Keeping our finger on the pulse of the HIV epidemic

Talk to your friends, family, and sexual partners about U=U.

By C.J. Tobe, Director of Community Health

Over the last few months many colleagues have expressed concerns that HIV prevention could be turned back 5 years because of the current health crisis. Let’s discuss HIV prevention to keep our fingers on the pulse of this epidemic that we’ve been battling for 35 plus years. While I have the bullhorn, I also want to talk about an unlikely form of HIV prevention and how surprisingly long it’s taking to get noticed.

When I moved to Palm Springs in 2015, I was shocked to find out through conversations on Grindr that many people were still unaware of U=U. To reach the most people I decided to update my personal social media profiles stating, “Undetectable=Untransmittable (U=U). If you are unsure what this is, please ask.” Now in 2020, 5 years later, I still have many people asking me “what is U=U”?

While significant progress has been made by HIV advocates across the world, stigma surrounding people living with HIV is still very much alive. It affects even those who are adherent to their HIV medications and who have a suppressed viral load, which means they cannot transmit HIV to another person through sex.

According to Dr. Anthony S. Fauci, M.D., Director, NIAID, NIH when interviewed at the 2019 International AIDS Conference,

"The concept of U=U is the foundation of being able to end the epidemic."

If we know that people living with HIV are taking their medications and are virally suppressed will not transmit HIV, then why are we not screaming this from the rooftops? Well, we should. Talk to your friends, family, and sexual partners about U=U.

What is Desert AIDS Project doing to help support those living with HIV to become undetectable?

At Desert AIDS Project we learned through the AIDS crisis that becoming undetectable is more than taking daily medication. It is a combination of factors such as a roof over your head, food in your belly, staying on top of your mental health, and following through on routine oral health exams. DAP’s integrated model of services supports those people living with HIV on their journey to U=U.

Knowledge is Power

U=U may be the foundation to ending the HIV epidemic but what else can we do to combat the multifaceted HIV epidemic?

Access to HIV and STI (Sexually Transmitted Infections) testing and treatment. At DAP, we test more than 5,000 individuals for HIV in 1 year, and the HIV test is Free. The frequency of testing varies depending on your risks. You could be tested every 3 months, once a year, or once in your life depending on the risk assessment done by our Community Health Educators. Even during the current crisis, DAP is providing access to HIV testing in the form of supplying free at-home HIV test kits.

Knowing your HIV status is empowering. Also, important is knowing your STI status. Why?

People who have a STI are twice as likely in acquiring HIV, so routine STI testing and treatment if needed will reduce the number of new HIV infections in any community. Routine STI testing will help prevent someone from contracting HIV and decrease transmitting STIs to a sexual partner as many STIs people are asymptomatic (No symptoms)

Anytime I engage with someone in-person or via social media apps who may be a potential sex partner, I always follow up the HIV status discussion with an STI status discussion.

I ask, when were you last tested? How many sexual partners have you had since your last test? This is not meant to judge a potential sexual partner’s sexual history or scare one of from your past but to empower yourself in taking control of your sexual health by having a transparent conversation with someone you’re about to become intimate with.

At DAP, we provide STI testing and treatment.  People turn to sex for stress relief, to cope with isolation, to eat, to have shelter, and to survive. If you want an appointment today for HIV and STI testing please call 760-992-0492.

Put PrEP in your step

How can we talk about the pulse of the HIV epidemic without the game-changing medications to prevent HIV called PrEP and PEP? PrEP stands for Pre-Exposure Prophylaxis, and is a pill (Truvada, or Descovy) that is taken to prevent someone who is HIV-negative from acquiring HIV. Similar to birth control, PrEP is a medication is taken once a day. If taken once a day PrEP has been shown to be 99% effective in preventing HIV infection.  PrEP dramatically changed the landscape of HIV prevention by giving us the first new tool to fight HIV since the beginning of the epidemic.

Similar to U=U, I was surprised to find out how many people today are still unaware of PrEP and its benefits. I updated my personal social media profiles to include “Do you know what PrEP is? If not, please ask me?” Every time I log on to an app there is always someone inquiring about PrEP. People also ask, who is PrEP for? PrEP is for anyone who is HIV negative and at risk for HIV infection

People express various concerns about PrEP including the cost, side effects and stigma.  PrEP was studied extensively before it gained FDA approval in 2012.  It’s been shown to be both safe and effective in preventing HIV. 

While the medication does carry a high price tag, there are many support programs to help offset the cost and most people can access PrEP with very little or no expense.  DAP is a provider of PrEP navigation services to help people look at PrEP for themselves and assist them with education, financial support and finding a medical provider.

Anyone using PrEP would first be tested for HIV and STIs.  This testing is repeated once every 3 months and is a great way to educate people about the value of routine HIV and STI Testing.  The more we normalize PrEP and routine testing the more comfortable people are with including these things as part of sound routine health care.

Between U=U and PrEP, we were starting to turn the tide on new infections, and HIV numbers across the country were going down for the first time in many years. As someone working in and committed to public health, it scares me when I consider that these game-changing HIV interventions might take a back seat during the current health crisis.

The responsibility for ending HIV falls to all of us. We have the tools to help end HIV in our community—but only if we resist the urge to forget just how deadly it has been in our community for decades.