Hello, Chicago!
As this is the first time I have written something for Windy City Times, I would like to introduce myself. My name is Pedro Alonso Serrano, and I am 26-year-old queer Latin@ of Mexican heritage. I was born and raised in Chicago, am a DePaul University graduate, and have dedicated myself to serving the Chicago LGBT community of color.
I work with the Adolescent Trials Network (ATN) for HIV/AIDS Interventions, a research network funded by Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), with additional support from the National Institute on Drug Abuse (NIDA) and the National Institute of Mental Health (NIMH). The ATN operates in cities across the country, including here in Chicago, through the Division of Adolescent and Young Adult Medicine at Stroger Hospital and the CORE Center. Since 2009 we have conducted three HIV pre-exposure prophylaxis (PrEP) trials with young men who have sex with men (Y/MSM) and transgender women.
PrEP is a very promising method to prevent HIV infection among those who are HIV-negative. With PrEP, antiretroviral medications that are usually used to treat HIV are taken by uninfected people to reduce their risk of infection. Recently, there have been several scientific studies which show that taking these antiretroviral medications for prevention can reduce a person's risk of becoming infected with HIV. Three of these trials—involving men who have sex with men (iPrEx) and heterosexual men and women (Partners PrEP and TDF2)—demonstrated that PrEP reduced the risk of getting HIV compared to placebo by between 44 percent and 75 percent. However, in both iPrEx and Partners PrEP, analyses of PrEP medications in blood samples suggests that those who were taking PrEP as directed (daily dosing) reduced their risk of HIV by greater than 90 percent.
Based on these studies, on July 16, 2012, the U.S. Food and Drug Administration (FDA) approved Truvada as the first ever medication to help reduce the risk of sexually acquired HIV among adults ages 18 and over.
Despite the FDA's approval of PrEP, we cannot simply assume that the results of these studies will be the same in other vulnerable populations in the United States. In the U.S., youth ages 13-29 years accounted for 39 percent of all new HIV infections in 2009. Over two-thirds (69 percent) of all new youth infections occurred in MSM and among young Black MSM, and new HIV infections increased 48 percent during 2006-2009. Yet, in the aforementioned studies, not a single participant was under the age of 18 and only a small number of the participants in the United States were 18-24. Understanding the safety, acceptability and feasibility of PrEP in youth is critical, as they have unique behavioral and biological considerations that are important to understand.
To that end, the ATN has opened Project PrEPare. Coordinated locally by Dr. Sybil Hosek and Dr. Jaime Martinez of Stroger Hospital, Project PrEPare is an innovative HIV prevention study designed to explore the safety, acceptability and feasibility of PrEP among YMSM who are at risk for HIV infection. We are now recruiting 100 HIV-uninfected YMSM ages 15-17 for the younger age cohort of Project PrEPare. To date, we have already completed enrollment of 200 youth into the 18-22-year-old cohort of Project PrEPare.
Once enrolled in the study, participants receive regular HIV, hepatitis, syphilis, gonorrhea and chlamydia testing and treatment on site as needed; hepatitis vaccinations are also available. They also receive full physical exams and follow-up with our clinicians. Moreover, they receive regular harm and risk reduction counseling, including condoms and lube for free. Given the level of commitment each one of our participants makes toward the science of PrEP, including ten visits over a year's time, each visit is well compensated for time and transportation.
Project participants often come to us without primary-care providers. As such, the division is often their first opportunity to access quality health care—provided by a team of specially trained case managers, social workers, psychologists, registered nurses, nurse practitioners and medical doctors—regardless of ability to pay.
Together with the staff at the Division of Adolescent and Young Adult Medicine, I have had the opportunity to coordinate the recruitment, retention and counseling of participants in our PrEP trials. Working with the young men and women participating in these projects has really been an amazing experience. Being invited to hear their stories and allowed to witness both their challenges and successes has been a privilege. Many of our youth state that their commitment to PrEP is not wholly personal, but also community based as they understand the bigger picture of being able to provide PrEP to more youth around the country as a direct result of their current participation.
This study will also be taking place in Los Angeles, Philadelphia, New Orleans, Boston and Denver. More information can be found on the Project PrEPare website—projectprepare.net—where participants can also find out if they are eligible. To contact me directly, please call 708-683-9415 or email PedroAlonsoSerrano@gmail.com .
Thank you, Chicago!
