In late September, Damon L. Jacobs, LMFT, the New York City psychotherapist who in 2013 created the popular Facebook group PrEP Facts: Rethinking HIV Prevention and Sex, announced on the group page that he was stepping down from being the lead administrator of the group. He’d started the group only a year after the Food and Drug Administration approved pre-exposure prophylaxis (PrEP), in the form of approving the HIV treatment med Truvada (FTC/tenofovir disoproxil fumarate) for HIV prevention.
“I created this group with two intentions,” Jacobs wrote: “(1) To have a reliable, fact-based source for PrEP information in social media and (2) To facilitate conversations about sexuality that were based in pleasure and science.”
Seven years and more than 20,000 members later, the group has become an indispensable place for those on PrEP—and those thinking of starting PrEP—to ask questions, share the latest data and info about PrEP coverage and ongoing PrEP science developments (such as forthcoming versions that will replace a daily pill with a periodic injection), and even have lively debates about the issues of sexual responsibility that PrEP brings up (in the COVID era, perhaps more than ever).
Going forward, the page will be administered by 35-year-old Michael Chancley, M.S.W., the PrEP clinic coordinator at Positive Impact Health Centers in Decatur, Georgia, just outside Atlanta. Prior to that, he worked with Black gay and bisexual men living with HIV in New Orleans (NOLA), his hometown, and also started doing PrEP advocacy there. Jacobs said that he asked Chancley, who has served as one of 10 PrEP Facts moderators the past few years, to take over the page because “his work in the South has demonstrated that he’s a same-gender-loving proud Black man who can take this group in the right direction. He is able to effectively use social media to help people feel informed, understood, and valuable. He embodies the values of Black Lives Matter as well as the joys of celebrating human sexuality. He has the skills and tools to unite, inform, inspire, and empower.”
We chatted with Chancley (and his Pomeranian, Sandy) about his path to this point and what he hopes to continue doing with PrEP Facts, especially now in the sexually tricky age of COVID.
Tim Murphy: Hi there, Michael! Congrats on your new role, and thanks for making time to chat. So, you said you grew up in NOLA?
Michael Chancley: Yes, I was 20 when Katrina hit. I was just coming into my sexuality around my second year in college. At that point, my family had started assuming I was gay based on different factors. But after Katrina, we moved to Tuscaloosa, Alabama. For a young Black man who’s just coming into his sexuality, you don’t want to be trapped in Alabama. So my option was to stay in this little country town with my family—who at the time weren’t exactly the most progressive, although they’ve definitely grown since then—or go back to NOLA, where my old job, at the Marriott, invited us back even when parts of the city hadn’t fully drained yet and most of outside the Central Business District was without electricity. I lived and worked out of the hotel.
But NOLA is a party city, and they prioritized reopening the bars and clubs. So at least I could socialize more than in Alabama, and it gave me the freedom to be really comfortable in my sexuality without my family looking over my shoulder.
So eventually I finished college there and got my master’s in social work, and during that time, I was doing my internship in the legal services department at CrescentCare (formerly the NO/AIDS Task Force), and then a friend left his job there as the CLEAR coordinator and I slipped into the role. CLEAR is an intervention. We were funded to do it with Black gay and bi males age 29 and under living with HIV. Individuals learn to set goals for health care outcomes, like increasing condom usage, working on their [HIV treatment] adherence, or asserting themselves more when talking to medical providers or case managers. You do things like role-play and vision boards, so it’s fun.
Even though it was for positive guys, it fell under the HIV prevention department. Doing that work helped me to start putting a face to the virus. At that time, I’d maybe only had two other young Black men ever disclose their HIV status to me, even though we all saw the HIV rates and the PowerPoint presentations. Then I’m in that job actually talking to people about their barriers to disclosing their status, to condom use, even to showing up for that intervention. It could be depressing and upsetting. You’re like, “Oh, OK, these are real people coming in with real issues.” And I was HIV negative, and I started realizing that staying negative was more complex than “Use condoms”—and staying HIV-undetectable was more complex than “Take your pills.” A lot of it challenged my own beliefs. I look back and think, “I can’t believe I thought this, or said that.”
TM: What were some of the underlying issues driving the complexity?
MC: NOLA is definitely a party city, so substance abuse plays a part. Then I started to understand that certain individuals had no place to stay, or even if they did, it was like six roommates in a two-bedroom apartment. I’ve had friends who needed to pay a bill and had sex with a sugar daddy but didn’t consider it engaging in sex work.
So all this was after 2012, when the CDC released guidelines for PrEP, which was new and interesting to me. I hadn’t gone on it myself yet, but I’d incorporate it into my outreach, which included outreach to what the field calls “high-risk”—which I hate—heterosexuals, when I was working at another agency. So I started PrEP myself on my 30th birthday in March 2015. My provider hadn’t even heard of it, so I had to print out the CDC guidelines for her.
At the time, PrEP was still very new. I was used to going to the doctor only when I was sick, not every three months for my HIV and STI tests like you do on PrEP. I had to talk myself into it. And I thought about having had to give positive [HIV] test results to people who’d just come in for a routine test. It made me look at my own risk behavior and realize that one day I might be on the opposite side of the table.
TM: What has it been like being on PrEP since?
MC: It’s been largely great. I’ve stopped and started it at times because I wasn’t sexually active. But for the last five years, I’ve been on it about 60% to 70% of the time.
TM: So two years ago, you moved to Atlanta, yes?
MC: I’d visited and loved it, so even though I had a good job in NOLA, when my lease was up, I packed everything I could in my car and took off, hoping I wouldn’t have to come crying back home. I actually heard about my current job through the PrEP Facts group. My supervisor posted it there, and I applied, and a few weeks later, I went on the interview.
TM: What’s the job like?
MC: Pre-COVID, we were a walk-in clinic for HIV and STI screenings, and we’d also do a soft pitch for PrEP and answer any questions clients had, such as explaining about medical and copay assistance programs. Sometimes it involved having hard conversations about people’s risk behaviors, where you’re thinking, “This person needs to be on PrEP,” but they may not think so. Everyone downplays their own risk, whether they have one or 200 sex partners. We try to get people to think about how they’re going to remain negative if they don’t consistently use condoms. Sometimes they come in and say, “I’m dating someone with HIV, and I don’t want to take the next step,” and we say, “We have the medical tools now where you can love and be intimate with them regardless of HIV status.” And sometimes they’ll ask for help with a substance use problem.
TM: So you’ve been in the PrEP Facts group for a while. How would you explain its purpose to people?
MC: It’s very informative, whether you are on PrEP, want to be on PrEP, or are an advocate. There’s lots there about what’s going on in the world of HIV prevention. It’s also not for the faint of heart. You get some very personal and explicit anecdotes about people’s sexual behavior and beliefs. It gives insight into what the community knows about HIV in general—and what it doesn’t know, which sometimes you can forget if you work in the field and never step out of your HIV bubble. There’s no holding back in the conversations, and that’s one of the things I love about it.
TM: Are there conflicts and tensions that come up on the page—around slut-shaming, racial disparities, scientific misinformation?
MC: All of those things. I think it’s still really hard for many people to wrap their heads around the idea of HIV prevention not necessarily having to be tied to the use of a condom. Sometimes people in the group want to tell others what they should be doing, instead of having a fact-based conversation. As a moderator, you’ll wake up and realize that posting has been going on through the wee hours, somebody slut-shaming someone else or calling them out for not knowing as much as them.
TM: Anything new or different you want to do with the site now that you’re the administrator?
MC: I definitely think our work as advocates is looking different due to COVID. There’s a new level of shame about, “Why are you on PrEP and sexually active when you should be social distancing?” That became so controversial in the group the last several months that we would have to remind people that it was not a COVID-19 page. However, we do want to talk about the ways that HIV and COVID intersect and overlap.
TM: What are you hearing about how people are negotiating sex and love in the COVID era?
MC: We’re in strange times right now between the election year, racial turmoil, and the pandemic. There’s just so much going on, and I think everyone is on the defensive. The conversation about sex during COVID can become very binary, where you either totally distance or you’re responsible for spreading it. There’s no middle ground to talk about the fact that people desire intimacy, probably even more so now because we’re locked down and stressed out. We know that mental health issues and substance use is increasing. And with all that, people need intimacy and compassion. We have to use what we’ve learned in HIV prevention, which is that there is no one right answer. We’re complex beings, and you can’t reduce everything to a PowerPoint slide or a poster.
TM: Damon talked in his sign-off about the importance of the site reflecting that Black Lives Matter. And now it has you, a Black administrator. Do you want to do anything in particular for the site around that?
MC: If you’re an advocate in the HIV field, unless you’ve been living under a rock, you know that there are disparities that impact Black gay men, Black and Brown trans women, Black and Brown [cisgender] women. So, definitely, I feel like there is space to talk about those issues. But the other side is that I think we can find ways to not just regurgitate statistics around disparities. I definitely know from my own community that we’re tired of the talking point being that one in two Black men will be diagnosed with HIV in their lifetime.
I also want to be able to have conversations like, “How do I have the PrEP conversation with my partner?” I would love to see those more personal conversations happening more frequently. People know how PrEP works now, but we still know there are [racial] disparities in PrEP uptake that don’t match the HIV rates. [Ed.: Gay Black men have higher risk for and rates of getting HIV but have taken up PrEP at lower rates than other gay men.] So how do we really talk about why the populations who could benefit the most from PrEP are not taking it? And sometimes those answers come not out of research at a conference, but out of one-on-one conversations. People come in to see me at work and know all the facts about PrEP but still ask, “Why should I be on this?”
TM: Michael, what’s your five- to 10-year plan?
MC: I want to go back for my doctorate in social work in a year or two, then start a private practice in mental health with a special focus on sexuality and sexual trauma, helping individuals and families deal with coming out.
TM: Cool. What are your sources of self-care, comfort, and joy?
MC: When the lockdown happened in March, I went through a period of not seeing my friends. But just like with HIV, we have to learn how to reduce our risk while still satisfying our needs. So I’ve had outdoor BBQs with my friends where we wear a mask. I’ve gone for walks in the park with my dog, Sandy. I know I can’t go to a crowded nightclub, something I love to do because I’m an extrovert, but I can go sit outside at a restaurant with a couple of friends.
TM: Can I ask how you are negotiating sex during COVID?
MC: I’m not in a relationship. At the beginning of COVID, I made sure I had one steady partner who was also practicing social distancing. I don’t wear a mask when I’m having sex, but I’m very transparent with my friends, people I’m coming into contact with who I may be putting at risk.
TM: Are you living for the Verzuz online music competitions like so many of us in the COVID age?
MC: It’s brought me joy. It’s a new way for us to interact while social distancing, all of us watching at the same time while chiming in. It’s not politics, it’s not the pandemic, it’s not racial injustice—we’re just talking about music. I was neutral in the last one. I love Patti [LaBelle] and Gladys [Knight] both and couldn’t pick a side. For the next one, I’d like to see two male R&B artists: Musiq Soulchild and Anthony Hamilton. I think that’d be a really good, interesting, competitive one.