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What Americans should do to prevent HIV/AIDS

What Americans should do to prevent HIV/AIDS
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Amid the coronavirus pandemic, many states are in varying states of opening. As states open, we should not forget about our sexual health. COVID-19 has impacted American sexuality, although the impact may be different depending on a person’s age, relationship status, or sexual preferences, etc. Due to the stressors of COVID- 19, people may find themselves engaging in behavior that they did not before the pandemic. For example, some teenagers may turn to sex to cope with the coronavirus pandemic. Unprotected sex could lead to serious health consequences, such as contracting HIV. There are, however, medications on the market that can prevent HIV.

Truvada and Descovy are potential options to provide a highly effective means for preventing HIV. Many people who stand to benefit from PrEP do not use these medications because they do not think they are at risk. (Truvada and Descovy, it should be noted, do not prevent other sexually transmitted diseases.) As a society, we must change what we think about who is at risk. Anyone who has unprotected sex with another person whose HIV status is unknown is potentially at risk for HIV; therefore, taking PrEP is a good way to prevent infection.

Traditionally, HIV has been considered a disease affecting only people from specific groups, such as those who inject drugs, have particular sexual orientations, or have multiple sexual partners. While people who inject drugs and men who have sex with men may have higher rates of HIV as a group, they are not the only people at risk. HIV is not a problem belonging to certain groups but rather a universal health issue associated with sexually-active people who do not know the HIV status of their partners. 

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Unfortunately, stigma and misinformation about HIV continue to shape how people decide about sexual activity and protection. One myth that persists is that a person has to be sexually promiscuous to get HIV. In my clinical experience, I have treated at least a dozen people who claimed they had only had one sexual partner and were confused about how they could have attained HIV. Yet, HIV can be contracted from a single sexual encounter. Sadly, this is often the case for people who attain HIV from a spouse or long-time partner due to infidelity.

Another myth regarding HIV is that it is a disease that only affects the young. According to the Center for Disease Control, nearly half of the people living in the United States with HIV are 50 years or older. HIV does not only infect people within a certain age group but can be particularly concerning for older individuals who may already have other medical problems such as diabetes, high blood pressure, heart disease and now potentially COVID-19.

While serious, none of these facts should cause mistrust or create fear. Instead, they should motivate all sexually-active individuals to take the proper precautions to avoid infection.

Condoms can prevent HIV, of course, but many people prefer not to use them. This is why PrEP medications such as Truvada and Descovy offer invaluable options for preventing HIV. Both can be taken as a tablet once a day for those who have tested negative for HIV. (For those who are HIV positive, taking Truvada or Descovy alone can be harmful.) One’s healthcare provider can prescribe both medications. Given the current need for social distancing, some healthcare providers provide remote access to care and medications. In addition, at the end of 2019, the Trump administration unveiled a new program making pre-exposure prophylaxis (PrEP) for HIV available for thousands of Americans who are uninsured.

As a society, we need to take charge of our sexual health. That includes changing the way we think about HIV risk. If at risk, one of the steps we can take is talking with a health care provider about PrEP. HIV can be prevented and we should guard against it.

Candice A. Sternberg, M.D., is an assistant professor of Clinical Medicine in the Division of Infectious Diseases at the University of Miami and a Public Voices Fellow of The OpEd Project.