PrEP can stop HIV’s spread
Ronnie Grace was 28 years old when he discovered that he was HIV positive. Thirty years later he is still living with the disease and, thanks to advancements in antiretroviral therapy, Grace could live another 30 years. That’s how far HIV treatments have come over the past three decades.
In the mid-80s things were different. HIV was called a “death sentence,” and Grace lost more than 50 friends to the disease.
Grace told me that when he lived in Los Angeles, he even participated in “search parties” to find people who were suffering from AIDS-related dementia. When he moved to Atlanta years later, things were not much better.
During this time, there was much ignorance, denial and silence around HIV and AIDS. The gay community for the most part had to deal with the death and trauma of losing loved ones by themselves because many people blamed them for their condition.
It was a scary time, and while tremendous strides have been made in treatment, the stigma associated with the disease remains.
Grace said a lot of young gay people living with HIV today were not even born when people were dying daily from the disease. “They have no idea what it was like to go to a club and ask where’s Charles and have someone say he’s sick or he’s in the hospital,” he said.
A newly diagnosed 22-year-old can live another 50 years with HIV and not spread the disease if he or she is on treatment and understands the seriousness and diligence it takes to manage the disease.
The disease is not viewed as a death sentence today, and young people are more prone to take risks.
This lack of history makes Grace’s job as a public health HIV prevention program coordinator with Diverse & Resilient that much more difficult.
Bevan K. Baker, Milwaukee’s health commissioner, said the Internet has made it easy for young people to hook up. People can post that they want to have a sex party at a location and within 30 minutes, they can have people there participating.
HIV still disproportionally impacts young black gay men of color. In Milwaukee, 40% of young black men who have sex with men are HIV positive. Nationally, one in eight Americans with HIV don’t even know they have the virus.
To stop the spread, it’s important for people to know their status and have access to condoms. And if they are at high risk for HIV they need to get on medicine such as pre-exposure prophylaxis, (PrEP) to protect them from getting HIV.
Last week, I was invited to Diverse & Resilient to find out more about the PrEP. The blue pill, which is about the size of an 800mg Motrin, has been called the miracle drug because it can reduce the risk of getting HIV by 90% when taken daily. While PrEP has been around for nearly two years, those at the greatest risk still don’t know about it or don’t know it’s available here.
Lori Hartz, a nurse practitioner with the Greater Milwaukee Center for Health and Wellness, who attended the meeting, said HIV infections can be reduced if those at the highest risk — young black males who have unprotected sex with men and those in the transgender community — are placed on PrEP.
She also noted the importance of privacy at her practice. No one knows if you are in the waiting room because you have a bad back or if you are there to get HIV medication.
This helps in reducing the stigma associated with the disease. PrEP works by stopping the virus from entering cells and replicating. This prevents HIV from establishing itself and the person remains HIV negative.
PrEP with condoms offers the best protection for those sexually active. PrEP alone offers no protection against other sexually transmitted infections such as gonorrhea, chlamydia and syphillis. Milwaukee is ranked in the top 10 in the nation in STIs and Milwaukee County experienced one of the largest gonorrhea outbreaks ever in 2015 with 1,200 new cases.
The state and community partners are building a website that focuses on PrEP. The site will list doctors who provide PrEP, rank doctors, provide personal stories of those on PrEP and tell people how to best connect with a physician near them on bus routes.
This is a positive step in getting information out, but the media needs to help spread the word, too. HIV is a community health issue, and I was a bit disappointed that I was the only reporter who attended.
The only drawback to PrEP is the cost. At $200 a pill, somebody is profiting big and that’s ridiculous.
Hartz said her agency works to keep costs down through insurance, grants and other programs. That’s fine but it should not cost $73,000 a year to keep a person from contracting or spreading HIV.
Until we come up with a cure for HIV, efforts to get those at the highest risk on PrEP need to be a priority. The website will provide privacy to help connect people to the best doctors and services making it more likely that they seek help and get on treatment.
Getting the word out is just the beginning, stopping the spread needs to be the goal.
James E. Causey is a Journal Sentinel editorial columnist and blogger. Email jcausey@journalsentinel.com. Facebook: fb.me/james.causey.12 Twitter: twitter.com/jecausey