Sexual Health in Times of COVID

Sexual Health in Times of COVID

Hola Cultura interviewed Mary’s Center Outreach Coordinator Airam Thurman in late 2020, and we are re-sharing the interview now during National Condom Month, with Valentine’s Day around the corner. View the original post, including the Spanish version, on Hola Cultura’s website here.

Practicing safe sex during the age of COVID-19 not only entails protecting from sexually transmitted diseases (or STDs), but also ensuring that partners are COVID-free. Airam J. Thurman, the outreach coordinator in the sexual health department at Mary’s Center, stresses the importance of resources and education in preventative sexual health. But longstanding inequities in under-resourced black and brown communities, mean that people of color are often disproportionately impacted by sexually transmitted diseases. And cultural barriers can also play a role.

“There’s all this miseducation, and I think that happens a lot especially in our black and brown communities,” Thurman says. “We come from these very conservative backgrounds, where we just don’t talk about sex or we view sex very differently.”

COVID hasn’t stopped him from doing his job. He continues to perform HIV testing at Mary’s Center and hosts virtual workshops on sexual health education through social media. As part of our partnership with Mary’s Center, Thurman dropped by our S.P.E.L. storytelling program to provide tips and resources to practice safe sex during COVID-19.

How is the pandemic impacting people’s sexual health?

By talking to different people that come into the clinic, I’m realizing that people are a little bit more cautious. People are also becoming more creative about how to have sex now. You have to get out of the mind frame of ‘I want to make sure I protect myself from getting an STI,’ and into the new mind frame of thinking: ‘I need to protect myself in that area, but I need to protect myself from getting COVID, as well. How do I go about doing that?’ So, people are starting to have that conversation and becoming a little bit more creative about ways that they can be intimate and be safe.

What would you say is the most creative thing you’ve heard about?

I don’t want to make you all blush, but obviously I talk to a lot of people. There is nothing I have not heard. A few couples started role playing. They felt like ‘Well, if I have to wear a face mask, why not be creative?’ Or ‘Let’s be creative with our [sexual] positions, so that we aren’t breathing in each other’s faces.’ Or ‘Let’s not kiss on the mouth.’ Those are some of the mild things I feel comfortable sharing with you guys. People are really thinking outside the box, which is fine because when people start looking at things as restrictions—the minute I tell someone, ‘Only do this.’—most people feel the need to rebel. Instead, I’m like, ‘Don’t look at them as rules, just look at it as a challenge to be creative. A lot of couples have risen to that challenge.

What recommendations do you have for people trying to practice safe sex during the age of coronavirus?

When the coronavirus first started, New York City put out a really good ‘How to have sex’ [online guide]. I read through it and it’s proven a lifesaver for me. It had a lot creative ideas about doing things on video chat, using your facemask, and finding ways that you two can pleasure each other without even having intercourse. Like I said, now people are not just worried about sexual health, but about our main health. Sometimes it’s hard to tell people how to have sex, right? It helps to give a guide to people, so everyone can go read through it and see what fits for you and your partner.

How has the pandemic affected relationships when it comes to sexual intercourse?

People are more cautious about who they’re inviting into their bedrooms. What I’m noticing, and one of the things that I really encourage, is asking, ‘Where have you been?’ or ‘Where have you traveled to?’ Hopefully that trend will translate into sexual health questions like, ‘When’s the last time you were tested? Have you ever had an STI?’ People are a little bit shy about asking those questions versus asking, ‘Have you been out in a big crowd?’ But people are starting to communicate more before they’re intimate with people.

How has STD testing been affected by the coronavirus?

Mary’s Center is very unique in this aspect. If anybody needed to get tested—let’s say you woke up Monday morning and felt like you had some symptoms—typically you just come right in. We would get you tested that day [prior to the pandemic]. Now that is still available in a sense, but our sexual health coordinator would go through some [COVID-19] screening questions with you first before allowing you to come in. So you just can’t walk in [right now], but you can still come in the same day. You have to give us a call beforehand.

Is it harder to get tested? Do test results take longer? How has the actual pandemic impacted that aspect of testing?

Surprisingly, not much has changed. Let’s say, ‘Bob’ calls and says, ‘I need to get tested.’ Instead of just walking in, he now has to call. We’ll ask them three questions. He’ll come in and get tested. Typically, we tell patients it will take five business days—that’s the long end of things, but the test results usually come back in earlier. Thankfully, the [test turnaround] time has not changed due to COVID.

How has the pandemic affected the number of people infected with STDs and sexually transmitted infections (STIs)?

I haven’t seen any data yet, but from what I’ve seen anecdotally, people are still up to the same behavior. If we looked at things in the beginning of the pandemic, people were really cautious. Then we hit a moment where people just got antsy and went back to their old ways of doing things. Believe me, those calls are still coming in where people are like, ‘I need to get tested.’ So I’m interested to see what those numbers look like in the long run. We’re still having people coming in and getting tested. They haven’t quite heeded direction about being creative. You would think [getting tested for STIs] would trend downwards [due to the pandemic], but what I’m noticing is that [there’s] still a steady trend that we’re noticing of people coming in and getting tested.

Are there differences by race or ethnicity and the rates of infection for HIV and AIDS?

Absolutely. One of the things that really was an eye opener for me when I moved to D.C. is just how disproportionately people of color are affected with HIV. Right now people are talking about how black and brown people are disproportionately affected by COVID. But specifically, just looking at the pre-COVID HIV numbers, our black and brown communities are affected the most. So, if you’re looking at a white population compared to brown and black; unfortunately brown and black [people] are getting hit the hardest when it comes to HIV and AIDS.

Why do you think some communities have stable numbers, while others are seeing rising infection rates?

Two things: resources and education. If you look at data—take a population of white gay men— a lot of times they have the access to and the money for PrEP, a pill you take once-a-day to prevent you from getting HIV. What’s interesting is their [white male] HIV rates are dropping. So, you might think they are starting to have safer sex, but their STI rates remain steady. So, it’s not that they’re necessarily having safer sex. They are just able to get a hold of a medication that prevents them from getting HIV.

When I go into black and brown communities lot of people are unaware of PrEP. The second most common question I get is, ‘How much is it going to cost me?’ So, a lot of times, even if you’re aware of PrEP, you’ve already told yourself, ‘I’m not going to be able to afford it.’ Just by having these conversations with our communities, I’m educating them. Now they have the resources because I tell them, ‘I’ll make sure that you don’t have to pay out of pocket. There are resources for you.’ Just having that conversation and education really affects our black and brown communities. I don’t think it’s happened before.

Learn more about PrEP and how to get it from Mary’s Center.

What would you say as far as using condoms? Would that also be paired with the PrEP pill?

Absolutely. I cannot stress this enough. If you are single and having sex; please, please, please use a condom. It’s another layer of protection for you. The PrEP pill will protect you from HIV, but it does not protect you from Chlamydia. It does not protect you from Gonorrhea. It doesn’t protect you from Syphilis. Sometimes we do get caught up in the heat of the moment. We are all imperfect. We’ve all had those moments where passion catches up with us, and we can’t think straight. The PrEP pill will protect you from one of risks [of HIV/AIDS] which is not curable. What this pill is to me is just an extra added layer of protection against HIV. If you were to come into the clinic, I can give you a shot for syphilis or Chlamydia or Gonorrhea. I can’t do that for HIV. HIV is not the death sentence it once was, but it’s also not curable either.

How is your job changed, if at all, because of the COVID pandemic?

My job has definitely been impacted. I’m the outreach coordinator. I have to be out in the communities. So, that means if there’s a church event, any type of event – a school event, [an event] at the library – I’m there. I’m involved. I’m talking to individuals. I’m testing individuals.

When COVID came, all of that just stopped, so I had to think, ‘How can I be innovative and still reach out?’ I changed direction, doing a lot of social media campaigns. I miss being out and involved. I feel like, if you’re scared to get tested and you’re talking to me in person, I’m able to literally take you by the hand and go, ‘It’s okay. I’m right here. Let’s test. I can have your results back to you in five minutes.’ I can do that right there on the spot. Over social media, you may build your courage while hearing me talk. You might say, ‘Tomorrow, I’m going to get tested.’ But tomorrow comes and you may not get tested. I’m noticing that happens. So, I really missed [in-person] interaction.

What is it like using social media?

Different organizations will invite me to give a healthy sex conversation. I work with a university here where they do these virtual, ‘Let’s talk about sex’ nights. They submit their questions beforehand. Some of them are Zoom meetings. Some are Instagram Live. People have gotten really creative. More people are comfortable, because they can be anonymous, you don’t have to turn on your camera. You can ask the things that you’ve always wanted to ask and get the answers.

Are people more open to talk about an experience that they may not feel comfortable sharing in person?

That is the bright side. During town halls, for example, I’m not seeing faces but people are more comfortable with asking me questions and voicing opinion, which is good. A lot of times in person, people are shy. So that is the benefit, but after we talk, are you still going to have that courage and momentum to go get tested? What I’m noticing, is that’s not quite always the case.

— Melissa Pérez Carrillo and Mariángel Villalobos, Hola Cultura S.P.E.L. participants

This interview has been lightly edited for clarity and concision. View the original post, including the Spanish version, on Hola Cultura’s website here.

Learn more about Mary’s Center’s sexual health services here.