In your work with prevention studies, were you involved in the iPrEx study at all? What are your thoughts on the study results around pre-exposure prophylaxis [PrEP] and where prevention is headed from here on out?
One of the projects for which I'm project director explores the acceptability and feasibility of pre-exposure prophylaxis among young men who have sex with men [MSM] in Chicago. In that study, we were looking to enroll 99 young men and follow them for six months. We had enrolled 68; then the iPrEx data came out, and enrollment and recruitment into our study were halted. It was felt that it would be unethical to offer a placebo when we have a study such as the iPrEx study demonstrating such strong efficacy for the study drug. Now we're looking to be able to offer our participants who are on no pill, and our participants who are on placebo, an opportunity to roll over into the PrEP arm and be followed for six months. There are some talks about us becoming sort of a sub-study of the iPrEx study.
This has been a huge part of my life for the past couple of weeks, particularly since the iPrEx data were released. I've been very vocal about the need for data that reflect the populations most at risk here in the United States of America. In the iPrEx study there were 2,500 people, approximately. Nine percent of that, or about 250 people, were from two cities in the United States -- San Francisco and Boston. And there were only five young, black men who have sex with men who were a part of that study. Five.
I raised the concern, as we were making the decision to halt and change our study: What do we know about these iPrEx data? Initially, we didn't know much. We knew that there was an overwhelmingly young cohort. More than half of the folks were under the age of 25 years old. My study is being conducted through the Adolescent Trials Network. And part of the justification for this study was that the larger PrEP studies were not including younger people, and not including younger people of color.
Our decision was made before we knew that there were only five black and/or Latino youths in the iPrEx study. We have significantly more African Americans and Latinos currently enrolled in our study than the iPrEx study had altogether. We have some data; we're on a path to find out some things about the acceptability and feasibility of this intervention with the populations most at risk in the United States. We're making these kneejerk reactions to some data that really do not reflect our population.
Subsequently, we did something that really doesn't happen often in research: We hosted a community forum to get community feedback on how we should move forward in light of the iPrEx results. Some of our participants were in the room, as well as stakeholders and general community folks who were interested. They expressed some of their concerns and thoughts. It was resounding: Folks were very clear that resources needed to be provided for us to be able to explore this intervention in the populations most impacted.
We were very clear. We're thinking about the United States, but we're thinking about Chicago, specifically. We will be advocating for those resources to have Chicago included. That information was forwarded on to the funders of our study, and to the Adolescent Trials Network. I'm certain that we will become a sub-study, of some kind, of iPrEx. That was really to allow our participants an opportunity to roll over into that, but not necessarily to open it up to other folks; what we're pushing on is for it to be opened up to more folks in Chicago.
We should know within a couple of weeks. A proposal has been written; it's all being worked out.
More of Keith Green on TheBody.com
HIV & Me: An African American's Guide to Living With HIV (Updated December 2010)
Profiles in Courage: Keith Green (January 2006)
Articles and interviews by Keith Green in Positively Aware (May/June 2004 - Present)
Let's return to you personally: You wrote a piece for the publication Positively Aware back in early 2009, in which you talked about going to school and being outside of the nominal "HIV world," and what that meant as far as talking about your HIV status in a professional capacity. Can you talk a little bit about how you handle disclosure in your work?
Each individual situation requires a different internal dialogue, if you will, about the need to disclose. At that particular moment, I was very unsure about where I was going, in terms of my professional academic career. I didn't know if I wanted to come back to HIV, and I was considering a lot of options.
In some environments, it is not necessarily productive to have that information on the table, because the focus should not be on me, the focus should be on whatever population it is that I am committed to serving at that time. Oftentimes, if the focus is shifted to me, then it's difficult for me to be effective in that environment.
I've learned this holds true in academics and in social work: The focus is not on my HIV status, or on my sexual orientation, necessarily. Though my HIV status and sexual orientation may allow me to be in spaces that some people may not be able to get into, they are just not the focus.
What was your experience in Madison? How was it to spend two years outside of the comfort zone of Chicago, and adjust to a new place?
I don't want the people at the University of WisconsinMadison to take this in the wrong way, but it was really like a vacation. It was an escape from the HIV world. Although I still was working some, my focus was totally different. I became a huge college sports fan. It really changed my life, in a very good way.
The experience of college life on that level is something I've always wanted, but I never thought I would be able to experience. When I became HIV positive and dropped out of school, etc., I figured if I ever went back to school, I'd have to work full time and I would not get to experience the campus life. But I was able to do that at Madison.
It was awesome. It was so much fun! I made friends that I probably would not have made otherwise. I went to basketball games. I went to football games. The Badgers are going to the Rose Bowl this year -- that is phenomenal. That is still my escape. College sports are an escape for me. The Madison campus is still an escape for me, because it's two and a half hours away; I can drive up, see my friends, hang out, and get away from Chicago.