In April, the Kansas City Care Clinic opened its third location, in the Northeast area of Kansas City, Mo. It’s at 4601 Independence Ave., the site of the former Neighborhood Family Care clinic. The two other KC Care offices are in Midtown, at 3515 Broadway St., and in the Research Hospital area, at 2340 E. Meyer Blvd., Suite 200
Jonathon Antle is a prevention specialist at KC Care and program coordinator for the HIMM Project, or High Impact Men’s Movement. (See Bradley Osborn’s September 2016 Camp story on the program at https://goo.gl/1pUMBb.) He’s held this position since joining the clinic in May 2016.
“I do prevention promotion,” Antle said. “That is through awareness of HIV, how it’s contracted, what the risks are, and promoting regular testing instead of every couple of years. Every three months is a good routine.”
Antle, 31, comes from southwestern Missouri and has lived in Kansas City for nine years. His degree was in music education, rather than having a social work or medical background. He has a personal reason for moving to the work he does now.
“My PrEP years is what made me make this shift,” he said. “I got s**t-shamed because people make assumptions as to why you take PrEP. The honest reason for me is that I had a partner for 18 months who I thought was mutually monogamous. After we ended the relationship, I found out he wasn’t. That was scary. Here I was, trusting this person who put me at risk. So for a couple of years, I was horrified. And I never want to be in that situation again. What is the most disappointing is that it’s our own community that is s**t-shaming the use of PrEP.”
PrEP is the acronym for pre-exposure prophylaxis. It’s been in use since 2004, but not widely proposed for those who are HIV-negative until 2012. Truvada, manufactured by Gilead Pharmaceuticals, is the main brand of this drug.
“Now, the new model that the CDC has for stopping HIV is really once you’re tested, there are two tracks to put you on,” Antle said. “If you’re positive, the first track is to get you in treatment, because we now know that if you’re able to maintain an undetectable status with your viral load fully suppressed for at least six months that it is nearly impossible for you to pass the virus as long as you stay on treatment.”
The study behind this recommendation looked at nearly 700 long-term couples who weren’t using protection, Antle said. One member of each couple had a negative status and the other was positive, on treatment, and undetectable. The researchers had planned for a seven-year study, but they stopped it in year five, he said, “because in five years of nearly 700 couples, not a single seroconversion happened.”
The other track that the CDC recommends, he said, is PrEP.
“If you test negative, what the CDC really wants is – especially for men who have sex with other men, however they identify – is to get them on PrEP, because it is ridiculously effective,” Antle said. “It depends on which study you look at, but the CDC says that it is at least 92 percent effective if you should be exposed to HIV. There are other estimates all the way up to 99 percent. Ninety-two percent is a little conservative, but CDC is a conservative group.”
Especially because of social media and hookup sites, Antle said it’s important for people to have an honest discussion about their HIV status. “There’s a conversation that should happen, such as ‘I want to trust people, but I also know people,’” he said.
Antle said the PrEP medication has been a huge asset to the community of men having sex with men (MSM).
For one thing, he said, it is affordable. “Most people don’t have to pay for it,” he said, because it is covered by most insurance. However, co-pays and deductibles can vary by insurance plan and some plans have limits as to how much they will pay.
“It’s one pill once a day to prevent HIV should you be exposed,” he said. “So it’s really ideal for men who have sex with men. It took about 20 months, but I’m no longer afraid of getting tested myself. Which is amazing. I’ve never been that way in my life until the last six months. Not having that fear has made me feel so much better about myself.”
“It also helps if I am interested in someone who is HIV-positive,” he said. “It helps fight that stigma and helps level the playing field. I don’t have to give a second thought to dating someone who is HIV-positive.”
Antle said that people’s reactions to HIV-positive test results vary.
“It’s never easy. You never know how someone is going to respond. Some are shocked, some are angry. It’s based on their circumstances and their expectations when coming in. Sometimes they’re just accepting.
“The first thing we do, other than let them sit for a moment and to ask them, ‘how are you doing,’ is to make a phone call to Linkage to Care, which is housed inside the Kansas City Care Clinic. This is a group of individuals with social work degrees. They are short-term case managers that focus on someone’s initial positive result.
“Within 20 minutes, we call a pager, and within 20 minutes, we hear back. They will, depending on the circumstances, meet that person wherever they are, walk them through, and give them information. Here are the next steps, here’s where we go from here. Make sure they understand they know this is not the end, and that they have the support system they need.”
He said the case managers stay with the clients for 90 days until they get everything sorted out, including insurance, housing and more.
Antle said he often compares being HIV-positive to having diabetes. “It’s a disease that’s manageable. You can have a long, healthy life. Are there complications? Yes. In the case of diabetes, there are insulin injections and some possible health conditions that can happen.”
Antle said that people are still dying of AIDS and that it often happens when people don’t stay on treatment due to life circumstances or poverty.
Part of Antle’s job is beyond the scope of a typical 9-5 day. He often meets with clients to do mobile testing at locations of their choice, including even the privacy of their own car.
As part of the HIMM Project, his group does HIV testing four times a month. They also do testing each month at gay bars:
• The first Saturday of the month, testing is at Sidekicks and Hamburger Mary’s. “That is the night of Bear Bust at Hamburger Mary’s and that is why we are there that night,” he said.
• The second Saturday of the month is at Missie B’s.
However, he said with a laugh, “when Pride rolls around, we probably won’t be testing because we’ll be at Pride all weekend.”