Why Aren’t More People Using PrEP?

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In 2015, Vice published a documentary looking at Truvada, the first FDA-approved drug with the means of preventing HIV infection (the non-brand name is PrEP). At the time, Vice’s video said that if an HIV-negative person takes the pill every day, he or she is nearly 99 percent protected from contracting the virus. The documentary explores the future of the drug and its revolutionary impact on ending HIV/AIDS.

So two years later, where are we?

HIV stands for human immunodeficiency virus, which can lead to AIDS or acquired immunodeficiency syndrome. In the United States, HIV is spread mainly by having sex or sharing injection drug equipment such as needles with someone who has HIV. Certain fluids — blood, semen, pre-seminal fluid, rectal fluids, vaginal fluids, and breast milk — from an HIV-positive person can transmit HIV.

One in seven people in the US who have HIV do not know they’re infected. Pre-exposure prophylaxis, or PrEP, is a way for a person who does not have HIV but who is at substantial risk of getting it to prevent HIV infection. You take a pill every day. When taken consistently PrEP has been shown to reduce the risk of HIV infection. People who use PrEP must commit to taking the drug every day and seeing their health-care provider for follow-ups every three months.

According to the Boston Globe, from 2000 to 2014, “Massachusetts saw a 47 percent drop in the number of people newly infected with HIV each year.” But Dawn Fukuda, director of the Office of HIV/AIDS at the Massachusetts Department of Public Health, said that decline is starting to level off.

By the end of 2015, more than 79,000 people had started PrEP since the pill was introduced. Massachusetts has the highest percentage of people taking PrEP than in any other state. That percentage is still minuscule, 0.07 percent or just 4,950, according to Truvada’s maker, Gilead Sciences.

Why the hesitation? One issue is that most specialists know PrEP as a way to treat patients who are already infected, instead of people at risk. Primary care doctors often don’t know enough about the drug to offer it. Another challenge is that taking the pill requires commit: a daily dose and tri-monthly check-ups.

So here are some facts about PrEP (you can also head to our site to learn more):

You must be HIV-negative to take Truvada for PrEP and you must continue using safer sex practices because just taking the drug may not keep you from getting HIV. According to 2016 results from a survey of retail pharmacies by Gilead Sciences, more than 79,000 people in the US started Truvada for pre-exposure prophylaxis (PrEP) over four years.

The side effects may include kidney or bone problems, changes in body fat, headache, stomach-area (abdomen) pain.

Who should take it? Anyone who:

  • Is not in a mutually monogamous relationship with a partner who recently tested HIV-negative, and

Is a…

  • gay or bisexual person who has had anal sex without a condom or been diagnosed with a sexually transmitted infection within the past 6 months; OR
  • heterosexual person who does not regularly use condoms during sex with partners of unknown HIV status who are at substantial risk of HIV infection (e.g., people who inject drugs or people who have bisexual partners).

HealthQuarters now offers PrEP. Do you have any questions or concerns? Book an appointment or call us today.

Check out “Getting to Zero,” they have some great material.

And remember:

Everyone between the ages of 13-64 should get tested at least once for HIV as part of routine care.

— Use protection, such as male or female condoms, to protect yourself when having sex with a new partner who has not been tested (ever or recently).

Hepatitis C in Massachusetts: What You Should Know

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Hepatitis C is the number one blood-borne illness in the United States.

As many as four million Americans have hepatitis C, a liver disease caused by a blood-borne virus, but most of them are unaware of their diagnosis. Because of this, the Centers for Disease Control (CDC) has recently recommended a one-time hepatitis C virus (HCV) antibody test for anyone born between 1945 and 1965.

Although there is no vaccine for hepatitis C, many doctors recommend that you receive vaccines against the hepatitis A and B viruses.

Treatments for hepatitis C have dramatically improved over time. The infection is treated with antiviral medications intended to clear the virus from your body. The goal of treatment is to have no hepatitis C virus detected in your body at least 12 weeks after you complete treatment.

In 2016, Massachusetts Medicaid program announced it was lifting restrictions that prevented many patients from getting the drugs that can cure hepatitis C after negotiating discounts with two manufacturers. With the restrictions gone, more than 3,400 people were expected to get treatment.

HealthQuarters currently tests and refers for treatment for hepatitis C and you can book an appointment or call us if you have any questions or want to get tested. If you have been or are in treatment for hepatitis C and like your provider, we’d love to hear about them to see about a potential partnership. In response to other community feedback, we’re starting to explore treating hepatitis C in our clinics and would love to hear what you think about HealthQuarters providing that service.

 

#MythBustingMonday: Not a Trend: “Stealthing”

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For this week’s episode of #MythBustingMonday, we are looking into stealthing, a form of sexual assault that people were calling a “sex trend.”

Stealthing is defined as the act of taking off a condom during sex without the partner knowing or giving consent.

Myth: Stealthing is fun for everyone.

Fact: Stealthing is sexual assault. It is a form of date rape that violates conditional consent. When a sexual partner agrees to sex under one set of circumstances that does not mean they agree to it under all circumstances.

Myth: That this “trend” is okay and a common practice in sexual intercourse.

Fact: Stealthing is creepy and ignores the rules the very basic rule of consent: that no one should do anything without the explicit permission of their partner.

Teen Vogue reports that a recent study for the Columbia Journal of Gender and Law found that there has been an uptick in this behavior. Alexandra Brodsky, who conducted the study, investigated this trend because it was happening to women she knew, but the victims didn’t have words to describe what was happening to them.

Myth: Stealthing is harmless and can be funny.

Fact: Nonconsensual condom removal during sex exposes victims to physical risks of pregnancy and disease, not to mention emotional trauma.

Myth: My partner has an IUD so it’s ok to stealth them since they can’t get pregnant.

Fact: Stealthing puts people at risk for STDs emotional trauma.

Myth: Stealthing is a recent idea.

Fact: Reproductive coercion is not new. The first sterilization law was passed in 1907, ushering in decades of reproductive coercion. Impoverished women, immigrants, and women of color were the recipients of forced sterilization. One quarter of adolescent females reported that their abusive male partners were trying to get them pregnant through interference with planned contraception, forcing the female partners to hide their contraceptive methods.

So remember to get active and enthusiastic consent for every sexual act, and it is always okay to say no.

If you discover that someone has sabotaged your birth control plan or would like to

You can give HealthQuarters a call if you need to talk more about anything or what to discuss other birth control methods outside of condoms.

Consent Is Sexy

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You’re making out — It’s great. You move it to the bedroom. You take off your clothes. You have sex.

What is missing from this basic description of a sexual experience? Consent.

“Do you want to do this?” “Is this okay?” “Do you like that?” “What do you want me to do?”

While many movies and TV shows show couples getting it on with very few words, that’s not the best, or most consensual, way to go. While consent can be given through actions and body language, it is very important to ask for consent before any sexual act. Consent is about communication.

First of all, a very important thing to remember is that just because you slept together, made out, participated in heavy petting once does not mean you automatically have the right to do that again. Someone — yourself included — may consent to that activity once and then not consent at different time. That is okay! Agreeing to kiss someone does not mean you are agreeing go further than that with them, and agreeing to having sex with someone does not give that person permission to have sex with you again in the future.

You can also change your mind at any time. It is important to communicate to your partner that you are no longer comfortable and wish to stop. A good practice is to ask your partner before you begin any new act and make sure both parties are comfortable with any and all activity. If someone says they are uncomfortable or no longer give consent, stop immediately.

Here are a few quick guidelines to consent:

Consent looks like:

  •      Asking before you kiss, touch, move forward sexually
  •      Using physical cues to let the other person know you’re comfortable
  •      Agreeing to activities by saying “yes” or “I am open to trying”
  •      It is not just one person’s job to ask for consent, and consent does not follow stereotypical gender rules. Everyone should ask, and ask often.
  •      Talking about STIs, other partners, birth control, how to feel safe

Consent does not look like:

  •      Refusing to acknowledge or pretending not to hear “no”
  •      Assuming that someone’s clothes, flirtation or physical contact is an invitation for anything more
  •      Pressuring someone into sexual activity using fear, intimidation, guilt, or other methods
  •      Someone being incapacitated because of alcohol or drugs

Consent boils down to being open and intentional with every act. Does this sound sexy to you? If not, we promise it can be. Bedsider says you should think of enthusiastic consent as planning a road trip together — you talk about where you want to want to go, what you want to do, you detail what you hope to see. You can ask questions like: “Where’s your favorite place for me to touch you?” “I love it when you ______.” “I have a fantasy—can I tell you about it?” And we all know that hearing what your partner wants to do to you, and wants you to do to them, is super sexy.

 

We would love to hear your “consent is sexy” stories!

#MythbustingMonday: Sex on Your Period

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#MythbustingMonday

On this #MythBustingMonday, we are here to bust open the myth that you can’t have sex on your period because it will be gross or not as pleasurable.

Here are seven reasons why period sex can be great:

  1. It can alleviate cramps. When we orgasm, the body releases oxytocin and dopamine, along with other endorphins that can ease any period-related pains. Those hormones are far stronger than any over-the-counter painkillers.
  2. You need less lube. You probably won’t find it gross once you start doing it. According to Bustle, researchers in the Netherlands found that sexual arousal overrides the natural disgust response, which means that once you get started, the fact that you’re on your period may not even enter your mind. Once you start doing it, everything else becomes secondary.
  3. It can deepen intimacy.
  4. You’re helping take down stigma surrounding periods and women’s bodies! It can help shorten your period. When you orgasm, your uterus contracts. Each contraction expels the blood and uterine lining faster than it would on its own.
  5. It can make you feel sexier. At a time when you are often bloated and crampy, having sex can boost your self-esteem.
  6. Most people are hornier while on their periods, so don’t ignore those urges!
  7. It’s easy to keep the clean-up quick and easy: shower sex, put down a dark towel, use a condom.

Remember, you can still get pregnant while having sex on your period, so be sure to continue your birth control.

And as always, if you have any questions, contact HealthQuarters!