The U.S. Centers for Disease Control and Prevention (CDC) are finally telling men who have sex with men to do what HIV-prevention specialists and support groups have been recommending for years: start talking about your HIV status.
The CDC launched the “Start Talking. Stop HIV.” campaign just last week. The campaign, complete with downloadable posters, brochures, banners, talking points, and videos, uses images of men talking with one another in loving or intimate situations. Notably, the campaign includes several images of men of color. Black men who have sex with men have the fastest-rising HIV infection rates in the country.
The move came just one week after the CDC told doctors that it is time to start prescribing an HIV prevention pill called Truvada as a form of pre-exposure prophylaxis, or PrEP, to groups at high risk for contracting HIV.
But while any effort to reach out to men who have sex with men is appreciated, some experts feel that the effort falls short. “The campaign is incredibly light, if not weak, on PrEP,” said Jim Pickett of the AIDS Foundation of Chicago in an interview with Healthline.
Pickett, director of advocacy for the Chicago HIV prevention group, said the campaign’s other emphasis, on treatment as prevention, is valuable but it doesn't say anthying new. Treatment as prevention (a longstanding strategy) aims to get people tested and, if they test positive, get them into treatment that will lower their viral load; people with lower viral loads are less likely to transmit HIV to sex partners.
A 'Historic' Move for the CDC
Kyle Murphy, director of outreach for the Washington, D.C.–based National Minority AIDS Council, said he is not sure he agrees with Pickett.
“This is the first campaign that specifically calls out the prevention benefits of treatment, including PrEP, making it pretty historic,” Murphy told Healthline. “I think that given how new both are—and how long it takes to develop these campaigns—it seems pretty on target to me.”
He said the campaign also reflects positively on the current administration. “The fact that a federal agency has invested in a campaign portraying gay men’s sexuality and love for one another in such a positive light further reflects this administration’s commitment to and affirmation of the LGBT community.”
Pickett did give the CDC props for one recent change. Earlier this year, the CDC changed its language regarding condom use to “sex without condoms” instead of “unprotected” sex, he said. The change was necessary, he argued, because sex on PrEP even without a condom is protected sex.
Still, the CDC recommend the use of condoms along with PrEP for high-risk groups. Although condoms can fail, they can be the only protection against many other sexually transmitted diseases.
Quarterly Testing for Everyone?
Pickett wants the CDC to encourage quarterly testing across the board. Currently, the CDC and other governmental organizations have a hodgepodge of guidelines based on risk. A spokesperson for the CDC said that gay and bisexual men should be tested every three to six months. For the general population, the CDC recommend that everyone be tested at least once.
“It’s [LGBT] Pride Month, and if I get infected just after getting tested, and then don’t get tested again until next June, HIV is just in my body doing its thing,” Pickett said. “I may be exposing people unwittingly, because I feel great.”
While some people have flu-like symptoms shortly after onset of infection, not all do. “Most of us are not very good assessors of our risk,” Pickett said.
Murphy and Pickett both said that more money needs to be made available for testing and other HIV prevention efforts. Pickett added that resources need to be better aligned to match the epidemic.