“So, I heard I don’t have to wear condoms anymore.  All I have to do is go on PrEP,” a twenty-something- year-old greeted me.  I nearly fell off of my stool.  “Is that what your heard?” I replied.  “Yup, all of my friends keep telling me I need to get the pill.  So I figured I’d come and ask if you can prescribe me some.”  “Glad you came to see me”, I answered, as I would to any sexually-active person of any age.  “Let’s have a little chat,” I continued.

What Is PrEP?

“PrEP” stands for Pre-Exposure Prophylaxis.  The word “prophylaxis” means to prevent or control the spread of an infection or disease.  PrEP is a way for people who do not have HIV to prevent HIV infection by taking a pill every day. 

Who Can Use PrEP?

Your doctor may consider prescribing PrEP for you if you are HIV negative and at substantial risk for HIV infection.  Being at substantial risk includes:

1. Anyone in an ongoing relationship with an HIV infected partner
2. Gay or bisexual men not in a monogamous relationship who have had sex without a condom or been diagnosed with a sexually transmitted infection within the past six months
3. A heterosexual man or woman who does not regularly use condoms when having sex with partners known to be at risk for HIV
4. Injection drug users who share needles or who have sex without a condom

What Medications Are Used For PrEP?

The U.S. Food and Drug Administration approved Truvada for daily use as PrEP for “at high risk for HIV infection” people.  Truvada is a combination of two HIV medications:  tenofovir and emtricitabine. These medicines work by blocking important pathways that HIV uses to set up an infection. If you take PrEP every day there will be enough medicine in your bloodstream to prevent HIV from taking hold and spreading in your body.  If you take PrEP inconsistently there may not be enough medicine in the bloodstream to block the virus.

How Well Does PrEp Work?

In several studies of PrEP, the risk of getting HIV infection was much lower (up to 92%) for those who took the medicines consistently compared to those who did not take PrEP.

Is PrEP Safe?

Some people in the clinical trials for PrEP had early side effects such an upset stomach or a loss of appetite.  These symptoms were mild and went away within the first month.   Others reported having a mild headache, while some had changes in the laboratory measurements of their kidney function.  Still others had changes in tests measuring bone thickness. 

Should I Go On PrEP?

For heterosexual couples where one partner has HIV and the other does not (a discordant couple), PrEP is one of several options to protect the uninfected partner during conception and pregnancy. 

People who use PrEP must be able to take the drug every day as well as follow up with a healthcare provider every three months to check for possible medication side effects, HIV testing, and for prescription refills. 

Although PrEP is a powerful HIV prevention tool, no prevention is 100% effective.  Individuals who use PrEP should use it along with other effective HIV prevention strategies.  These include:

1. Using condoms consistently and correctly
2. Getting HIV and other sexually transmitted infection screening with your partners
3. Choosing less risky sexual behaviors
4. Participation of injection drug users in needle exchange programs or entering drug rehabilitation            
   

As I always remind my patients of any age, PrEP does not prevent you from getting any other sexually transmitted infections such as chlamydia, gonorrhea, syphilis, herpes, or human papilloma virus.  You can talk with your healthcare provider to find out if PrEP is right for you.

A Pew Research study showed that Blacks not only have different experiences with guns from that of Whites, but hold different views of gun control. While Blacks are much more likely to become gun homicide victims, Blacks are only about half as likely as Whites to have a firearm in their home (41% vs. 19%). Hispanics are less likely than Blacks to be gun homicide victims and half as likely as Whites to have a gun at home (20%)

Amongst Whites, White southerners are significantly more likely to have a gun at home (47%) than Whites in other regions.  About six-in-ten gun household members (64%) say they “often feel proud to be American.”  In contrast, about half (51%) of other adults say this.

NFL legend Michael Strahan is now becoming a legend on TV and will shine in Harlem Thursday, October 15 for a book signing with Hue-Man Books at 7p.  MIST Harlem will host the signing of Wake Up Happy at 46 W. 116th Street.

Strahan made his name on the football field, setting the record for single season sacks in 2001. In 2014, he was inducted into the Pro Football Hall of Fame, but his star has shined brighter and for longer than his 216 history-making games with the New York Giants, which included a win at Super Bowl XLII.

In 2008, Michael joined the Fox NFL Sunday pregame show as a commentator, and in 2012, he beat a competitive roster of candidates to replace Regis Philbin as co-host of the wildly popular Live! with Kelly & Michael.  In April 2014, he joined Good Morning America as a special cohost, and Barbara Walters has selected him as one of her 10 Most Fascinating People of 2014.

Who will care for your special needs person when you are gone or no longer able? Wayne Butcher, a beneficiary advocate with The Arc of Northern Virginia, suggests setting up a Special Needs Trust (SNT).

A SNT is a legal vehicle used to set aside funds for the benefit of an individual with disabilities.  SNTs are not considered an asset or resource by certain government benefits programs and do not affect government benefits eligibility. 

As a result, Supplemental Security Income (SSI), Medicaid coverage, and other means-tested benefits are not jeopardized by the existence of a funded SNT.  Added Port Of Harlem Money contributor Nick Abrams, “Special Needs Trust can be funded with life insurance, cash, investments, and other personal assets.”

Port Of Harlem magazine and its charity, Port Of Harlem Gambian Education Partnership (POHGEP), continues to makes progress with your support.  Thank you.

The magazine is now responsive, meaning that no matter what size screen you are using to view Port Of Harlem, the text, images, navigation, and graphics will size to look good and function well. There should not be a lot of zooming, pinching and scrolling for you to enjoy reading the e-magazine on a desktop, laptop, tablet, or mobile phone.  

About half of our readers now access Port Of Harlem via a mobile device.  At the top of each issue is a link, “If Opening From an E-mail, Click Here for Better Viewing” for you to experience a better view on a mobile device.  Also, our background is now white for easier reading.  “Our goal is to make the magazine informative and easy to read,” says publisher Wayne Young.

The Charity Thanks You

Readers have responded to the magazine’s call to donate to the POHGEP.  Two readers even called to write a check for the entire balance. “16 Gambian students now will be able to pay their school fees and know that a person in America and the world care about their well-being because of the generosity of our readers,” says Young.

From the funds we recently won from the DC Humanities Council, we paid several Gambians who helped make our Facebook Chat with the Gambians at the Humanities, Arts, and Technology festival success. One of the participants, 19-year-old Rugiatou Bah (pictured), a 2015 graduate of Kotu Secondary School in Kotu, The Gambia, wrote, “I shared the money with my family because it happens to be my first payment, so I need their blessing.”

Bah was a member of the Facebook Friends group who has remained in contact with the group and would like to become a medical doctor.  She added, “but I don't think it will be possible for me, so want to try the nursing field.”

If you have a teenage student or a group of them interested in participating in an hour-long organized Facebook chat with their Gambian counterparts, let us know. We plan to organize another session in the near future.

Washington
Samora Pinderhughes Ensemble
Billy Strayhorn: The Sutherland Hotel
Kennedy Center Millennium Stage
2700 F Street, NW
Fri, Oct 16, 6p, free

7th Annual American Indian Festival
Patuxent River Park
16000 Croom Airport Road
Upper Marlboro, MD
Sat, Oct 17,10a-4p, free,
some nominal fees for activities

Haiti: From Independence to Earthquake & Beyond
CR Gibbs
Greenbelt Library
Tue, Oct 20, 7p, free

Children’s Africana Book Awards Festival
Smithsonian National Museum of African Art 950 Independence Avenue, SW
Sat, Oct 24, 11a-2p, free

Baltimore
Rusty Hassan/lecture
Craig Alston/performance
Why Strayhorn: Making the Case
GOUCHER College
Kelley Lecture Hall
1021 Dulaney Valley Rd
Tue, Oct 20, 3p, free

Boston
Boston Book Fair
Copley Square
Fri, Oct 23-Sat, Oct 24, free, $ some events