There has always been stigma around all sexually transmitted diseases, but especially around Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS).
Emma Kaywin has made it her mission to destigmatize HIV and AIDS and now, due to some recent research, her mission might have just become a little easier. I got a chance to sit down with her and ask about her work, new research, and a drug that is changing the way the world sees HIV.
First of all, where do you work and what do you do?
I currently work at the Institute for Advanced Medicine, which is the designated AIDS center at Mount Sinai Health System [in New York City], which provides comprehensive care for people who are HIV-positive. We provide more than just medical services (such as mental health and substance use programs) because HIV is a disease that hits on every type of disparity. It started with predominantly gay men who were mostly white. Now, because of issues with access of care, it affects predominantly men of color who have sex with other men, heterosexual women of color, a large contingent of trans women, people who engage in sex work, and intravenous drug users. What I do specifically is I write grants to fund our programs and I run our peer program, which is where we train patients to help other patients. I also write a sexual health column for Bustle where I answer questions about sexual health every week.
Can you tell me the difference between HIV and AIDS?
HIV is a virus that is sexually transmitted, through vaginal fluids, semen, blood, and breast milk. There’s also some indication that it can be transmitted through what we’re calling “butt juice,” which is the liquid in your anal cavity. It’s not transmitted through kissing or saliva. It’s a virus that attacks your immune system; it basically stops your body from being able to heal itself. AIDS is what happens when your immune system is so compromised that your body becomes very sick. If you are HIV-positive you can live for a long time, but at a certain point if you don’t take care of yourself, it takes over the immune system.
What are you excited about right now in HIV research?
There are drugs now that people who are HIV-positive can take every day that suppress the virus in your system. These don’t cure the virus, but they makes it so there are so few copies of the virus in your system that a test cannot find them. We call this “undetectable.” Until recently, we didn’t know what that meant except that we couldn’t find the virus. Now, thanks to the highly regarded PARTNER study, we know that if you are HIV positive and undetectable and are continuing to take medication, you can’t spread HIV. You should still be having protected sex to protect yourself from other sexually transmitted diseases, but in this study not a single person became HIV-positive [after having sex with an HIV-positive person].
I’ve heard there is a drug that can help prevent HIV, can you tell me about that?
There are actually two! There’s one drug that’s called Post-exposure prophylaxis (PeP), it’s like Plan B for HIV. It’s 28 pills instead of one, but if you think you’ve been exposed to HIV, you can go to your nearest clinic or ER and ask for PEP and if taken correctly it will very significantly decrease your risk of getting HIV.
There’s also a new drug that was approved in 2014 called Truvada, which was already a drug that people with HIV used, but they found a new use for it, which is called Pre-exposure Prophylaxis or PrEP, which is a pill you can take every day that can prevent people from getting HIV. It’s between 92-96% effective, which is more effective than condoms. So, if you know you want to sleep with someone who is HIV-positive or you’re having sex with people whose status you don’t know, this is a really good thing to be on, just like you would be on birth control. They’re also working on a ring and a shot version. So, what is really cool is that this is collapsing the barrier between HIV-positive and HIV-negative people and decreasing that stigma.
What about if an HIV-positive person wants to have a baby with an HIV-negative person? Does PrEP help with that?
Babies used to be born with HIV all the time, but that has pretty much completely stopped — there were zero babies born with HIV in New York in 2015. Now if an HIV-positive person is on medication and they want to have a baby with an HIV-negative person, PrEP can prevent the baby and the HIV-negative person from getting HIV.
What is the process like for getting PrEP?
Right now, it’s very expensive, but if you are over 18 you can go to a clinic or ask your doctor or go to Planned Parenthood to get it prescribed. Some insurances pay for it and in New York State there’s a program that can help you pay for it. And the pharmaceutical company that makes PrEP, Gilead, has a payment assistance program if you have a demonstrated need.
Thank you, Emma for dropping some seriously important knowledge.