It was an outside approach that caught fire.
“I felt there was something missing in which people could talk about HIV and sexual health in a way that was a little more modern than what we were used to,” said Jose Ramos.
Seeking to shake up the dialogue with a new weapon in the war on AIDS, Ramos founded the Impulse Group. Nine years later, the international organization has become a recognized model in effective and modern public health strategies. In a telephone interview from Los Angeles, Ramos discussed the history of his social group and challenges on the horizon.
“Trying to go to them instead of them coming to us, that’s how this whole concept begin,” Ramos said.
“Them” are sexually active young people -- specifically gay and bisexual men. While overall rates of new HIV infections in the United States have declined, the numbers are rising in self-identified gay and bisexual men ages 25 to 34. That’s where the Impulse Group comes into play.
With the support of the AIDS Healthcare Foundation, Ramos crafted teams and strategies to educate at risk populations in some of America’s largest cities. He had grown tired of what he called “stale” conferences and meetings full of bureaucrats reminiscing about the AIDS epidemic of the 1980s.
“They keep doing the same things and getting the same results,” Ramos lamented.
On the contrary, Impulse Group events feature provocative themes and explosive dialogue.
“Maybe it’s something they will react to because that’s how we get them into care,” Ramos said.
Volunteers, comprised primarily of young gay and bisexual men, power the organization. Naturally, there are sceptics.
“If you go and recruit a bunch of 19 and 20-year-olds and allow them to speak like people are speaking in their communities, people are going to be outraged,” Ramos said. “Not because they are doing anything wrong, but because they don’t understand it.”
In 2015, Impulse Group made its biggest wave when it hosted a pool party in Miami. Anyone over the age of 40 was asked to pay $50 to attend. This decision did not go over well with many South Florida seniors. The group’s Facebook page was flooded with complaints and negative comments.
“The age thing created the most backlash,” Ramos admitted. “I didn’t want people to feel that way again. We’ve never done it again. It did not work and it did not put us in a good light.”
Other events dealt with hook-up apps, unprotected sex, drug and substance abuse and prevention tools such as PrEP and PEP.
With a global presence in 18 cities, Impulse Group continues to seek solutions with innovative marketing. Ramos was born and raised in Mexico City and is proud of the work his group has done in what he describes as a macho culture.
“That has been one of my great satisfactions,” Ramos said of the Mexico City chapter. “We have done a lot of testing and linkage to care. It is our most successful international chapter.”
However, some areas of the map are more challenging than others. In the U.S., African Americans (40 percent) and Hispanics (22 percent) account for the largest numbers of new HIV infections. Ramos said more attention is needed in the South.
“Accessibility to resources within cultures plays a huge part,” Ramos said. “Washington D.C., Atlanta, Houston we have a lot of new infections in the black community. Some of the resources like PrEP (pre-exposure) or PEP (post-exposure) is not as easy to get there.”
PrEP is a once-a-day dose of Truvada that blocks transmission of HIV in nearly 99 percent of cases. Ramos said 87 percent of PrEP users are white males over the age of 30.
“It’s a big tool not reaching the black community,” Ramos said.
In South Florida, where new HIV infection rates remain high, Ramos said his team is not as diverse as he would like and change is needed.
“The team there is not as diverse when it comes to the black community so there is an opportunity for us to do a better job to target the black community and challenge my teams there to do a better representation of the black community because it is hard to reach a community that you don’t really understand,” Ramos said.
Substance abuse is also an issue in South Florida, which has a well-documented history as a party culture and base of operations for the illegal drug circuit. Stories of “cocaine cowboys” and Colombian drug lords have given way to “chem sex” parties of meth and heroin.
“South Florida is having an issue with drugs and addiction especially when it comes to meth,” Ramos admitted. “It is having an impact within the community there.”
Recently, Impulse Group’s South Florida chapter hosted an event in Wilton Manors which dealt with substance abuse and drugs. Again, cries of foul were heard across the community.
“People were offended because we were talking about drugs in the way that we were,” Ramos said. “But you have to realize if you listen to everybody around about how to be sensitive to this and that you will never do anything. Somebody will also be offended. Whatever you say in whatever way you say it somebody will always be offended.”
Impulse has its share of supporters too. Miik Martorelli, President of Pride Fort Lauderdale, posted this on the group’s Facebook page: “An incredible group of people educating the youth in our community through exciting events these guys are truly a special organization that enhance our community.”
Ramos decided to start Impulse Group after his best friend was diagnosed with AIDS and given only a few weeks to live.
“I want to give back but not in the way of giving money or donating food and clothes to some big organization,” Ramos said.
Impulse Group is not just shock and awe, Ramos said. A brotherhood has developed and showing compassion is essential, he said. Ramos told a story of receiving a Facebook message from a young man newly diagnosed with HIV and seeking help.
“About four years ago I got a message on Facebook from this 18-year-old guy,” Ramos said. “I met him for coffee. He had moved to L.A. from Ohio and was suicidal so I guided him through the process. I went to his first appointment with him. I remember the kid was so afraid and crying and he held my hand through the whole process.”
Creating and sustaining Impulse Group has been quite a process as well, one that Ramos admits is an education in itself.
“I do think we’ve made mistakes because the guys don’t come from the field,” Ramos said. “We have made adjustments through learning and we have been exposed to criticism. That said, I still believe if we take it outside the box and look for ways to reach people that is up to date we have a better chance of promoting healthier sex and life.”