It's 2017. A daily pill regimen that is over 99% effective at prevention HIV transmission has been available in the United States for nearly five years and is available in another handful of countries. We know that people with undetectable viral load are not at risk of HIV transmission to others through sex. And HIV incidence appears to be on the decline -- yet among some marginalized communities, HIV transmission rates are still on the rise, including young gay and bisexual men of color in the United States.
So what's available to help gay men and other men who have sex with men (MSM) navigate their sexual health -- including HIV prevention strategies -- in the world of today?
Two recent bold, community-driven and modern online interactive campaigns invite audiences to reach beyond the limitations of decades-old sexual health messaging that has maintained HIV-related community health disparities for too long, investing instead in something more powerful: You.
Sexual health educators can catch a breath of fresh air with these inclusive, evidence-based, accessible, and community-grounded resources. Let's explore some of the key features of these campaigns, plus a handy ratings system:
F*ck Without Fear
Creator: Los Angeles LGBT Center
Key feature: Check Your PrEP Score (B)
The PrEP Score tool walks gay and bisexual cisgender men in Los Angeles who don't use IV drugs through a step-by-step assessment of HIV risks to determine whether PrEP or PEP might be the best option based on a person's given sexual behaviors. For those who score low, the tool is sure to remind men to reconsider their options if these behaviors change.
PEP use is one indicator that these behaviors may be changing. The knowledge this tool provides may make it easier to transition from PEP to PrEP in the future if that's a more appropriate strategy at that time.
An important disclaimer reveals a limitation of the tool:
"This tool was developed using data from gay and bisexual men living in Los Angeles. This tool may not be appropriate for heterosexual individuals, Trans* individuals, injection drug users, or people living outside of Los Angeles. This calculator does not consider situations where HIV-negative guys are in long-term relationships with HIV-positive guys."
Key feature: Resource Provision (A)
Prephere.org encourages its audience to schedule a no-cost appointment with one of their providers — in addition to considering if PrEP is right for them. The desire to bring you through the door to engage with a real live person on the other side is well demonstrated. "We can even help with transportation for those who need it," the website reads.
LALC's HIV/STD testing and treatment services can detect HIV as early as 7 days after an exposure. They also offer free testing and treatment for gonorrhea, chlamydia, and syphillis.
Key feature: Toolbox Options (B+)
F*ck Without Fear's ‘more is less' approach to communicating safer sex options keeps a potentially overwhelming decision pretty simple: PrEP or PEP? Either way, you're invited to visit the Los Angeles LGBT Center to discuss your options with someone eager to help you identify and claim the tool that's right for you.
For those with little interest in pharmacological prevention tools, this campaign may miss the mark. For those willing to take a daily pill who have little interest in reading about all the different potential options in the toolbox, this straight-to-the-point campaign promoting PrEP, PEP is magnificently on target.
Key feature: Personal Empowerment (A)
The campaign's photo models reflect communities most disproportionately impacted by the HIV epidemic . Consistent with the overall campaign, there are few photos at all, directing the reader instead to face the bold print prompt: F*ck without fear.
Overall Assessment: Brevity is bliss (B+)
What would your sex life look like if health services providers invited people to a conversation rather than telling them what to do with their own bodies? What if you could fuck without fear? This campaign cuts right to that chase and eagerly awaits your answers.
The Sex You Want
Creator: Gay Men's Sexual Health Alliance of Ontario (GMSH)
Key feature: Visibility (A)
Perhaps the most noteworthy of many excellent features in this Canadian campaign created by and for gay and same gender loving men is its exceptionally inclusive community representation. Sexy illustrations in still images and videos model a varied range of body shapes, sizes, and histories, skin colors, sexual interests, and health-promoting behaviors.
Authentic reflections of the target audience demonstrate organizational commitment to racial and ethnic diversity. Transgender gay men are visible, engaged, and reflected in all the same contexts as cisgender gay men. The campaign's radically sensible condom video treats men with prosthetic cocks no differently than men whose cock requires no assembly.
Key feature: Interactive filter (B+)
Not sure where to start with decision-making? Check out the interactive filter to help anyone figure out the right combination of HIV status management strategies for their relationship.
This tool, like the campaign itself, is designed for guys. Gender neutral language might reach a broader audience within the intended target demographic, including same gender loving and bisexual men whose sex partners may not always be men.
However, once you input your respective HIV statuses, the filter highlights specific pages that are relevant to you and your partner based on the information you give it. If literally the only thing you know about safer sex is how to click buttons and read a webpage, this tool should still connect you with exact information relevant to your situation.
Key feature: Toolbox Options (A+)
Choices in the toolbox include condoms, PrEP, viral suppression, PEP, seropositioning, serosorting, and much more. Every option comes with its own short video — which you might not want to watch at work — to introduce each concept in simple, sensitive, and sexy style.
And a bonus: This campaign acknowledges and supports mental health as an integral component of sexual health.
Key feature: Community Engagement (A)
On a more organizational/technical note, the logistics that went into this campaign demonstrate exemplary community engagement. According to Dane Griffiths, Acting Director of Gay Men's Sexual Health Alliance of Ontario, their campaign's steering committee "included cisgender and transgender gay and bisexual men, knowledge experts, our funder, and co-chairs of our Gay, Bi, Queer, Trans Mens Working Group, Poz Prevention working group, and Rural-Suburban working group."
Additionally, GMSH had a scientific review committee vet each piece of information, and a group of Francophone stakeholders did a French scientific review and supported the translation of the campaign to ensure cultural relevance and appropriateness. They hosted focus groups that "were diverse with respect to race, age, and socioeconomic status," according to Griffiths, and now 30 partner organizations are working to mobilize their local communities around this campaign.
The most evident limitation in the otherwise remarkably representative campaign is that it is only representative of men. Transfeminine and/or non-binary-identified people who often coexist at the margins of gay men's spaces won't find themselves reflected here, despite that the campaign may accurately communicate the exact healthcare information they're after.
Overall Assessment: Radically sensible (A)
What if health services providers asked people what they desire and need in an effective HIV intervention, and provided them the necessary resources to create and support those community-driven interventions? Pretty much like this.
"The HIV prevention tools of today are grounded in scientific evidence. Let's inform ourselves and pass this information along to our peers and partners," Griffiths encourages us. "The Sex You Want is yours to have."