Last December 3th-4th it was held, at San Francisco, the first American National HIV PreP Summit, which brought more than 600 activists from US and other regions of the world to the center of the city in California.
Maybe in Spain, where we are still struggling to explain what Prep means, and discussing about prehistoric ghosts of this preventive and revolutionary method ( secondary effects, pharmaceutical companies black hands or its effectiveness) we may not see relevant a meeting of this kind, but for our organization is a key issue, and it has been a privilege and opportunity to be a part of it through the AIDS/HIV treatments European Group (EATG), which we are a member of.
To explain the context, and for newcomers, Prep is HIV preventive pill. Yes, as clear as you read it.
Is it true that HIV infection can be prevented by a pill?
Even though it is not being given due importance, Truvada usage, one of the antiretroviral drugs available in the market for HIV infection, also prevents it, and very effectively. We already told you in previous posts.
Prep is effective and safe, and it comes from the community movement, and the observation of real life from people living with HIV. From the community evidence came the scientific evidence, not without solving big economic and institutional support challenges.
“Truvada whores” came into the front scene, and with them, previous discrimination conducts against prevention arose again. Does anyone remember when women were called whores for keeping condoms inside their purses? Or when people who started using other contraceptive methods were called whores? The normative and moralist lobby came back to attack the sexual freedom of people, especially against historically isolated communities, who were only taking care of their sexual health in a more effective, responsible and safer way than the rest of the population, which has never been pointed out for their sexual diversity.
We should not use the treatment of certain diseases as a behavior control method.
Being with more than 600 people, most of them PreP active users or distributors who work on a daily basis implementing this preventive method, strongly increases the value of this treatment, especially when you observe a total implication from the several groups affected by HIV: trans people, women, immigrants, and of course gay community and men who have sex with men.
When we say it increases the value of this preventive method is because, being a community movement at its origin, it has been in the US where there is an absolute involvement of the community, far away from the oldest and more well known LGTBI organizations in our country, who are still struggling with power fighting and “pink-washing”. This attitude is driving them away from the reality and the needs of the people who belong to the wrongly named LGTBI community. Community? #NoComments.
Two days of meetings and essays, mostly about how to overcome the obstacles which they find on a daily basis in the US in order to grant this preventive method against HIV. These obstacles are mainly coming from morality and the “buts” from doctors, trying to avoid a legal access to this pill, and of course to the economic coverage of the same. However, there were also essays about figures and conclusions: Prep is not only an effective method on a health level and the most powerful alternative to end HIV epidemy on a short term, the preventive pill means so much more:
- Prep is the vehicle to be the sexual person you want to be. Lets leave aside the idea of ideal candidates for Prep and lets start talking about people choosing Prep as a preventive method ideal for their characteristics, and the way they want to live their sexual life.
- Prep reduces HIV anxiety and the daily panic suffered by many people belonging to the most prevalent collectives, which limit their adequate sexual and personal development in most cases.
- It helps reducing HIV stigma. People accesing Prep will have a broader knowledge of the virus, and also about the real daily issues of the people living with it, reducing fears coming from discrimination and lack of information .
- It helps broadening and improving sex health assistance. A person who regularly go to the medical center to get the pill and have the necessary medical checks (HIV and other tests), is a person more aware and informed of his/her sexual practices, so we have better quality space and time to talk and inform than when we do the HIV testing, as this is a time where the person is not very willing or keen to receive counseling.
- Prep is a matter of human rights and social justice, and it is a way of social transformation which enable to make the reality of our sexual relationships visible. On a daily basis, our health care system medicalizes the population, sometimes with drugs which has no clinical utility. This is due to many diseases and to prevent medical conditions (example: contraceptive pill, methadone, HIV post-exposure prophylaxis, HIV mother-sibling prophylaxis, cholesterol pills, etc.) Why so much prejudice and barriers in Prep case, being it so necessary and powerful?
Most of this information was part of the content of the closing session “It is time to stop being a target and become a priority”, by Sarit A. Gloub, New York Hunter College Doctor, who got the recognition and the most sound and exciting ovation that we have lived in the latest years on HIV area.
Sarit calls for a change in the intervention on sexual health care and stop talking about people with HIV high risk practices, as, in many cases, people who can benefit from our services don’t feel themselves as “high risk conducts”. To qualify all sexual practices without condom as “high risk”, makes healthy sexual life a pathology from the doctor point of view. Questions made in medical checks about specific data (number of partners, number of STD’s -sexual transmission diseases, number of anal sex unprotected practices) move the professional away from the patient worries or unawareness, from their own risk perception, and it does not help the patient to reflect about himself/herself.
US Health professionals are aware that Prep use is reducing condoms use, and that Prep implementation is driving us to an increase of other infection detection (not to a direct increase of the infections itself), but, as Doctor Sarit said I don’t give a shit!, if this means to face, for the first time ever, sexual health care as a priority in public health care. We cannot, and we should not , use the control and treatment of other infections as a way of controlling the population sexual conduct.
If you judge me, if you consider me a bad person due to my sexual desires, I may not want to go back to your health service.
The American community is living a honey moon with the excellent results that Prep is bringing to their cities. But they are not the only ones. In countries like England, where there is still not legal access to Prep, recent studies show a reduction of new HIV transmissions due to “wild Prep”. These studies are being monitored by ONgs and community services like 56 Dean Street.
What is Spain waiting for, when we are European ranking leaders on new infections ?
We are allowing our population, our young people (especially LGTBI community), to buy drugs illegally from abroad laboratories or in the black market, in order to protect themselves and feel safe from something that should never be seen as negative or risky, our sexuality and erotism. Another trick they are using is to use friends drugs or go to Hospitals ER to ask for Pep and use it as Prep.
Yes, Prep is already in Spain, but while Health Ministry is looking to the other side, the population is moving forward in order to avoid risking their health. And not only the population, from our Organization Apoyo Positivo, we are aware that some doctors, through Social Security system, are supplying Truvada to HIV patients partners, without protocols and without universal access.
Prep should be granted to any person who wants to live their own sexuality as they desire and whom they want to live it.
Has anyone in a sexual health care center asked you what kind of sex you would like to have?
We need Prep NOW! Sign it, distribute it, resend it, ask. We can only succeed to stop the epidemy in Spain with your support.