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HIV PrEP program thrives in St. Louis, makes ‘tools to end the epidemic’ widely accessible

Dr. Rupa Patel (left) and Jesse Milan discussed the past, present and future of HIV/AIDS in St. Louis and beyond on Tuesday's St. Louis on the Air.
St. Louis Public Radio & AIDS United
Dr. Rupa Patel (left) and Jesse Milan discussed the past, present and future of HIV/AIDS in St. Louis and beyond on Tuesday's St. Louis on the Air.

Every year on Dec. 1, the international community mourns those who have been lost to HIV/AIDS and celebrates the ongoing progress in treating, preventing and researching the disease.

On Tuesday’s St. Louis on the Air, president and CEO of AIDS United Jesse Milan told host Don Marsh that the day of commemoration is “an opportunity to remind people that this is still an epidemic nationally and globally.”

But Milan’s work as an advocate and organizer is, of course, an everyday pursuit, not least because he has been living with HIV for over three decades.

Also joining the conversation was a guest who intimately understands the impact of HIV on the St. Louis community: Dr. Rupa Patel, director of Washington University’s Pre-Exposure Prophylaxis HIV (PrEP) Program.

PrEP is a daily preventative pill that Patel administers to patients. By taking the pill, patients are able to suppress the virus before they are exposed to it, in order to maintain an HIV-negative status.

Patel’s goal when she began the program in 2013 was to make Missouri medical practitioners aware of PrEP. Five years later, she hopes that medical practitioners in the region will “integrate PrEP into [their] daily, routine modalities.”

Milan made note of St. Louis’ long-standing and significant ties to HIV/AIDS research, recounting the story of Robert Rayford, a black St. Louis teen whose mysterious 1969 death is now considered the first AIDS fatality in the United States.

The omission of Rayford’s case from the traditional HIV/AIDS narrative speaks to the limited space people of color are given in the cultural reimagining of the history of HIV, despite a widespread understanding that these communities tend to be those most often harmed by the virus. This prevalence, agreed the guests, comes down to access.

According to Patel, the pervasiveness in the United States of HIV in communities of color has to do with the “social determinants of health: socioeconomics, access to healthcare, awareness, comfort … safe spaces and support groups.”

Milan concurred, saying, “HIV/AIDS is part of the larger social justice question… access to health care creates a greater sense of health equity.”

In addition to the importance of financial access to care, both guests highlighted the significance of sexual health education and information for the treatment and prevention of HIV.

Despite the evident biomedical efficacy of the PrEP pill, Patel suggested that some the most important aspects of her work with PrEP are education and open dialogue, saying, “The biggest part of the program is creating a safe space for any individual that wants to come and talk about … sexual health.”

“Much of the work,” Milan added, “begins with education. The more people know, the more the stigma is reduced – and the more people are able to support people living with HIV.”

Access to education and financial assistance, in addition to medical advancements, make Milan and Patel optimistic about the future of HIV care in St. Louis and beyond.

“Biomedical changes in just these last few years are transforming the lives of people living with HIV,” said Milan. “Now they can also transform the lives of people who are negative to ensure that they stay negative.”

To learn more about PrEP and other HIV testing, prevention and treatment resources in Missouri, see theMissouri Department of Health and Human Services' PrEP Webpage.

St. Louis on the Air brings you the stories of St. Louis and the people who live, work and create in our region. St. Louis on the Air host Don Marsh and producers Alex HeuerEvie HemphillLara Hamdan, and Xandra Ellin give you the information you need to make informed decisions and stay in touch with our diverse and vibrant St. Louis region.

Copyright 2021 St. Louis Public Radio. To see more, visit St. Louis Public Radio.

Xandra Ellin is so psyched to join the St. Louis on the Air team as this fall’s production intern! Xandra graduated from Wesleyan University this spring with a degree in Psychology and American Studies. She found ways to incorporate a passion for radio into her academic pursuits, with an honors thesis that dealt with the psychological and sociocultural phenomena that have historically made localized radio a viable mechanism for social change in American communities. Xandra’s career in public radio began at her college radio station, WESU, where she was the Public Affairs Director by day and a music DJ by night. She has also had two production internships prior to this one: one at WYPR in her home city of Baltimore, MD in 2017 and another at WNPR in Hartford, CT in 2018. When she's not at KWMU, Xandra spends her time going for runs, watching bad reality television, and serving up some quality local artisan brews through her side hustle at the Craft Beer Cellar in Clayton.