New cases of HIV in the Miami area are the highest in the nation and the Latino population is one of the most at risk.
An effort has evolved to bring those numbers down through education and access to the HIV prevention drug PrEP in some unconventional ways.
Prevention305 has trained “peer navigators” to reach Latinos, primarily – many of whom are immigrants and/or don’t speak much if any English. The navigators use popular gay dating apps like Grindr and Tinder to introduce them to the drug.
Miami resident John Byrne started Prevention305 a few years ago and serves as its executive director. He’s also the founder and controlling partner of Raw Story Media and AlterNet Media – part of a group of LGBT-owned news sites in the U.S.
It was a rare false-positive HIV test that spurred Byrne toward starting the nonprofit.
“If you’ve had a false-positive, you know it can take a week to get the confirmation back,” Byrne said. "I thought, 'Oh my God, I'm that one in a million person, because I was taking PrEP.' I thought, 'No one needs to go through this.’”
The drug was solidly top of mind for Byrne and he didn’t think enough was being done to get the word out about it. PrEP reduces the risk of HIV transmission by more than 90 percent, according to the Centers for Disease Control (CDC). For drug users the risk is lowered by more than 70 percent.
What is it?
PrEP stands for pre-exposure prophylaxis. The CDC says you’re considered very high risk if you’re a gay or bisexual man who has anal sex without a condom. It also considers as very high risk those who are HIV-negative, but are in an ongoing sexual relationship with someone who is HIV-positive.
PrEP is a combination of two HIV medicines sold under the name Truvada.
When used correctly, the CDC says PrEP can stop HIV from taking hold and spreading. Critics though point out that PrEP does not prevent other STIs such as syphilis.
From posters to peers
Byrne’s early push for outreach consisted of a grassroots effort of making posters for health centers and fitness clubs – the “Swallow This” graphic that shows a blue PrEP pill on a man’s outstretched tongue. He had the poster done in both English and Spanish.
“I slowly realized as a white person in Miami what I was running up against,” Byrne said. “The translation of the poster in Spanish didn’t work. I realized I couldn’t do this on my own.”
On a whim he began doing PrEP education on Grindr. He created a profile with PrEP information and the line: “Contact me if you want info on how to get PrEP.”
“I was blown away by the response,” Byrne said. “There was a demand. Some had heard about it, but didn’t know where to go.”
For a year he went to conferences, made connections and wrote grants (he got one each from Gilead Sciences and AIDS United). Byrne, 37, then hired a digitally savvy gay Venezuelan man to be his program director – Marco Torrealba.
Torrealba, 34, was tasked by Byrne this year to hire peer navigators and train them in customer service, marketing and technology to make the dating app connections with Latinos about PrEP.
“People don’t have access because a lot of the information is in English,” Torrealba, who moved to South Florida three and a half years ago, said. “This is why Latinos are not having access to PrEP, the lack of information. When you are an immigrant, you can be in a bubble. Sometimes you get nervous.”
Torrealba said his training methods are heavy on the use of empathy and innovation.
“In order to reach and communicate with a different culture you have to be very empathetic,” he said. “Those who are arriving or those who don’t speak English or fear for any political situation will not go inside [a health clinic]. The best way to do it is to have a [peer navigator] right there.”
His peer navigators create profiles on the sites and spread the word about PrEP. Torrealba said the format takes some of the initial nervousness away and he stresses that they are not creating fake or misleading profiles. All his peer navigators are younger and are people of color.
“Once they say hi to the person; how are you today; I am fine; [then they say] I want to tell you I am here to offer PrEP,” Torrealba said. “People say yes or no. Peer navigators are trained and have to be aware to be straight with the message. That person will block you and report your profile otherwise.”
Byrne and Torrealba have found an audience with Instagram as well, hiring Instagram influencers, both because it’s effective and because not everyone uses gay dating sites or apps, he said.
“People go to Instagram to see if you’re for real, see a face, see a video, see who is working at Prevention305,” Torrealba said.
Prevention305 is able to help a client receive the drug more quickly with wait times reduced from months to weeks. In most cases, the drug is available for free, either through insurance or if a client makes less than $58,000 a year and doesn’t have insurance.
Anyone can sign up on their website to book an appointment and to go over options.
“Clients know they aren’t alone in this process. Peer navigators are with clients during the appointment if they have questions or are nervous,” Torrealba said.
By the numbers
In less than six months, Prevention305 has reached almost 300 people and has about 100 taking PrEP.
“While it may not sound like a lot, there's only about 1,500 people on PrEP in all of Miami-Dade, so I think our early success is a big number,” Byrne said.
Byrne said to look for Prevention305 at events and festivals around South Florida and said he’s also working toward opening a mobile PrEP clinic in collaboration with the University of Miami’s Miller School of Medicine at The Gaythering hotel, sauna and bar in Miami Beach.
- Prevention305’s website in English and Spanish is at prevention305.org and prevencion305.org.
- Complete CDC information on PrEP is available at cdc.gov/hiv/risk/prep.