Take pride in your sexual health: Some facts about HIV
by Chris Shoaf
It’s time for an update on the facts surrounding harm reduction and HIV. We can’t let fear and ignorance stop us from knowing the facts and knowing our own HIV status. Under-education about HIV often leads to fear and negative viewpoints.
We’ve created dangerous and stigmatizing words like ‘clean,’ ‘DDF,’ and ‘infected.’ This stigma often creates fear of HIV testing, treatment, and creates worse outcomes for sexual health. Just because someone is living with HIV does not mean that they shouldn’t lead a life of pride and happiness like anyone else. HIV is a manageable condition, not a death sentence, and definitely not something you should be ashamed of.
Some communities face disproportionate incidence of infection and most of that can be attributed to barriers of stigma and a lack in services well fitted to that community. People of color and the transgender community are the most grossly underserved populations in the United States. Inclusion of key populations will help reduce HIV prevalence.
HIV testing is very important and everyone should have at least one test in their lifetime. Those who are sexually active or who may have additional risk factors should test more frequently – annually or year to quarterly. The purpose of testing isn’t only to know your HIV status, it also gives you the opportunity to have an honest discussion about sexual health and harm reduction with a trained professional.
For persons who are newly diagnosed with HIV through testing, the objective is to link them to care as quickly as possible. In the United States, the Ryan White CARE Act provides people living with HIV access to healthcare if their income falls below 400 percent of the federal poverty line.
When a person is diagnosed with HIV in Oklahoma, a disease intervention specialist (DIS) will contact the individual and help them to notify any of their past sexual partners. The DIS’ job is to ensure the treatment and prevention of communicable diseases. If they make contact with you, get a quick test. If you don’t, follow-up contact may be less discreet.
Condoms are the most widely available means of harm reduction. Proper and consistent use of them greatly reduces the spread of not only HIV, but also other sexually transmitted infections (STIs). Something important to note: Spermicidal condoms and spermicidal lube damage the tissues in the vagina and anus, increasing your chances of contracting HIV and other STIs.
In addition to condoms, biomedical interventions are also available to prevent HIV infection.
Pre-exposure prophylaxis (PrEP) is the newest dish on the harm reduction buffet. PrEP is biomedical intervention in the form of a once-daily antiretroviral medication called Truvada. It’s important to remember that PrEP only reduces the risk of HIV, not other STIs.
Post-exposure prophylaxis (PEP) is another biomedical intervention. Antiretroviral drugs are prescribed within 72-hours after HIV exposure or probable exposure. They must be taken for 28 days. PEP is more commonly used for victims of sexual assault and healthcare workers who may have been exposed to the virus. In Tulsa and Oklahoma City, PEP is available to victims of sexual assault through the Sexual Assault Nurse Examiners (SANE) program.
Treatment as Prevention (TasP) is the most important and efficacious harm reduction strategy for preventing HIV. It is a means of keeping those living with HIV healthy through the use of antiretroviral medicines. Most persons living with HIV who achieve and maintain complete viral suppression (commonly called “undetectable”) will live as long as a person who is HIV-negative.
The medication allows the immune system to rebound and nearly eliminates the probability of transmitting HIV to another person. Being “undetectable” means that so few virions are present in a person’s blood that laboratory tests cannot determine how many copies are present but the virus is still there and could be transmitted.
The probability of contracting HIV from someone who has tested negative for it is very low. Keeping the viral load undetectable is why TasP is so important and why linkage to care is paramount to ending HIV in our lifetime.
There are other methods of harm reduction. Check them out at www.preventhivok.org/education.
We need to keep the conversation about HIV going. HIV does not get the attention that it did when AIDS deaths were common, before the antiretroviral era. Lack of discussion often leads people to being misinformed about HIV and new methods of prevention.
I encourage you to talk to your friends and community members about these HIV facts. Please feel free to send any questions regarding this article, harm reduction, or HIV to TIDALtulsa@gmail.com.
The Gayly – June 25, 2016 @ 7 a.m.