Of the estimated 1.2 million people with HIV in the United States, 13% are unaware they have it. This is despite ongoing scientific advancements enabling people with HIV to live long, healthy lives, and a vast increase in frank and candid conversations from people in the public eye, like Billy Porter and Jonathan Van Ness, to dispel the stigma surrounding the virus.
“I still think there is a lot of stigma surrounding HIV and prevention, and I also think there’s still a distrust from certain communities of the medical establishment, lack of education and comfort with providers,” said Dr. Antonio E. Urbina, medical director at the Mount Sinai Institute for Advanced Medicine and a professor of medicine at the Icahn School of Medicine at Mount Sinai in New York City.
“We have made strides in terms of decreasing the number of new infections, but we still need to demystify the tools we have to prevent it by universally adopting a more sex-positive attitude,” Urbina told HuffPost
Feeling comfortable with and empowered by your medical provider to speak openly about your status, ask questions and seek treatment are crucial tools in the fight to eradicate HIV and treat those living with it. But there are plenty of other things infectious disease doctors recommend that people do in order to keep themselves safe.
Know your status.
The most obvious-sounding one is also one of the most important. It’s not only for the benefit of your sexual partners and for the betterment of your health but also to ensure you’re getting the correct and most effective treatment possible.
“When a person is aware of their status, they can engage in informed conversations with health care providers to explore personalized prevention strategies,” Dr. Taimur Khan, associate medical research director of the Fenway Institute in Boston, told HuffPost.
“Regular testing facilitates early detection, which can lead to early treatment, reducing the risk of HIV transmission and contributing to better health outcomes. It also opens the door to other preventive measures, like PrEP, which can be tailored to individual needs and circumstances.”
Inquire about new treatment options.
PrEP, or pre-exposure prophylaxis, is already a widely known method of protection and prevention. When taken in pill form as prescribed, PrEP reduces the risk of getting HIV from sex by 99%.
It also helps to maintain the U=U, or undetectable equals untransmittable, status. When your viral load is undetectable, it’s also untransmittable. When someone has HIV and is taking antiretroviral therapy (ART) to maintain their undetectable status, they cannot spread the virus. Since PrEP assists in preventing someone from contracting HIV even if they are exposed to it, it also helps to protect the wider community.
But not everyone feels like taking a pill every day. For those people, it might be worth inquiring about other options.
“We already have approved a long-acting bimonthly injectable called Apretude,” Khan said. “That might be able to option the window for capturing the most vulnerable populations or most impacted. It’s widely available and FDA-approved, most insurances will cover it. It just hasn’t really scaled up significantly because it’s still new, and I also think it takes a bit of infrastructure at a site or clinic to have a flow and process for getting it approved and actually doing the injections.”
Practice safe sex and injection.
Every doctor we spoke to stressed the effectiveness of consistently wearing condoms when engaging in anal, vaginal or oral sex, and for those who inject drugs, participating in needle exchanges or ensuring clean needles are used. For more information about syringe services programs, click here.
Prioritize being in a safe space.
It’s just as important to feel empowered to discuss your sexual health with a partner as it is with your health care provider.
“There should be no shame or judgment surrounding sex. This is one of the reasons transmission continues to occur,” said Robin Hardwicke, a professor of obstetrics and gynecology at UTHealth Houston who specializes in infectious diseases. “Sex is a natural part of human life; an expectation. Be free to have sex, but be responsible enough to protect yourself and your partner.”
“Find a provider or clinic where you feel comfortable talking about these issues,” Urbina added. “If you start to talk about this and you get shut down or they’re not responsive to your needs, you should go somewhere else until you really feel comfortable. If you feel you have to hide or not disclose something so important, it’s not a fit.”
Treat HIV as part of your overall health.
Finally, it’s important for both medical professionals and their patients to remember that they would be better served looking at HIV through the lens of overall health and not just sexual health, Khan told HuffPost.
“The stigma that has long been associated with HIV is being challenged by emphasizing a shift from discussing ‘risky’ behavior to promoting sexual practices that are safe, consensual and enjoyable,” he said. “By addressing HIV as one aspect of a broader sexual health conversation that includes other [sexually transmitted infections], vaccinations, mental health and substance use, the focus is placed on comprehensive care and well-being. This inclusive approach helps to dismantle the blame and shame often associated with HIV and repositions it as a manageable health condition.”