SWEAT Philly Helps Young MSM Access Medical Services
Philadelphia, one of the nation's most well equipped HIV care and treatment cities, is home to several youth outreach organizations that seek to empower HIV-positive youth to live happier and healthier lives. One of the newest on the block is Sexuality with Education and Truth (SWEAT), an program under the Dorothy Mann Center that helps young gay men access vital medical care.
"I've always had a passion for working with young people," said SWEAT Project Director and Founder Noel Ramirez. "HIV-positive youth shouldn't feel shame about their status, but empowered to make good health decisions now and for the rest of their lives."
SWEAT is a six-week, group level intervention program geared towards the reduction of HIV stigma, providing 'medical home' or HIV care practice, safer sex negotiation, adherence, counseling/treatment education, engagement and re-engagement in the larger HIV/AIDS community in Philadelphia.
"The SWEAT Project aims to ensure that HIV-positive young men who have sex with men (MSM) feel loved, honored and respected in their medical practices," said Ramirez.
The 27-year-old licensed social worker has a Master's Degree in Public Health, and worked as a medical case manager at Drexel's Partnership. He performed early intervention services and worked with the HIV testing program, and distinguished himself by his passion and ebullient disposition.
In 2012, Dorothy Mann's partner program, the Drexel's Partnership Comprehensive Care Practice (DPCCP), one of Philadelphia's largest HIV/CARE practices, recruited Ramirez to run SWEAT. By January 2012, he and his "slam dunk creative team" of Program Administrator/Supervisor Theresa Parrino, Health Educator Tira Faison and Graduate Intern Carly Linder, began their programming.
After months of running on a shoestring budget, SWEAT received funding through a competitive round of grants issued by the Health Department and Centers for Disease Control, which allowed the team to expand their services to five HIV care sites throughout Philadelphia.
Ramirez said that SWEAT aims to accommodate young MSM under 30 years old who are newly diagnosed and interested in social support, are struggling with treatment and staying adherent, have been engaged in care for a while, and are interested in learning more about the services available at their clinic and in the community.
Battling HIV-Related Shame and Stigma
Many people living with HIV can feel shame surrounding their contraction of the virus. This shame actually discourages them from learning about disease management and making informed choices in sexual encounters. This is especially true for young, HIV-positive MSM, who may still be striving to come to terms with their sexual orientation.
"One of the biggest issues we talk about with our guys is how they feel about sex now that they’re living with HIV," said Ramirez. "There’s a lot of shame-based messaging out there that can make HIV-positive, young MSM feel guilty about being sexual and deter them from learning about safer sex practices, or simply from getting treatment."
Stigma deters testing frequency, doctor visits, medication adherence, safer sex practices and awareness that HIV-positive people dwell in every echelon of society in the world.
"Along with the National HIV AIDS Strategy, our project strives to overcome HIV stigma, which is our main challenge in HIV-positive, young MSM," he said.
But participants at SWEAT have additional travails to surmount than stigma: many have disclosed experiences of trauma and violence, which can have lasting affect that lead to destructive sexual behavior.
Ramirez said that SWEAT was currently working with Philadelphia’s Office of HIV Planning to start a consumer advisory board to ensure that young, HIV-positive MSM are included in the larger conversation of ending AIDS in Philadelphia.
Because of the SWEAT team’s alacrity and thoughtful program structure, HIV care sites and medical providers have welcomed SWEAT’s involvement as a part of their offerings to patients. Ramirez said that SWEAT would do a prospective and retrospective medical chart analysis to assess changes in common HIV health indicators (CD4 and viral load counts). SWEAT participants and evaluators alike have made particular note of the team’s ability to create a safe space where young, HIV-positive MSM can express themselves freely.
"It is difficult for some men to present at a clinic, let alone at a group for HIV-positive gay or bisexual men," said Ramirez. "But I’ve seen so many of our guys come out of their shells over time and share so much with us that they wouldn’t have shared with anybody before."
During an MSM community forum held by the CDC’s director of HIV, a 19-year-old SWEAT participant stood up and spoke to the crowd about his experience living with HIV, as if he did it everyday. At that moment, Ramirez poked his assistant director, and said, "That is why we’re doing this."