Dr. Joshua Gonzalez is a board-certified urologist specializing in male and female sexual dysfunction, and co-founder of the supplement brand Popstar Labs. He shared some of the biggest myths surrounding HIV and AIDS, and how providers can help LGBTQ+ individuals access better care.
What are some common misconceptions or myths about HIV/AIDS that you frequently encounter in your practice, and how do you address them?
One of the biggest misconceptions about HIV we encounter is regarding transmission of HIV through sex. If someone living with HIV is on appropriate medical therapy and has an undetectable viral load, they cannot transmit the virus through sex. This has been shown in multiple studies. Undetectable = Un-transmittable. Period. This concept is unfamiliar to many patients still to this day.
In your experience, what are some effective methods or interventions for promoting HIV prevention and education within diverse communities, including LGBTQ+ populations?
The queer community has always been at the forefront of the battle against HIV. Because of that, they are typically more well-informed about options available to reduce the risk of HIV.
That said, I make it a point to discuss options for STI and HIV prevention with everyone no matter how they identify. Approaching someone from a non-judgmental position and asking about their specific sexual practices helps you assess risk and provide them with the best recommendations on how they can protect themselves from STI and HIV. Having these frank discussions from a sex-positive perspective helps people feel safe and more willing to share what kinds of sexual activities they have engaged in.
What barriers do LGBTQ+ individuals and other marginalized communities face when it comes to accessing HIV testing, treatment, and support services, and how can healthcare providers address these disparities?
One of the biggest barriers I see facing LGBTQ+ individuals in accessing HIV testing, etc., is a lack of providers with the skill set to talk openly and honestly with them about their sex lives. Medical education does not place enough emphasis on sexual health and even less attention is paid to individuals having sex outside of the hetero norm.
Providers interested in treating LGBTQ+ individuals need to provide safe spaces for them to feel comfortable having personal and sometimes uncomfortable conversations about sex. When someone feels listened to and can share openly about their sexual experiences, the door begins to open to offering them services like HIV testing, treatment, etc.
Can you share any strategies or approaches for creating inclusive and supportive healthcare environments for LGBTQ+ individuals and others affected by HIV/AIDS?
Making sure to have paperwork and materials that are inclusive is a very easy way to create supportive healthcare environments for LGBTQ+ individuals. Ask for specifics: How does someone identify? What is their sexual orientation? What pronouns do they prefer? All of these questions are important to not only foster a supportive environment, but they can be extremely helpful from a clinical perspective as well.
Healthcare providers should also avoid making assumptions about someone based on how they identify. For instance, never assume that just because someone identifies as a member of the LGBTQ+ community that they are engaging in a specific sexual activity or aren’t interested in fertility and reproductive health. I’ve seen far too often patients feel judged or neglected because of assumptions their provider made.
