Growing up in the 1980s in California, my earliest memories of learning about sex were in relation to the AIDS crisis. As a child, I remember being told how HIV is transmitted, what sort of sex puts you at greater risk, and how to protect yourself against it.
While all of this information was shared with me in a rather matter-of-fact tone that didn’t include the intense moralizing that many folks encountered during their sex education, the fear of HIV was still palpable. And for me, this wasn’t just abstract.
When I was in my 20s, I found out that a very close family member had tested positive for HIV. In the early aughts, when this happened, it still felt like a death sentence despite the fact that HIV medications and treatments were becoming more effective. Moreover, HIV diagnoses were still intensely stigmatized.
Fortunately, California was leading the way both in efforts to provide effective HIV treatment to those with positive diagnoses, and to destigmatize testing and the use of preventative medications like PrEP (Pre-Exposure Prophylaxis), a daily medication that can reduce the chances of becoming infected with HIV by 90 percent.
And these campaigns were highly effective — so effective that in 2015, UPMC physician John Mellors called together a meeting in Pittsburgh of health care providers and community service organizers to discuss how to improve treatment locally. Richard Smith, Project Director of HIV/AIDS at Jewish Healthcare Foundation, recounts, “Individuals in Pittsburgh got together to talk about what was happening in San Francisco, because at the time it had a significant drop in HIV diagnoses and were doing cutting edge work around PrEP.”
Sue Steele, program coordinator of the HIV/AIDS program at Jewish Healthcare Foundation, says, “We thought that Allegheny County would be a great place to create a similar program that could disseminate to other smaller cities.”
She explains, “Pittsburgh’s HIV rates had been stable for 10 years, we have a low migration rate, and we have a lot of good support systems, community organization, and community-based health care.”
On World AIDS Day in 2015, AIDS Free Pittsburgh launched as a collective initiative of healthcare institutions and community-based organizations to support those living with HIV/AIDS, and those in high-risk communities. Following the example of San Francisco and New York, the organization set three goals: to increase access to PrEP, to routinize and destigmatize HIV testing, and to put in place a rapid linkage to care for those diagnosed.
One of the major successes of these efforts has been the increased information about and access to PrEP. Dr. Ken Ho, chair of the PrEP subcommittee of AIDS Free Pittsburgh, says, “We’ve developed multiple programs to make PrEP more accessible in Pittsburgh.” He goes on, “My hope is that our efforts will translate to a continued decline in HIV infections.” These efforts have included putting together PrEP toolkits for providers, hosting informational happy hours for pharmacists, and multi-pronged advertising and media campaigns to chip away at the stigma associated with HIV.
And while this work is centralized on HIV prevention and care, it has larger implications for the community. Ho comments, “I think this will ultimately reduce stigma against not only people living with HIV, but also people who are at risk of HIV. I hope we will uncover opportunities to have honest conversations about sex, wellness, and health with each other.”
I know that access to this information and community-based efforts to have open and honest conversations about sexual health and wellness would have made my experience less scary, and I am very grateful that Pittsburgh is leading these efforts.
For more information about resources, testing sites, and access to PrEP, visit aidsfreepittsburgh.org. Questions about PrEP can be texted to 412-773-1120.