Be PrEPared: The Importance of Inclusivity in Healthcare

COLUMBIA, SC (APR 17, 2017) — The MediaSen Group covered a story last month regarding PrEP education being more available to the public than it is today. This is important especially in states such as South Carolina where the rates remain at its highest among gay and bisexual men and people of color.

However, PrEP (pre-exposure prophylaxis) is not the only matter that keeps these individuals away from healthcare providers. Between issues with lack of access to providers, insurance issues, or overall treatment in the facilities upon arrival, the fear of disclosure among individuals rise. Especially with LGBT individuals, this avoidance causes a surge of risky behaviors with very serious results including HIV. Sexual health is a touchy subject among individuals, especially in the United States. However, an essential part of healthcare lies upon the medical professionals’ treatment and understanding of the patient when it comes to physical, mental and sexual health.

Damon L. Jacobs, a licensed psychotherapist, author, relationship therapist and PrEP educator from New York City, presents a comfortable and flexible environment for his clients in an effort to show a different side to healthcare and medical practice. When he started taking Truvada in July 2011, very little information was released to the public about PrEP. This opened the opportunity for him to provide a forum for individuals interested in learning about PrEP through social media. On July 2013, he created the Facebook group PrEP Facts: Rethinking HIV Prevention and Sex, a forum for discussion about PrEP and sexual health as well as providing members with resources and research on PrEP.

“On July 1, 2013, I started this group because there was no local information and there was no place online amongst all the ‘Truvada Whores’ bull that people were screaming about Truvada, most of which was factually untrue”, Jacobs stated. “There was no one refuting these claims that people were making or these ridiculous assertions that people were making about Truvada, you know, ruining your kidneys or leading to this horrible second wave of AIDS. It was just all crazy stuff.”

Not only does his concerns lie in the misinformation about PrEP, but healthcare ethics as well.

“I wanted to provide a forum where people – at least anyone in the world with a Wi-Fi connection – could learn what PrEP was, learn what PrEP wasn’t, learn how well it works, see the science for themselves and get materials that they could download and print and take to their doctors.”

Unfortunately, it led to many running into a lot of stigmatization, shaming, and profiling from a number of healthcare providers all over even though there were positive results in parts of the nation. It also led to a lot of lecturing of what individuals should do in their lives.  Jacobs, the author of the book Absolutely Should-less, thinks that is one of the issues in healthcare facilities today, especially in rural areas of the nation.

“One thing you will learn about from me is that I don’t believe in the word ‘should’ because I have no authority to tell anyone what they should do with their minds, with their hearts, with their body, with their spirits, their souls – I cannot tell people what they should do.”

However, there are many with different views as Jacobs, which causes the rift between communities such as the LGBT community in which they are afraid and avoid going to healthcare providers to avoid dealing with discrimination, judgments and shame. A 1998 survey among nursing students showed that 8–12% “despised” LGBT people, 5–12% found them “disgusting,” and 40–43% thought LGBT people should keep their sexuality private.  Those statistics still stand today with modern day medicine.

“It’s such an inappropriate way to conduct medicine because that’s not medicine, that’s morality,” Jacobs stated back in March.

According to the Centers for Disease Control and Prevention, homophobia, stigma (negative and usually unfair beliefs), and discrimination (unfairly treating a person or group of people) against gay, bisexual, and other men who have sex with men still exist in the United States and can negatively affect the health and well-being of this community. Fortunately there are several healthcare professionals such as Jacobs who are available to the public that will work with and include clients, no matter what gender identity or sexual orientation.  He even made a spin on the acronym for PrEP, motivating individuals to be “Proactive, Responsible, and Empowered about Pleasure & Protection”.

“Remember I told you earlier that I don’t like the word ‘should’. Part of that is because of how I see that work in healthcare, when someone is told what they ‘should’ do by an authority figure even when that authority figure is giving them really good information. But when you tell someone what they ‘should’ do with their body, they generally tend to shut down.”

PrEP at this time is a subject matter in the medical industry with partial views among healthcare providers.  It also provides an outlook at the outer spectrum of divide with inclusivity of patients in facilities today.

“I wanted to provide a forum where people, at least anyone in the world with a Wi-Fi connection, could learn what PrEP was, learn what PrEP wasn’t, learn how well it works, see the science for themselves and get materials that they could download and print and take to their doctors.”

This is an evolution of individuals taking matters for themselves in order to be proactively progressive in their daily lives.

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