Y’all may not know, but Ms. Ruby has her doctorate in psychology. Okay, I know what you might be tittering: She shrinks heads.
In the late eighties, the heyday of the AIDS epidemic, I counseled individuals who were newly diagnosed. Of course at that time, an AIDS diagnosis meant death. My patients taught me a lot, about myself, and about dying. One big lesson I learned is that death is No Big Deal. More on that in another column.
Late last year while at the Desert AIDS Project in Palm Springs, I attended a summit and met fellow therapist, Damon Jacobs, who works with many of these issues in his clinical practice in New York and is an active voice in our community. I liked Damon straight away.
In practice for nearly fifteen years, Damon knew at five years old that he wanted to be a
psychotherapist! The author of two books, Rational Relating and Absolutely Shouldless (a must-read. Truly.), he describes himself as an HIV prevention specialist who focuses on health, love, and pleasure. Re-read that sentence again. I don’t know of any other professional doing this specific kind of work. Damon began his mission of HIV prevention in 1991, by frequenting bars and clubs and setting up a table to share information.
Mister Jacobs has championed PrEP and has discussed its efficacy in such media outlets as The New York Times, MSNBC, Huffington Post, and NPR. He also conducts training, workshops, and lectures. He speaks searingly from his transparent heart, having started on PrEP in 2011.
Until the age of eighteen, this inspirational chap was reared in Culver City, California (not far from my digs), then, after attending college in Santa Cruz, moved to San Francisco. Moving to New York in 2005, Damon also extends his knowledge out onto the Internet waves through FaceBook.
As I was in New York City over the summer attending a workshop at GMHC, I decided to contact Damon. We met at his office in the 1100 block of Broadway in Manhattan, then walked across the street to Madison Square Park. The day was perspire-y humid. As I carry my picnic basket, I feel like Little Red Riding Hood, especially in my wide-brimmed sunbonnet. Damon thinks it is cute. We park our carcasses on a grassy knoll.
Ruby Comer: [Spreading out the red-checkered table cloth on the ground under a breezy oak tree I inquire] Why be an HIV activist?
Damon Jacobs: My interest in HIV activism and education came about as a direct consequence of my coming out in the mid-eighties. I saw the impact of AIDS on the mental health of my brothers and sisters who had lived through the worst of the crisis. It became clear to me that helping my community meant more than just sitting in an office listening. It meant actively fighting the homophobia that was creating so much death and pain, as well as educating people about how to experience sexual pleasure while reducing risk.
We need more peeps like you, Jacobs. Go ahead and open the picnic basket.
[He does and utters in glee] Peanut butter and jelly! My fave.
I was hoping you’d say that, and the products are from Trader Joe’s…and organic, too! [He giggles with delight.] So, who has inspired you the most?
Well, during the last months of his life in 1990, Vito Russo taught a class at my college on his book The Celluloid Closet [and the movie version was later] co-produced and narrated by Lily Tomlin. He would teach about movies and play clips about gay and lesbian representation in Hollywood films. Inevitably, the video would fail to play, and we’d just be sitting there in the auditorium, waiting. Vito would fill in the gaps by telling us stories about his New York activism, about his deceased partner Jeffrey, and about the progression of AIDS in his own body.
Oh gosh, yes. I remember Vito quite well. There was a doc made on him several years back.
In one of the last weeks of class, Vito reflected on his life, how he enjoyed partying, but wished he hadn’t wasted so much of his time “making small talk at bullshit cocktail parties.” He died a few months later. To this day I can see him and hear him so clearly saying these words.
Impactful. [Shaking my head in awe.]
Why did this prominent activist/author choose to spend the last few months of his life with a group of college students? It was about a lot more than movies. He was there to motivate, to inspire, to have us act up, fight back, and not waste so much time “making small talk at bullshit cocktail parties.” He was the first person I ever met, hugged, and then lost to AIDS. Vito was the first person who got me interested and active in prevention.
You’ve known quite a few who have succumbed to AIDS….
Throughout the following years, I got to know, love, and lose many folks to AIDS. Each and every time, it was a reminder of how necessary it is to reach people and prevent more infections—and more death.
When I was studying for my license—many moons ago!—there were pros and cons on self-revealing to a patient in therapy. What’s your take?
I’m up front and out because I believe that is the most effective way to teach. A dear friend named Ntombi Howell said to me in 1997, “A liberal is someone who talks about ‘them.’ An ally is someone who talks about ‘us.’” That helped me to realize that my life had been shaped and altered by people like Vito Russo and Ntombi, who spoke and taught based on their own personal and private struggles. The more specific they were, the more universal their message. So I realized then that if I was given the privilege and platform to speak publicly, there had to be a personal component.
That makes pure sense.
Plus, I think talking only about facts is boring. [Bobbing my head furiously!] A robot can do that. But nothing replaces the salient impact of having another human being tell you their story.
[With a serving spoon I dab some broccoli slaw onto my paper plate.] Why do you so strongly believe in PrEP?
I strongly believe in PrEP because the science has clearly demonstrated over and over that it works so well. In 2011, I didn’t feel that strongly when I began using it myself. Back then, the only solid information about PrEP came from [the] iPrEx [study], and that was still a work in process. But even then it was clear that no one who took the drug four or more times a week became HIV-positive. That was enough for me to begin using it for myself. Now, of course, there are over thirty studies including more than 8,000 participants who have all come to the same conclusion: PrEP works. We never had those kind of figures for condoms, we just told people to wear them based on our best guess that they worked to prevent HIV, despite there being only one study in 1989 that suggested this was true.
Point taken. Address the fact that there are no long-term studies.
There may not be long-term studies about the drug itself, but there are certainly plenty of studies that have been conducted about the medications in the drug, tenofovir and emtricitabine, that span well over twenty years. Remember, Truvada itself was originally approved by the FDA for HIV treatment in 2004. Tenofovir and emtricitabine were both patented as HIV treatments medications in 1996. So although the indication that they can be used as HIV prevention wasn’t approved until 2012, the medications themselves are not new.
Have you experienced any side effects, Damon?
I’ve been using Truvada consistently for nearly six years. During that time I’ve only had two major side effects: Great sex, and much improved sleep. [He dons a huge sparkling smile, as do I.] I say that because we don’t tend to remember that positive impact PrEP has on enhancing the quality of life for those of us who were traumatized by the AIDS crisis.
[He pops the tab on a Dr. Zevia soda I brought—a naturally flavored soft drink.] I have never experienced a physical or medical side effect. I’ve always worked with doctors who follow standard protocol and draw my blood at least twice a year, to make sure that Truvada isn’t hurting my kidneys, or that there are any side effects that I could not detect. So far, there are no side effects or negative impact. This does not come as a surprise, given that Truvada is considered to be safe as a daily aspirin.
You know, I heard you mention a couple of times…PrEP-O-LICIOUS [stuttering to emit the words]. Whaat?!
[He chuckles.] PrEP-O-Licious was an occasion that came out of the gorgeous mind of Honey LaBronx, née Ben Strothmann. She came to me in 2013 in utter disbelief that PrEP had been approved by the FDA the prior year, but no agencies or organizations or clinics in New York City would share this information with their at-risk patients. We created this event to use entertainment and drag shows as a means to share information and resources with the greater NYC community.
What a fun idea. I like your style of entertaining as a tool for education.
We did these two years in a row. The first time in 2014 was a resounding success. The second time in 2015 was not so much. [He ponders.] Ya know Ruby, it’s that one on one approach that has really made the difference, I believe, in getting the word out about PrEP, and helping people learn and decide if this is right for them.
I like your method. You said to me a while back that you haven’t asked anyone to use a condom since you began taking PrEP.
Yes indeed. I really was one of those rare folks who only used condoms with new sexual partners in the late nineties, and most of the 2000s. But that started slipping in the later 2000s, especially following a break-up in 2010. I was having these incredibly pleasurable experiences of feeling a man inside me, accompanied by tremendous terror weeks and months after.
All of a sudden a Frisbee splats right into our food. “So sorry,” apologizes the handsome chap, playing with his friends. I take advantage of the interruption.
Damon, what’s your all time fave film and what was the last country you visited?
I first saw Harold and Maude when I was fourteen. Never before or after has a movie so blatantly and beautifully portrayed subversion of the status quo, survival through trauma, humor about death, and shocking expressions of sexuality.
Bravo. Exceptional choice!
And I was in London about a year ago, shortly after the election, and the U.S. was a laughingstock to them…rightfully so.
Puh-leez [I say with dread] don’t get me started on that billionaire bully. The man is embarrassing. [I stop myself.] Moving on! In your practice, my dear, what is the major HIV issue that clients are dealing with?
Not knowing what undetectable means! [He remarks with gravity.] Seriously, in New York City, in 2017, people living with HIV who have been undetectable for years are still being told they present a risk to others. So conveying the truth to them, followed by their outrage and betrayal that this information did not come from the primary doctor who supposedly is there to care for them, has been a consistent issue this past year.
What has remained consistent in my work the last two decades is the sense of isolation and trauma that many people living with HIV have been coping with. Sometimes that isolation is self-imposed. They are too shell shocked to consider getting close to others after having lost so many. [I give a knowing nod.] Other times it comes from being rejected by a person who identifies as HIV-negative and [is] reactive to fear and ignorance. My work has sought to continuously support people to build a narrative that helps them to make meaning out of loss, uncertainty, confusion, rejection, and survivor’s guilt. Recognizing strength, resiliency, creativity, humor, and courage have been integral to this journey.
What a needed support you are, Damon. Thank you for your service. I mean it. Tell me, what do you find is the number-one reason why younger “kids” are acquiring HIV?
[He instantly replies.] Not being given adequate information and/or resources by leaders in their communities. If they receive any kind of sexual health information it is generally based on telling them what not to do [he takes a breath]…versus… embracing and celebrating sexuality.
Dig in deeper with Damon at: DamonLJacobs.com.
Ruby Comer is an independent journalist from the Midwest who is happy to call Hollywood her home away from home. Reach her by e-mail at [email protected]