Winning Faith, Trust and C …

Vaccinations: Winning Faith, Trust and Credibility  

A look at the history of global pandemics 

By Shubha Kerkar MD, FIDSA, FACP, AAHIVS 

The possibility of control and eradication of the current global pandemic of coronavirus (SARS-CoV2) is now a distinct reality because of two promising vaccines that have shown safe and effective performance in preventing 95 percent of infections in preliminary data of phase 3 trials. 

How will these vaccines work? 

Vaccination prepares the human immune system to combat specific infections. In addition to the very basics, such as barriers to exposure with facial covering/masking, physical distancing and handwashing, vaccination is a powerful tool in the armamentarium of defenses against COVID-19.  

Both the Pfizer and the Moderna vaccines are based on a novel platform using “messenger” RNA to create vaccines (mRNA). They do not use the live virus or even any particle of a virus. They do not affect or interact with our DNA in any way. mRNA never enters the nucleus of the cell, which is where our DNA (genetic material) is kept.  

The cell breaks down and gets rid of the mRNA soon after it is finished using the instructions.  

COVID-19 mRNA vaccines give our cells instructions to make a harmless piece of “spike protein, which is found on the surface of the virus that causes COVID-19. COVID-19 mRNA vaccines are given in the upper arm muscle. Once the instructions (mRNA) are inside the muscle cells, the cells use them to make the protein piece. In a placebo-controlled clinical trial where 30,000 to 40,000 volunteers in vaccinated vs. unvaccinated groups, there was a total of 100 infections, five in the vaccinated group and 95 in the placebo group. All volunteers who received the vaccine experienced no serious side effects, thus proving safety and efficacy.  

What does history tell us? 

In the real world, however, vaccines are only as good as the ability to be accepted by everyone. Winning faith and trust in vaccines depends on the credibility of the doctors, scientists and experts, and their ability to educate and help calm fears.  Once accepted, then the details of how to administer to the entire world population are practical challenges.   

 History tells us that vaccine strategies have successfully eradicated some of the deadliest infections on Earth, including smallpox, polio and measles, in times of scarce resources. The concept of vaccination was first noticed by the famous Dr. Edward Jenner in 1796 when he gave “lymph fluid” obtained from a milkmaid who had cowpox to James Phipps and established that he developed protection from smallpox.   

 In 2020, we celebrated the 40th anniversary of the eradication of smallpox, a deadly disease causing global pandemic for thousands of years. Worldwide vaccination was carried out in an era of no computers, no internet, no easy overseas transportation – all on foot – and simply targeting the worlds population one person at a time.  Of course, now, the challenges are different. 

What are we seeing today? 

Today, as I look around, not everyone is willing to accept vaccination as a silver lining in the dark cloud of this global pandemic. Perhaps there is no clarity, only doubt and mistrust, due to misinformation filtering through the current geopolitical scene, civil conflicts and social media, thus creating confusing layers. 

I remind all to look back in history: When Dr. Jonas Salk discovered the polio vaccine, 70 million mothers stood in line to get their children vaccinated – even before the benefits were confirmed.  Infantile paralysis was a devastating condition seen every year prior to that. Thanks to the polio vaccine – and the trust in that vaccine  today, it is part of childhood vaccination, providing 100 percent effectiveness in preventing polio. 

It is not just us here in the valley, our state or county. We must focus and be part of collaborative international cooperation and the contribution of global intelligence and unite in celebrating this great discovery. We must educate ourselves, gather all the courage and will to educate and counsel each other, and slowly win faith and trust in the possibility of prevailing in this battle against the COVID-19 pandemic. 

Dr. Kerkar is director of infectious diseases at Desert AIDS Project and an infectious disease consultant at Desert Regional Medical Center and Eisenhower Health. For more information on vaccinations visit www.cdc.gov/vaccines. 

Image of DAP care provider

Shubha Kerkar, MD, MS


Shubha has been performing infectious disease consultation since 1991 and has the distinction of having been a part of DAP since 1993 when she joined us as a part-time infectious disease consultant. Her practice is primarily focused on inpatient or hospitalized patients at both Desert Regional Medical Center and Eisenhower Health where she cares for individuals with serious infectious diseases. Once these patients recover and leave the hospital they continue on their path to a healthier life by transitioning to Shubha's office-based skilled management program at DAP. Click here to learn more about Dr. Kerkar.

More HIV Care with Updated HIVMA Guideli …

Media Contact:
Jack Bunting
[email protected]
(760) 323-2118

More HIV Care with Updated HIVMA Guidelines

Dr. Tulika Singh noticing more equity in HIV care

(Palm Springs, CA) November 12, 2020 – Significant additions to nationally accepted HIV care guidelines will help more patients receive excellent care, and will help stop new infections, according to Dr. Tulika Singh, DAP director of research.

The HIV Medicine Association of the Infectious Diseases Society of America updated its care guidelines for people with HIV (PWH). DAP’s Dr. Singh was one of only eight co-authors who worked on this important resource that will have a national impact on PWH. This is the first update since 2013.

“It is a one-stop shop for primary care guidance for all HIV clinicians!” says Dr. Singh. “Patients benefit when they get the best care.”

Significant additions in four areas address vital health issues facing PWH, and the teams caring for them. They include:

  • guidance for physicians treating transgender and non-binary patients with HIV,
  • leveraging Undetectable = Untransmittable (U=U) as part of patient education,
  • care for aging with HIV over 50, and
  • care standards for rapid start antiretroviral treatment.

DAP Health is an established authority in these areas, offering patients access to excellent and compassionate care, regardless of insurance. These updated HIV primary care guidelines used by thousands of clinicians in the U.S. will enable better care for patients, even if they never come to DAP.

“This will help clinicians all over who might need more experience and resources in these areas,” says Dr. Singh.

Transgender and Non-Binary Patients Added

This is the first time these guidelines approach HIV care for transgender and non-binary patients, a group disproportionately affected by HIV and who face extra barriers in healthcare.

“HIV care for transgender and non-binary patients is special, and it needs to be treated so,” says Dr. Singh, who was the second lead for this section of the report.

According to a study by UC Riverside, only 15% of transgender and non-binary individuals reported it was easy to find a provider with sufficient knowledge and experience on issues related to transgender people.

“Education and experience in this area are helpful to reduce bias, and that is important,” says, Dr. Singh. “We want to establish trust and enable transgender and non-binary patients to be fully engaged in their care.”

U=U and Rapid Start ART

Other important affirmations affecting health outcomes for PWH include treatment as prevention, starting antiretroviral therapy (ART) as soon after an HIV diagnosis as possible, and aging with HIV.

Even though effective HIV treatment reduces the level of HIV to "undetectable" levels and makes PWH incapable of transmitting HIV to their sexual partners, many clinicians are not sharing this information with PWH. These guidelines address U=U as well as the stigma it can prevent.

According to the update:

“Clinicians should emphasize that adherence to antiretrovirals not only improves the patient’s health but prevents HIV transmission to others. Undetectable = Untransmittable messaging is welcomed and encouraged by communities with HIV and should be part of routine messaging in the clinic as a means to mitigate stigma. The primary reason for treatment failure, particularly among patients who take initial regimens, is suboptimal adherence to care or treatment regimens.”

Dr. Singh says how quickly patients start ART also affects transmission rates and points to why doctors haven’t been as effective they’d like in stopping new cases.

“Despite having extensive experience in HIV treatment and care, caregivers struggle to reduce high HIV prevalence and rising HIV incidence rates, due to delays in starting ART,” Dr. Singh says. “This is due to previous protocols and practicing traditional HIV medicine.”

DAP recently won designation as a Rapid ART Implementation Site, standing with just 10 other healthcare organizations in the U.S. The Award for Special Projects Of National Significance was won in a competitive grant process and is bestowed by the Health Resources and Services Administration (HRSA). Read more here.

About Desert AIDS Project

DAP Health (DAP) is a humanitarian healthcare organization in Palm Springs, CA offering a combination of medical, dental, counseling, social services, support groups, alternative therapies, in-house pharmacy and lab, and other health and wellness services. DAP’s sexual health clinic offers STI testing and treatment, Pre-Exposure Prophylaxis (PrEP), Post-Exposure Prophylaxis (PEP), and HIV and HCV testing. DAP’s Get Tested Coachella Valley campaign, the nation’s first region-wide free HIV testing and access to care initiative, was recognized by the White House for helping to bring about an AIDS-free future. DAP has earned a “Four Star” rating from Charity Navigator for the twelfth consecutive year – landing DAP in the top 6% of nonprofits rated. The distinction recognizes that we exceed industry standards in terms of our financial health, accountability, and transparency.

For more information, visit www.desertaidsproject.org

About U=U & Prevention Access Campaign

Prevention Access Campaign is a health equity initiative to end the dual epidemics of HIV and HIV-related stigma by empowering people with and vulnerable to HIV with accurate and meaningful information about their social, sexual, and reproductive health. Find out more here.

Undetectable = Untransmittable (U=U) is a growing global community of HIV advocates, activists, researchers, and over 990 Community Partners from 102 countries uniting to clarify and disseminate the revolutionary but largely unknown fact that people living with HIV who are on treatment and have an undetectable viral load cannot sexually transmit HIV.