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Everything You Ever Wanted to Know About …

by Daniel Vaillancourt

Everything You Ever Wanted to Know About DoxyPEP

Words by Daniel Hirsch

 

A hefty dose of antibiotics. A big syringe in the derrière. Getting treated for an STI is not fun — to say nothing of the symptoms and risks involved with contracting one like syphilis, gonorrhea, or chlamydia. With the CDC reporting rising numbers — gonorrhea is up 11% over the last five years, syphilis is up 79% — risk of infection is on the rise.

 

However, clinicians around the country, spurred by recently released guidance from the CDC, are recommending the antibiotic doxycycline as a means of post-exposure prophylaxis (DoxyPEP for short) to prevent the spread of STIs. I spoke with DAP Health Chief of Community Health C.J. Tobe about this prevention strategy.

 

Let’s start with the basics. What is DoxyPEP?

DoxyPEP, or doxycycline, is a 200 milligram pill that can be taken within 24 to 72 hours after sex. It reduces a person’s chance of contracting either chlamydia, gonorrhea, or syphilis by up to 70%. Doxycycline has been around for quite some time and is used to treat STIs and acne.

 

How sexually active do you need to be to justify a prescription?

It’s going to look different depending on a person’s lifestyle and the conversation with their provider. For example, if you have sex Friday, Saturday, and Sunday, you can take DoxyPEP that Monday morning and you’re good. Let’s say you’re having sex five times a week, then you should probably talk to your doctor about switching to DoxyPrEP.

 

And what’s DoxyPrEP?

DoxyPrEP would be taking 100 milligrams of doxycycline daily as a preventative measure. That’s typically for people who either want to make sure they’re protected, or they’re having frequent sex, or they may be a sex worker.

 

Are there side effects? Isn’t doxy tough on the GI tract?

A lot of the side effects that get reported are GI issues. So we recommend people take the medication with food or a carbonated drink. When people take a higher dose of doxycycline, like 200 milligrams twice a day, the side effects increase. If you go on DoxyPrEP, that’s just 100 milligrams once a day. And I can tell you it’s such a low dose that the majority of folks don’t have side effects.

 

One of my worst nightmares, and it’s one shared by the World Health Organization, is that an STI becomes resistant to antibiotics. Is that a concern with people regularly taking doxy?

Part of the medical community is hesitant to embrace this strategy because they don’t know what could happen in terms of drug resistance. The other half are saying, “We need to get people on it right now because it’s an important preventative tool.” There’s always going to be a risk of drug resistance when people don’t follow the dosing recommendation of a doctor. As a public health person seeing the rise in STIs, I think a patient who is having sex should have that conversation with their doctor and see if DoxyPEP is right for them. Personally, I’ve been on doxy since 2020 and it’s been a lifesaver.

Feeding a Family on a Budget

by Daniel Vaillancourt

Feeding a Family on a Budget

Here are eight tips for smart shopping.

Words by Maggie Downs

 

Feeding a family while on a budget can be challenging. But with strategic planning and smart shopping, it’s possible to provide nutritious meals without breaking the bank, says registered dietician Robert Davis from the Comprehensive Perinatal Services program at DAP Health. Here are his tips to maximize your budget while keeping your family well-fed.

 

Meal Planning

Start by planning your meals for the week ahead. Take stock of what ingredients you already have on hand and build your meals around those. Plan meals that use similar ingredients to minimize waste and save money. “Choose just one day to do your planning and shopping so you know what you have and can shop for just enough to take you through the week,” Davis says.

 

Shop With a List

Make a grocery list before heading to the store — and stick to it. This will help prevent impulse buys and ensure you have everything you need to prepare your planned meals. “Don’t get distracted by sale items,” Davis says. “So many times, the sale items are tricky at getting us in the door at the grocery store, but they tend to be the highly processed foods, like cookies or chips or crackers. Some of these foods won’t provide as much nutrition, and they might even make us more hungry.”

 

Don’t Skip the Frozen Aisle

Frozen produce is nutritious, readily available, and can be even more economical than buying fresh. It can also save time in the kitchen, since the produce doesn’t require trimming and washing.

 

Embrace Meatless Meals

Incorporating vegetarian meals into your weekly menu is an excellent way to save money. Beans, lentils, tofu, and eggs are all affordable sources of protein that can be used in place of more expensive meats and dairy. “Non-animal foods are very nutritious and budget-friendly as well,” Davis says. “Consider two days a week having a family meal that doesn’t involve animal proteins.”

 

Shop Seasonally

Purchase fruits and vegetables that are in season, as they tend to be less expensive and more flavorful. Visit the farmers market for fresh produce that supports local growers.

 

Buy in Bulk

Stocking up on staple items can save you money in the long run. Look for deals on larger quantities, and consider joining a wholesale club to access greater savings. “Some of the shelf-stable grain options can be created faster than going out and getting something from a restaurant,” Davis says. He recommends keeping the pantry packed with brown rice, whole wheat pasta, or quinoa, which are all high in fiber, offer B vitamins, and can be cooked quickly with some veggies and a protein.

 

Utilize Leftovers

Don’t let leftovers go to waste! Get creative and repurpose leftover ingredients into new meals. For example, leftover roasted vegetables can be added to salads or turned into a hearty soup. Davis likes myplate.gov for recipe ideas.

 

Cook From Scratch

Pre-packaged and convenience foods are often more expensive than cooking from scratch. Invest in basic ingredients, and learn to prepare simple meals at home. Not only will this save you money, but the time spent with family can be priceless.

Everything You Ever Wanted to Know About …

by Daniel Vaillancourt

Everything You Ever Wanted to Know About Poppers

Words by Daniel Hirsch

 

Poppers. Not only are they a staple of disco dance floors, sex shops, and — more recently — gay internet memes, but openly queer pop star Troye Sivan recently placed them front and center in the mainstream by openly paying homage to them with his summer 2023 smash hit “Rush,” a song title that not-so-coincidentally is the name of a beloved brand of poppers.

But what exactly are poppers? What risks do they present users? And how can these risks be mitigated? I spoke with DAP Health Chief of Community Health C.J. Tobe and asked all of the tough questions.

 

What are poppers?

C.J. Tobe: Basically, poppers is the casual name for a liquid inhalant. Most people are probably familiar with using poppers on the dance floors in the ’60s, ’70s, and ’80s. Then they transitioned into being extremely useful during sex. There are four different chemicals that can make up poppers [amyl nitrite, isopropyl nitrite, butyl nitrite, and pentyl nitrite].

 

Why do people do poppers?

Because they feel good. They make sex even more enjoyable. It also helps relax people. So people who may have sex anxiety or need “liquid courage” (like we talk about with alcohol) may find poppers helpful.

 

What actually happens to your body when you use poppers?

When you inhale poppers, your blood vessels are going to expand, and it’s then going to increase the blood flow and oxygen level within your veins. So that’s what makes it feel euphoric. It’s like a rush, essentially. But while all that is happening, it’s also gonna decrease your blood pressure. Obviously, people with heart conditions are definitely advised to be very, very cautious.

 

Speaking of being cautious, if one were to do poppers, is there any way to do them more safely?

Probably don’t use them alone, because using them will increase your blood flow, which will then lower your blood pressure. Just in the event that you do pass out, you don’t want to be alone. So … poppers and porn? Not the best idea.

A lot of people who use poppers, especially during sex, are also taking erectile dysfunction medicine. That’s an added risk for decreasing blood pressure, which can eventually cause someone to pass out — potentially even vomit and die as well.

 

Are there any other risks to consider?

Generally, some research shows that using poppers can put you at a higher risk of getting an STI, including HIV. Everyone should regularly be screened for STIs and HIV. We also recommend considering being on PrEP (pre-exposure prophylaxis) or PEP (post-exposure prophylaxis) to prevent HIV, and/or on DoxyPrEP or DoxyPEP to prevent STIs.

Next one’s for the bottoms: Poppers make sex more enjoyable, but they’ll also give you a high, where you become dizzy and you don’t know exactly what’s going on. You could put yourself in a vulnerable position, where someone could take advantage of you. They could tie you up, or do a “booty bump” [insert unwanted drugs into your rectum]. It just makes you less aware of your surroundings, which also could increase the possibility of something negative happening.

 

What about the dreaded, so-called “poppers nose,” (aka chemical burns in one’s nostrils)?

My advice to prevent this would be to inhale through your mouth. Just like a cigarette [without putting your lips on the bottle]. It bypasses actually going up through your nostrils and won’t give you a headache. I learned that from an expert who reps a national poppers brand.

 

Can poppers be addictive?

There’s little research to prove or disprove the addictive effects. However, from a cognitive behavioral perspective, anything can become addictive, especially agents that produce pleasure, promote escapism, or assist in numbing.

Poppers create a sense of euphoria, so someone can very well become accustomed to this experience while having sex, and require it to allow for a full sense of pleasure due to the association. However, ultimately, physiological dependence? No. 

I would add to this: It is very much recognized as a relapse trigger for those in recovery. The erotic experience can create what is referred to as “euphoric recall,” which directly sets off a chain of thought and behavior patterns. So related to addiction, it is definitely high-risk. 

 

How come poppers are sometimes sold with code names like VCR cleaner or tar remover? Why the code names? Are poppers legal?

From my last understanding, it’s illegal to consume nitrite, as well as some of the things that go into poppers for recreational use. So, when you would go into a store, they’re sometimes number coded: “I want number two, I want number eight, I want the yellow or the red.” Legally, we’re not really allowed to state that you were there to get poppers in a sex shop or store. It’s legal to sell it, but it should not be used recreationally.

 

Anything else to add?

I know this is going to sound very corny, but talk to your doctor! I know it’s so basic to people. We can Google all day… But, ultimately, just tell your doctor you want to do poppers. Or let them know you’ve been doing poppers for 10 years. They can look at your medication list for any potential risks and ensure you are receiving sexual wellness support.

I think the more education and knowledge we have around health matters, the better. Even if your doctor may not be culturally competent on poppers, you can start that conversation to make them curious. Get them educated on poppers so they can help guide and educate some of their other patients.

And I just have to add, here at DAP Health, we are very culturally competent. We all know all about poppers. And we provide service without stigma, shame, or judgment. You can always ask your DAP Health provider anything.

 

Image courtesy of Not So Innocent adult entertainment store, 2100 North Palm Canyon Dr, Palm Springs, CA 92262

A Guide to Safely Hooking Up Online

by Daniel Vaillancourt

A Guide to Safely Hooking Up Online

While popular online dating and hookup apps offer a convenient way to meet new people, their relative anonymity can also leave you open to danger. It’s therefore essential that you prioritize your safety. This guide is aimed at those who use these apps and would like to reduce the risk of situations that are uncomfortable at best, and life-threatening at worst.

 

Before

Define Expectations
Discuss intentions and desires openly. Talk in detail about what you’re both looking for, including any kinks/fetishes. If either
of you uses drugs, communicate your preferences and boundaries clearly.

Exchange Face Pics
Insist on receiving recent face pics. If they refuse to share, that’s a red flag. Move on.

Get a Phone Number
Swap phone numbers, then give a call or send a text. If they refuse to share, that’s a red flag. Move on.

Take Screenshots
Capture the person’s profile, face pics, and all your texted conversation, including their phone number. This documentation can be vital if issues arise later.

Tell a Friend
Share details (who, what, where) with a trusted friend. Ask that they check up on you if they don’t hear from you within an agreed-upon time.

Secure Valuables and Beware of Scams
Be cautious and secure your valuables. Be vigilant about scams and fraudulent behavior.

Install a Security Camera
If you have security cameras, such as a security doorbell or surveillance system, use them to observe the person before opening your door. If you don’t have cameras, you can still lessen potential risk by telling the person you do.

Trust Your Instincts
Above all, no matter what, listen to your gut. It rarely lies. If anything feels off at any point, you have the right to end the interaction at any time — even during or after sex. Consent is continuous, and you can withdraw it at any moment.

 

During

Trust Your Instincts

Above all, no matter what, listen to your gut. It rarely lies. If anything feels off at any point, you have the right to end the interaction at any time — even during or after sex. Consent is continuous, and you can withdraw it at any moment.

Note Physical Characteristics
Pay attention to distinctive features such as scars, tattoos, or birthmarks. This may be useful to identify the person later.

Bondage
Be extremely careful when using bondage and restraints with someone you don’t know.

Stay Sober
Don’t play when you’re under the influence of drugs or alcohol, which can lead to poor judgment and leave you very vulnerable.

Engage in Safer Drug Use
If you do choose to use drugs, do so as wisely as possible. And test them beforehand, whether they’re from an unknown source or not. Free fentanyl and xylazine testing strips are widely available — including at DAP Health — and can help prevent accidental overdoses.

 

This Isn’t Fun Anymore!

Drugged and/or Assaulted?
You may suddenly find yourself incapacitated, or unable to consent. Common symptoms of having been drugged include drowsiness, disorientation, dizziness, and/or excessive intoxication despite having consumed a minimal amount of alcohol or drugs.

Collect Evidence
If you can do so safely and discreetly, take photos or videos of your attacker, yourself, relevant objects, and your location. This evidence could help legal action you may choose to pursue.

Leave
If you believe you’ve been drugged, or are in immediate danger, try to leave safely.

Stay, Scream, Fight Back
If leaving isn’t possible, scream to attract attention, and/or use any available object to defend yourself.

Call 911
If you can, call 911. Explain your situation as clearly and calmly as possible, providing your location. If you’re unable to speak, stay on the line to allow emergency services to trace your call.

 

After

Remember It’s Not Your Fault
It’s important to recognize that shame and embarrassment are common responses, but please know you are not to blame. Assaults can happen to individuals of all genders, and you are innocent in this situation.

Seek Medical Attention
This is crucial to ensure your well-being and to collect any potential evidence.

Make a Police Report
If you’ve experienced a crime, reporting it to the authorities can help prevent further harm to others. Also, remember that reporting a crime won’t result in trouble if you’ve been using drugs.

Embrace Support
Recognize you’ve endured emotional and physical trauma, and that seeking help is a courageous step. Whether you reach out to friends, family, or specialized support organizations, countless others have walked similar paths. You’re not alone in this journey. Support is available to uplift and guide you through it.

 

These are simply suggestions, and it’s essential to use what works best for you and your situation.

 

 

A Guide to Hookup App Lingo

This glossary is your dating app decoder.

[+] HIV-positive

+/- Interested in HIV-positive/negative

420-friendly Into marijuana

Admin Short for administer (injecting someone with drugs)

Anon Short for anonymous (a preference for not knowing personal details before connecting)

On Deck Having drugs for sale

BB (AKA Bareback, Raw, Breeding, Taking Loads) Condomless anal sex

DDF Drug- and disease-free

Discreet Closeted or in a relationship but looking

DL On the down low (closeted or in a relationship but looking)

DTF Down to f***

Host Hooking up at their place

Looking Interested in hooking up

NSA No strings attached (sex without emotional fidelity or future expectations)

Party Into drugs

PNP Party and Play (refers to drugs and sex)

T Tina (crystal meth)

Travel Not hooking up at their place

March is Colorectal Cancer Awareness Mon …

by Daniel Vaillancourt

March is Colorectal Cancer Awareness Month

Here’s the 101 so that you can keep yourself and those you love safe.

Words by David Russo

 

“Colon cancer is the battle we can win with early detection and regular screening.”

                                                                                                               — Unknown

DAP Health’s Associate Chief Medical Officer Dr. Silas Gyimah is fond of that inspiring citation of unknown derivation. As the founder of the Palm Springs-based, queer-led nonprofit Cheeky Charity — whose mission is to facilitate colorectal and anal cancer prevention, early detection, and support, with a focus on the young and LGBTQ+ populations — so am I.

“At every visit, we verify records to see if a patient is due for a screening,” Gyimah says. “If they are, we schedule them, focusing on FIT [fecal immunochemical test] and colonoscopies as our primary screening methods. This is a true implementation of the quote above.” 

Let’s delve more deeply into this largely preventable and curable disease.

 

Colorectal Health: Understanding and Prevention

Colorectal cancer (CRC), once predominantly a concern for older adults, is now increasingly affecting younger individuals. This shift necessitates a renewed focus. Understanding the nuances of colorectal health is vital for individuals of all ages.

 

Understanding Colorectal Cancer

CRC originates in the colon or rectum, part of the digestive system. It usually begins as small, noncancerous (benign) clumps of cells called polyps that form on the inside of the colon. Over time, some of these polyps can become colon cancers.

 

Symptoms To Be Aware Of

CRC might not cause symptoms right away, but if they occur, they may include changes in bowel habits, rectal bleeding or blood in the stool, persistent abdominal discomfort, a feeling that the bowel doesn’t empty completely, weakness or fatigue, and unexplained weight loss. It’s important to consult a health care provider if any of these symptoms are experienced.

 

Risk Factors

Certain factors increase the risk of developing CRC. These include older age, a personal or family history of CRC or colorectal polyps, inflammatory intestinal conditions, a low-fiber/high-fat diet, a sedentary lifestyle, diabetes, obesity, smoking, and alcohol use. Genetics also play a role, with some inherited genes increasing the risk.

 

Prevention Strategies

Prevention of CRC starts with lifestyle changes. A diet rich in fruits, vegetables, and whole grains — and low in red and processed meats — can reduce risk. Regular physical activity is crucial. Maintaining a healthy weight, avoiding smoking, and moderating alcohol consumption are also recommended.

 

The Importance of Screening

Screening for CRC is one of the most powerful weapons for preventing the disease. It’s generally recommended to begin screening at age 45. Screening can find precancerous polyps, which can be removed before they turn into cancer. For people at higher risk, such as those with a family history, screening may be recommended earlier.

 

Navigating the Rising Trend in Young Adults

The rising incidence of CRC among young adults is a complex issue that involves a combination of genetic, environmental, and lifestyle factors. It’s important for young adults to:

  • Be aware of their family history.
  • Minimize known risks.
  • Incorporate healthy preventative habits into their lifestyle.
  • Regularly check for symptoms.
  • Discuss screenings with their health care providers if they have risk factors.

 

Conclusion

As our understanding of colorectal health evolves, it becomes clear that CRC is not just a concern for the elderly. The increase in cases among younger adults emphasizes the importance of awareness and proactive health measures across all age groups. Through lifestyle modifications, regular screening, and early detection, the impact of CRC can be significantly reduced.

 

Resources

Colorectal Cancer Alliance, colorectalcancer.org

American Cancer Society, cancer.org/cancer/types/colon-rectal-cancer

Centers for Disease Control and Prevention, cdc.gov/cancer/colorectal

Cheeky Charity, cheekycharity.org

 

In a partnership between DAP Health and Cheeky Charity — and in honor of Colorectal Cancer Awareness Month — 50 eye-catching banners will be flown throughout downtown Palm Springs during March to help raise awareness and reduce stigma.

Where Did All This Peanut Allergy Come F …

by Daniel Vaillancourt

Where Did All This Peanut Allergy Come From?

Words by Ellen Bluestein

 

According to the American College of Allergy, Asthma & Immunology, as of 2017, 2.5% of children in the United States have peanut allergy. While that percentage may seem small, it translates to more than 1.8 million kids with a potentially fatal condition. 

 

“Probably about 20 years ago, it was clear that this was not only a growing problem, but it had already become a public health problem in the United States and around the world,” says Dr. Andrew Liu, a pediatric allergist at the University of Colorado. “I don’t know that we’re sure why or how peanut allergy has become so prevalent. But I think it’s pretty clear that it’s real.”

 

Researchers have been exploring several possible hypotheses. One — the hygiene theory — explores the idea that with the advent of germ-killing cleaning products, our environments no longer provide the exposure to microbes that the immune system recognizes and learns to fight off.

 

“What is a microbe-rich environment? One where we’re living around a lot of animals,” says Dr. Liu. “There have been a lot of studies where it looks like allergies are less common in kids growing up in farming environments or in developing nations where people live very closely to their animals. Some people think … that the immune system doesn’t see enough of those microbial exposures early because we’ve gone and cleaned up our environment.”

 

Early exposure to peanuts — between four and six months of age — may be one way to reduce the allergy. “The original observation was in Israel, where they had this teething cracker called Bamba which has peanut in it,” says Dr. Liu. “And they observed that within communities where this was a common cultural practice, the prevalence of peanut allergy in the kids was really low compared to what they were seeing in other communities.”

 

This led to more research and ultimately a definitive study on prevention. Children were given Bamba or a derivative, and then followed. Those who received the cracker were unlikely to develop peanut allergy compared to those who didn’t get it. “It looked like early exposure … when our bodies are learning about what is safe … is an essential time period,” says Dr. Liu. “If the immune system learns that the peanut is not something to be concerned about, then that stays.”

 

While there is still much to be discovered, Dr. Liu is optimistic that there will be remedies for those who suffer from the life-threatening condition. “There’s work going on to develop treatments to either reduce or prevent the severe reactions to those who are peanut allergic,” he says. “There continues to be investment in a lot of research … to try to get to that place where there are treatments that can be helpful for people and young kids who are allergic.”

Behavioral Health Resources for the Lake …

by Daniel Vaillancourt

Behavioral Health Resources for the Lake Arrowhead and Surrounding Mountain LGBTQ+ Community

At DAP Health, we recognize the profound impact trauma can have on individuals. Whether it’s the aftermath of a hate crime, perceived threats, or other distressing experiences, we understand that the effects of such events can be long-lasting.

It’s crucial to remember that healing begins with sharing your thoughts and feelings with someone who understands and cares. Even in a virtual setting, DAP Health’s dedicated professionals are here to support you every step of the way and provide a safe and empathetic space for you to process, heal, and reclaim your mental and emotional well-being.

We will continue to reach out to partner organizations to update this list of mental health resources that can be accessed in person or virtually. If you are a partner organization that can support the community, please use the form below to submit your organization’s information, and a DAP Health team member will contact you to validate your information before adding it to this list.

Lake Arrowhead LGBTQ+ (lakearrowheadlgbtq.org)

From the nonprofit’s website, its mission: We will create an all-inclusive, safe community for everyone. Our goal is to raise funds to create a LGBTQ+ Center for resources, recreation, learning, counseling, and health care. Our building will be available to anyone who needs it.

Furthermore: Lauri Carleton was not only a beloved mother, wife, and friend but a founding member of our Mountain Provisions Co-op community and a fierce advocate for love, equality, and human rights. Her tragic death has left a void in our hearts, but her vision for a more caring, inclusive, and engaged community lives on.

Lauri’s vision for a better world: Lauri was a pillar in our community, an unwavering champion of values that sought to break down barriers and build bridges. Her dedication to equality and her courage in flying the LGBTQ+ flag exemplify her commitment to creating a world where love knows no boundaries. The Lauri Carleton Memorial Fund aims to keep her spirit alive, by supporting local and inclusive community-building initiatives that reflect these same values.

SAC Health (sachealth.org)

A dedicated Lake Arrowhead support line was established at 909.219.6880 on 9.14.23 and will be available Monday through Friday, from 7:30 a.m. to 5:00 p.m., for as long as needed. After-hours, the line accepts messages. Behavioral health offerings include individual in-person counseling for adults and youth (IEHP, Molina, Risk Management, Medicare, Medical). Virtual options are available (except for Medicare). Group counseling is available, with coverage requirements. Appointments for one-on-one counseling are available at the end of the month. Group sessions will be held virtually once a roster is developed.

DAP Health (daphealth.org)

DAP Health’s department of behavioral health provides services focusing on treating mental health and substance use with individual therapy or medication management, as necessary, and specializes in serving the LGBTQ+ community. Appointments are in person or virtual via phone, laptop, tablet, or smartphone. Call 760.992.0450 to schedule.

 

Queer Works Therapy (queerworks.org/freetherapy)

Appointments can be requested online, with intake within 48 hours and the first appointment within a week. Behavioral health services include LGBTQ+ affirmative therapy (virtual sessions open to all California residents, with fees based on income level), LGBTQ+ trauma-informed therapy (specializing in care for victims of hate crimes or perceived threats), trans-affirmative therapy (focused on transgender, gender-diverse, and intersex care).

The LGBTQ Community Center of the Desert (thecentercv.org)

Affirmative, virtual, low-cost therapy is available to all California residents. For more information, or to be added to the waitlist, call 760.416.7790, Ext. 3.

 

Photo courtesy of Mountain Provisions Cooperative, Lake Arrowhead.

Know Your PrEP Options

by Daniel Vaillancourt

PrEP: So Many Options

As seen in GED Magazine

The HIV prevention world has changed dramatically in the more than 10 years since the U.S. Food and Drug Administration (FDA) approved Gilead Sciences’ Truvada as pre-exposure prophylaxis (PrEP) in July 2012.

Following the discovery that Truvada can pose renal and bone density problems in some individuals (which, thankfully, go away after the medication is discontinued), the FDA approved Gilead’s more kidney-and-bone-friendly Descovy as PrEP in October 2019. While Truvada is currently available as a generic equivalent, Descovy is still under patent.

More than a year ago — on December 20, 2021 — the FDA approved GSK’s Apretude, the first and only long-acting injectable form of PrEP, which requires a new dose every two months.

According to the Centers for Disease Control (CDC), when taken as prescribed, PrEP reduces the risk of HIV infection from sexual activity by more than 99%, and by at least 74% for those who use intravenous drugs. You should be on PrEP for HIV protection if you are 18 years or older, are sexually active (or soon planning to be), and are HIV negative.

“The great news with injectable PrEP is that it is a wonderful alternative for people who have issues with adherence and may forget to take their daily pill,” says DAP Health Clinical Supervisor of Sexual Wellness, Nurse Practitioner Trent Broadus. “It’s also very helpful for unhoused people who may have nowhere to store their meds, or who may be concerned that they’ll be stolen. Even more exciting, longer-lasting forms of injectable PrEP are currently being studied. Data are promising on one injection that would last a full six months.”

Before starting PrEP — whether orally or by injection — you’ll need to get tested for HIV, STIs, kidney function, and Hepatitis B and C.

Some people experience gas, nausea, or headache when beginning PrEP. These side effects typically go away within the first week. Note that it takes at least one week on PrEP before you’re protected for anal sex, and three weeks for vaginal sex.

Most insurance plans cover oral PrEP for HIV. Injectable PrEP is covered by Medi-Cal, but some Medicare and private insurance plans may require you to go through your primary care provider.

All forms of PrEP require regular follow-up HIV, STI, and kidney function testing. Every three months for oral PrEP; every two months for injectable PrEP.

You should talk to your doctor before stopping any medication. And if you stop taking PrEP, talk to a health care provider about using other HIV prevention strategies.

If you’re interested in PrEP, contact a DAP Health PrEP navigator at 760.656.8400. You can also talk to any nurse or nurse practitioner during your visit if you want to discuss which PrEP may be right for you.

If you don’t have health care insurance, or if you need financial assistance, a PrEP navigator can also explain your options, help you get access, and answer questions about finding a doctor or working with your pharmacy.

And remember: All PrEP visits and lab work done at DAP Health’s sexual wellness clinics in Palm Springs and Indio are always free of charge to all patients.

Managing Seasonal Affective Disorder (SA …

by Daniel Vaillancourt

MANAGING SEASONAL AFFECTIVE DISORDER (SAD) 

Words by Ellen Bluestein 

For most people, seasonal affective disorder — commonly known as SAD — starts in the fall and continues well into the winter months. “It saps your energy and makes you feel kind of low, moody, and depressed,” explains DAP Health Behavioral Health Director Dr. Jill Gover, affectionately known on campus as Dr. G. “And then those symptoms will resolve themselves in the spring and summer months.” While the exact cause of SAD is unknown, “It’s very likely that it’s connected to a drop in serotonin,” says Dr. Gover. “When we go into the winter months, we have less light. Sunlight produces serotonin. When we have drops in serotonin, it can trigger depression.” 

Additional symptoms of SAD include sleeping too much and having intense carbohydrate cravings. “When we crave carbohydrates, we’re usually low in serotonin in our brain chemistry,” Dr. G. says. “And if we eat a really high-carb diet, it often involves some kind of weight gain, which can exacerbate the depressed feelings.” There can also be difficulty concentrating, feelings of hopelessness and worthlessness, low energy, oftentimes guilt, and even suicidal ideation. “When you have this winter depression, as it’s sometimes called, and just a kind of overall malaise, it’s important to seek professional help,” adds Dr. G. 

According to Dr. Gover, the first line of treatment is daily exposure to light within the first hour of waking up. “Natural outdoor light appears to change your brain chemistry,” she says. “It produces serotonin.” The doctor also recommends making your environment sunnier and brighter. “Open the blinds and trim back trees to get more sunlight into your home,” she says. “Get outside, take a long walk. Simply sit on a bench and soak up the sun. Even on a cold or cloudy day, outdoor light is very helpful. That early light is very important.” 

Exercising regularly also helps by producing serotonin as well as dopamine, the neurochemicals needed to feel good. “And it’s important to normalize sleep patterns,” Dr. G. affirms. “Go to sleep and get up at the same time every day. And don’t nap!” 

With the sun shining 354 days a year on average in Palm Springs, SAD is not as prevalent here as in other parts of the country. However, for those who experience that mood shift every fall, DAP Health can help. “We offer behavioral health services and any one of our licensed clinicians can provide excellent treatment,” Dr. Gover emphasizes. One of the most effective treatments for SAD is phototherapy, which involves sitting in front of a special light box. “We have psychotherapy, we have medication management, and we can assist patients in locating a light box and give them criteria to identify high-quality products so they can also engage in light therapy.” 

Dr. G.’s warning: “Winter depression can definitely become very serious and really interfere with the quality of your life. If anybody is struggling, if they are experiencing any symptoms, then I encourage them to seek therapy.” 

Aging Positively — Reunion Project 202 …

by Dustin Gruber
HIV and Aging Conference Header Image

Contact: Steven Henke                                 
Director of Brand Marketing 
(612) 310-3047 
[email protected] 

FOR IMMEDIATE RELEASE  

August 5 2021  

Local Organizations Collaborate on HIV & Aging Conference  

Aging Positively — Reunion Project Set September 18, 2021  

Aging Positively — Reunion Project, the annual Coachella Valley conference aimed at providing practical information and inspiration for those aging with HIV, will bring together community leaders to improve the lives of older adults living with HIV for a virtual conference on Sept. 18, 2021. The conference will feature an HIV research panel of top experts discussing HIV and aging issues in our community.   

September 18 is National HIV/AIDS and Aging Awareness Day — a day to call attention to the growing number of people living long and full lives with HIV and to aging-related challenges of HIV prevention, testing, treatment, and care.    

The virtual conference is free to attendees and open to the public. Presented by Eisenhower Health, this year's event is the result of a unique collaboration among local service providers and organizations focused on improving the shared experience of older adults living with HIV.  

People with HIV are living longer lives, thanks to advancements in scientific research and medical treatments; today, about half of HIV positive individuals in the U.S. are age 50 and above. Aging persons living with HIV have experienced tremendous loss, stigma, and discrimination throughout their lifetime and within the healthcare system.  In comparison to similar HIV-negative populations, individuals aging with HIV may experience an early onset of aging complications such as neurocognitive decline, impaired physical function, frailty, and falls.    

Karl Schmid, the entertainment reporter for ABC7 LA will speak on HIV and the media. The ABC reporter, who came out as HIV Positive in 2018, uses his multimedia platform, +Life, to educate and combat HIV stigma.  

At ABC7, Karl has been a regular contributor since 2013, joining the team as a correspondent and producer on the then-weekly and syndicated "On The Red Carpet." 

A passionate activist in the fight against HIV stigma, Schmid launched +Life (www.pluslifemedia.com) in 2019 online to help foster a new conversation around what it means for people living with HIV and to tackle the stigma still associated with the virus. +Life is also part of Localish TV on the newly launched Localish TV network. 

"HIV is not killing people but stigma is, and this is what needs to change," Schmid said in a statement. "We need to talk more about HIV and its advancements, about what U=U means, and we should not be stigmatized by society. 

"We need to have more information on mainstream media about how you contract HIV, prevention and treatments available so that people stop stigmatizing those that are positive and realize that anyone can have HIV and live a completely normal and healthy life."  

Since coming out as HIV-positive, Schmid has used his platform to educate and fight bias.  

Keynote speaker Andy Bell of Erasure fame will share his personal story. Bell is a founding member of Erasure.  Formed in 1985, when former Depeche Mode and Yazoo member Clarke advertised for a new singer. The duo quickly became enormously successful in the U.K., U.S., and several other countries with hits like “Chains of Love,” “A Little Respect,” and “Oh L’amour.” Now, three decades into their career, they are considered one of the most adored and influential synthpop bands selling more than 25 million records. In 2019, Erasure released their 18th studio album, The Neon. 

Bell has become an icon within the LGBTQ+ community for his honesty, compassion and support. Among his support of various LGBTQ+ causes, Bell has served as an ambassador for New York’s Hetrick-Martin Institute, and he is currently a patron of the Cambridge, England-based charity Diverse and of Above The Stag, London’s only LGBTQ+ theater. 

Topics and speakers:  

  •  Keynote speaker: Andy Bell from Erasure 
  • “Honoring Our Experience” with Gregg Cassin 
  • “KeeLee Meditation” with Dr. Daniel Lee, from the University of California, San Diego's Owen Clinic 
  • “HIV & The Media”: Karl Schmid is the entertainment reporter for ABC7 LA. He recently revealed his HIV status and has been an advocate for U=U as well as breaking down HIV stigma. 
  • HIV research update panel: 
    • Borrego Health: Valerio Iovino, i-Care 
    • DAP Health: Dr. Tulika Singh 
    • Eisenhower Health: Dr. Ken Lichtenstein 
    • Palmtree: Dr. Carlos Martinez 
    • HIV+ Aging Research Project-Palm Springs (HARP-PS): Jeff Taylor  
    • Caregiving with Perry Wiggins from The Center, end-of-life doula Alex Snell, and Richard Bass from PALS (Planning Ahead for LGBTQ Seniors)
    •  “Let’s Kick ASS”: Brian DeVries speaks about sustaining and making new friendships late in life 

What: The Aging Positively — Reunion Project 6th annual HIV conference is a collaboration between the HIV+ Aging Research Project—Palm Springs and other nonprofit community partners. It will be a virtual conference consisting of a mix of facilitated discussions, panels, and presentations led by key researchers, advocates, and long-term survivors of HIV/AIDS.  

When:  The 6th Annual Aging Positively — Reunion Project virtual conference will be held 9 a.m. to 2 p.m. on Sept. 18, 2021. 

Where:  Attendees can attend the conference from the digital device of their choice.  In-person elements may be announced later.  

How: Registration is free and open on Eventbrite: https://www.eventbrite.com/e/hiv-aging-virtual-conference-tickets-162082616469  

Collaborating Organizations:  

ANAC   

The Association of Nurses in AIDS Care (ANAC) is the leading health care organization responding to HIV/AIDS. Since its founding in 1987, ANAC has been meeting the needs of nurses and other healthcare professionals in HIV/AIDS care, research, prevention, and policy.  

 ANAC aims to promote the health and welfare of people affected by HIV/AIDS by:  

  • Creating an effective, engaged network of nurses in AIDS care. 
  • Studying, researching and exchanging information, experiences and ideas leading to improved care and prevention. 
  • Providing leadership to the nursing community in matters related to HIV/AIDS infection and its co-morbidities. 
  • Advocating for effective public policies and quality care for people living with HIV. 
  • Promoting social awareness concerning issues related to HIV/AIDS. 

Borrego Health   

Borrego Health provides high-quality, comprehensive, compassionate primary health care to the people in our communities, regardless of their ability to pay. They serve these communities and adjoining regions with respect, dignity, and cultural sensitivity as a medical home and safety net for essential health care and social services. Borrego Health is a non-profit 501(c)(3) Federally Qualified Health Center (FQHC) and a Federal Tort Claims Act Deemed (FTCA) facility.  

DAP Health   

At DAP Health, no one wonders if they belong — they just feel it. People can rely on culturally competent and stigma-free care at DAP Health.    

DAP Health offers medical and mental healthcare tailored to patients and clients by clinicians who listen to them. DAP Health has been meeting the diverse needs or its community since 1984, and it offers culturally competent care with no stigma about a person’s race, being LGBTQ+, or living with HIV. By actively listening, we can offer people care and services that meet their unique needs.     

  • Sexual wellness — DAP Health’s Orange Clinic offers STI testing and treatment, Pre-Exposure Prophylaxis (PrEP), Post-Exposure Prophylaxis (PEP), and HIV and hepatitis C testing.
  •  Thriving with HIV and ending the epidemic — DAP Health helps patients living with HIV thrive by staying healthy, undetectable and untransmittable to others. They become part of DAP Health's family beginning with testing, linkage into care, and then being enrolled in medical and mental healthcare, dentistry, social services, and prescription access. 
  • Mental health services — DAP Health offers individual and group therapy and has a substance abuse program that emphasizes recovery and relapse prevention. Mental health is health — no stigma, no shame. It just takes seeing a person truly where he/she/they are in their personal journey. 
  • Ongoing primary care — Join more than 9,700 patients who enjoy culturally competent care from clinicians and care teams who become like family. DAP Health's team works with patients to coordinate their care and ensure they have everything they need to stay healthy.  

Eisenhower Health  

Eisenhower HIV Clinic: Recognizing the complex health care needs of the LGBTQ patient population, Eisenhower Medical Center offers a comprehensive range of clinical, research and education resources — starting with a team of dedicated primary care doctors who have exceptional experience and expertise.  

Eisenhower HIV Clinic Primary Care Services: Providing state-of-the-art care for HIV patients requires knowledge of the latest treatments and best practices in the detection and treatment of HIV. Eisenhower's HIV Primary Care program is focused on the overall health of each patient, including:  

  • Appropriate utilization of advances in HIV care to sustain the best possible quality of life, including appropriate STD and cancer screening as well as healthy aging  
  • Best practices to prevent the spread of HIV  
  •  Compassionate access to new medicines for highly drug-resistant patients  
  • Our team includes HIV primary care doctors Board Certified in Internal Medicine or Family Medicine, with an additional certification as an HIV specialist with the American Academy of HIV Medicine (AAHIVM).  
  • Eisenhower Health is proud to collaborate with many nonprofit organizations here in the Coachella Valley providing HIV and related healthcare services, through partnership connectivity of services, referrals, and education.  

HARP-PS   

The HIV+ Aging Research Project-Palm Springs is a grassroots community non-profit that conducts research and provides education to improve the quality of life for long-term HIV survivors in the Coachella Valley. They collaborate with academic partners throughout Southern California and nationally to conduct socio-behavioral research on issues like resiliency and COVID-19 affecting HIV survivors. They hold monthly provider events to provide education on HIV Treatment issues, and they held monthly COVID Rounds during the peak of the COVID-19 pandemic. They also provide the monthly Positive Life HIV education series with topics and speakers tailored to the unique needs of their HIV survivor community. They created the annual Reunion Project daylong regional seminar to bring together the HIV and aging community in Southern California. Last year they combined forces with DAP Health and other community partners on the Aging Positively-Reunion Project event, which is held each year on or around HIV and Aging Awareness Day on September 18.    

Jewish Family Service of the Desert 

Since its inception as part of the Jewish Federation of Palm Springs and Desert Area in 1982, JFS has grown—not just in size, but in its ability to serve the people of the Coachella Valley. Beginning as a small group of volunteers who checked in on seniors and disabled people who lived alone, JFS Desert has evolved into an organization of professionals and volunteers that provide a broad range of support and services to thousands of Coachella Valley residents each year.  

JFS Desert’s experienced case managers can assist in exploring potential resources. They will assess clients’ eligibility for services and programs and can help facilitate the application process to obtain benefits and support. JFS case managers are a resource for the Coachella Valley, providing emergency financial assistance to prevent homelessness. JFS also works with local and county organizations to advocate for the rights of seniors in the valley. The JFS case management team takes a holistic service approach, collaborating with internal departments to ensure clients’ needs are addressed. We are dedicated to making sure that mental health issues and affordable housing stay front and center for our valley citizens.   

Let’s Kick ASS Palm Springs 

Let’s Kick ASS Palm Springs is an inclusive social group seeking to reduce the stresses of AIDS Survivor Syndrome. They welcome members regardless of HIV status, race, gender, age, or sexuality, believing that the individual is the best judge of the impact of HIV on their life. LKAPS organizes social functions providing opportunities to develop friendships and community.  

They support education and advocacy to raise awareness of AIDS Survivor Syndrome, long-term survivors, and the challenges they face.  

People feel better when engaged in social activity. LKAPS helps long-term survivors overcome isolation by creating social opportunities. From their popular monthly potlucks, twice-monthly coffee socials, bowling team, and movie nights, to now-established annual events such as June 5's Long-term Survivors Day reception and the Thanksgiving Day feast, LKAPS benefits its members through engagement with their local community of HIV survivors.  

PALS  

PALS (Planning Ahead for LGBTQ Seniors) is a volunteer-led community initiative based in Palm Springs that helps LGBTQ+ adults and friends plan ahead before a health or other life-altering situation arises.   

Having a plan in place mitigates stress and anxiety, ensures that LGBTQ+ adults are in control of their future care and legacy, and relieves the burden on family and friends.  

The Center   

At The Center, they like to say they create vibrant community by helping LGBTQ+ people along their way, wherever they might be in life’s journey. Even better, The Center likes to live it, breathe it, and do it. If someone is looking to meet new friends, get resources, or enrich their life and their place in community, they have come to the right place.  

Based in the Coachella Valley, The Center serves people of all ages, totaling more than 70,000 visits annually. How do they attract so many people? They do it with meaningful, relevant and mission-focused programming that addresses three strategic initiatives:  

  •   Ending isolation and loneliness  
  •   Connecting people to resources and community  
  •   Enriching individual and collective experiences 

About DAP Health 

DAP Health is an advocacy-based health center in Palm Springs, Calif., serving more than 10,000 patients, offering medical and mental healthcare, STI testing and treatment, dentistry, pharmacy, and lab services. A variety of wraparound services enable patients to experience optimal health, including social services, support groups, alternative therapies, and other wellness services. Excellent HIV care is provided by the largest team of specialized clinicians in the area.      

DAP Health opened one of California’s first COVID clinics and hotlines to offer screening, testing, and treatment. DAP Health also is working to address the social determinants of health that are causing negative health outcomes during this pandemic, like food and housing insecurity, joblessness, isolation, and access to ongoing healthcare.  

DAP Health’s sexual health clinic offers STI testing and treatment, pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP), and HIV and hepatitis C (HCV) testing. DAP Health has earned Charity Navigator’s highest rating for the twelfth consecutive year — landing DAP in the top 6% of nonprofits rated. The distinction recognizes that DAP Health exceeds industry standards in terms of financial health, accountability, and transparency.      

Visit www.daphealth.org to learn more.