FOF #2201 – PrEP Myths Even Your Doctor Believes

Aug 11, 2015 · 1985 views

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Truvada may be 99% effective at preventing HIV infections, but it is still surrounded in controversy, with people saying it will turn gay men into disease spreading whores and that it could create an HIV superbug. But none of that’s true so why do these myths persist?

Today Marriage and Family Therapist Damon L Jacobs joins us to dispel the myths surrounding this new prevention method.

    Comments

  1. GaryS says:

    Hmmmmm.
    Ok, so an hour long advertisement for Truvada……

    Although ANY sex positive discussion about taking responsibility for your health is always a good thing, this podcast’s biased tone really concerned me.

    With 39% of new (and increasing) AIDS cases in the US occurring in the 13-24 age group and 81% of infections and deaths being of people of color, spending a podcast on HIV prevention whining about how privileged adult males (and do I assume mostly white?) are too timid to get up the courage to ask their doctors for PrEP medications, seems a bit precious to me.

    I would imagine that very few in the above case groups have access to appropriate health care (does CHIP fund PreP?), nor do intravenous drug users at risk have the money to purchase fresh needles let alone or Truvada.

    Also, I find Mr. Jacobs use of his personal experience in the incorrect use a condom in anal sex as an example of why condoms are not effective in preventing STDs very specious reasoning.

    Even his oft sited CDC guidelines for use of PrEP indicate that the health care professional should “….encourage condom use for additional protection.’ when using PrEP.

    Though I understand that Mr Jacobs is a family therapist and not a public heath educator, I find his neglecting to address and apparently dismiss the use of condoms as presently the most readily available protection against infection from HIV and (when used correctly) STDs, very irresponsible and quite dangerous.

    • Hmm, so not sure if the opposition here is PrEP itself, or assumptions about privilege? Indeed Gary$, or anyone, can come to my Facebook Group https://www.facebook.com/groups/PrEPFacts/ and see people of all genders, ages, and races share their struggles and triumphs navigating homophobia and discrimination from the medical system.

      It’s interesting that Gary$ is hearing that the problem is that people are “timid.” That is not at all the case. The barrier to care hasn’t been on the consumer side, it’s been dealing with the doctor myths that Fausto and Mark presented in this episode, which have sadly become the norm for so many men and women seeking to utilize PrEP.

      Sure condoms are the most “available” protection. And they’re also the least used. Most gay and bisexual men gave up using condoms a decade before PrEP became available (http://www.ncbi.nlm.nih.gov/pubmed/25469526). So, instead of stigmatizing and pointing fingers, I find it’s more effective to meet people where they’re at, and from there encourage adherence to PrEP, as well additional protections if possible.

      Thank you for listening!

      • GaryS says:

        Damon,
        Hmmmm,
        My opposition to PrEP?
        None whatsoever.

        My incredulity of a dialogue between a patient and health professional that would that would end something like, as per your ‘Doctors Myths’:
        Doctor: “I cant in good conscience give you a prescription for PrEP since it will allow you to become more promiscuous in your homosexual behavior.”?
        Yup.

        As a therapist you know better than I how verbatim these dialogues are, or if more often then not they are projections of the patient’s own internalized homophobia or sexual shame, or even laziness.
        But, pain is pain whether is self inflicted or the result of someone else’s insensitivity. So, I admit to also being insensitive to their pain with my ‘timid’ comment, and I apologize.

        Health care workers ignorance of the values and uses of PrEP is another story; of which you seem to be passionately getting the word out.

        However, it does sound as indicated by their interactions with doctors that a majority of the men you work with are privileged to have access to health care, education and support, (as indicated by their ability to reach out to your group) and to just being able to insist on being treated as an adult by health care workers.

        Compare them to the shocking statistical group of 13-24 year olds and 81% people of color, who are most likely in those groups due to their lack of access to health, education, and support resources. So I would say yes, these are THE ‘underprivileged’ who most desperately need our help, education and support.

        We should be outraged, if we accept the reports, that the US is one of only two industrialized nations where infection rates are on the rise, and its our CHILDREN who are being infected.
        It is our fault they are being infected. We are not doing enough to stop it.

        My disappointment was that in an hour podcast dealing with sexual health that neither you, nor Marc, nor Fausto, thought to take the opportunity to speak to that group who at this point have very little access to PrEP, and give them a quick chat with simple and accurate information as how can reduce their risk of infection, right now.

        No wonder new cases are on the rise and use of condoms by gay and bi men are in decline when we cant take a couple minutes out on a podcast as sex positive as Feast of Fun to educate and spread the word about basic safer sex practices.
        Think of the power that would have had.

        I appreciate you responding to my comments, and I thank you for getting the word out about the exciting opportunities of PrEP.

  2. Saulo says:

    Oh Damon… such a nice and intelligent man (and gorgeous as well). A great educator on such important matters. Nice to hear from him again! Kisses to you all!

  3. I just got a prescription for Truvada. I think it’s on everyone to do research and make a decision for themselves. One of my concerns in taking Truvada is long-term liver damage, as we haven’t had people on this drug for a life-time as PrEP, yet, and it’s well known that many drugs meant to treat HIV can be hard on the body. Damon dismissed this and said it was only processed in the kidneys, but the literature that came with my prescription said very clear that liver damage is a risk and should be monitored.

  4. Moreover, YES! You should still use condoms with truvada to reduce your risk of getting HIV and other STIs. I get that Damon doesn’t want stigma around his choice to bareback, it’s for each person to decide what is safer sex for them, but from a public policy standpoint, we should still be encouraging condoms, and the drug company is not promoting this as a safe means to bb.

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