By: Mira Garin and Morgan Manter
When cases of AIDS were first identified in the United States in 1981, most of the people contracting HIV had been born into a United States where homosexuality was criminalized. The lack of knowledge of this frightening new illness mingled with the existing cultural backdrop of anti-gay discrimination and led some early researchers to initially dub the condition “Gay-Related Immune Deficiency (GRID).” Although the Centers for Disease Control stepped in a few months later with the first case definition and terms Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS), the perception left by this misnomer that this condition only affected gay men stuck. HIV/AIDS patients, who were often anemic due to the virus, needed frequent blood transfusions, resulting in a critical blood shortage. Lesbian groups like the San Diego Blood Sisters organized blood drives and worked with local blood banks to ensure that donated blood would be directed to HIV/AIDS patients and led lesbians to frequently be seen as the caretakers of the AIDS pandemic. In 1996, fifteen years into the crisis, the number of incident HIV cases began to decline.
Although lots of progress has been made in treating AIDS and preventing the spread of HIV, the disease still disproportionately impacts certain minority groups such as men who have sex with men (MSM), Black/African American people, and Latinx people. One of the primary aims of The Sexual Health Equity Lab (SHEL) led by Dr. Erik Storholm includes reducing HIV transmission particularly among racial/ethnic, sexual, and gender minority groups which are disproportionately impacted. Advocates in Los Angeles wanted to develop a project to help increase the use of PrEP by underserved transgender and nonbinary women in Southern California. With Dr. Storholm’s substantial body of work on HIV and the existing Los Angeles-based efforts such as Project Eros, an ethnically diverse longitudinal cohort study assessing the impact of romantic relationships on sexual health outcomes like HIV risk and PrEP use, SHEL was a natural choice for developing the PrEP Well project which specifically focuses on structural barriers to HIV prevention.
Carrie Nacht, a second-year student in the UCSD/SDSU Joint Doctoral Program joined SHEL in 2021. During her undergraduate studies, Carrie majored in microbiology and took an Infectious Diseases Bacteriology course that discussed not only different diseases but how they impacted specific populations. “This led to me asking a lot of questions,” Carrie recounted, “why are some people impacted more than others? Why in these places?” She was particularly interested in global health because she finds it “interesting to see how the history and social determinants of health of a certain country or population can impact their health today.”
Due to COVID-19, the Eros project pivoted from in-person to virtual, a major shift in what was originally envisioned for the project. “However, enrollment is ongoing and going very well, so we think that our project has come out better in the end!” PrEP Well is a community-based implementation strategy meant to address structural barriers to HIV prevention faced by transgender and non-binary people in culturally competent and gender-affirming ways. “It has been a lot of thinking on our feet, working with shifting circumstances, and different budgets,” Carrie explained. “We were able to secure additional funding to add an entirely new aspect to the study that was recommended from our community partners and clients, which has been really exciting to see.”
“There isn’t a way to get through a PhD program or life without surrounding yourself with a team,” Carrie stated. “PhD programs are so hard – balancing work, school, personal life, and your own mental and physical health with very little time and money is so incredibly difficult [so] earning [the CHHS Outstanding Student Award] reminds me why I’m in this program and that this struggle will be worth it in the end.” In the first two years of her program, Carrie has drawn strength from her nuclear family and peers, most notably Mariana Katague and Alana Lopez with whom Carrie designed a Black, Indigenous, and/or People of Color (BIPOC) speaker series and Hannah Reynolds, Owen Jessup, and Mari Amato who are her coworkers at SHEL.
For Carrie, the most meaningful part of this work is the relationships that she builds with the people she works with and the impact that she gets to make in the Trans community. The Trans Wellness Center, a branch of the Los Angeles LGBT Center that partners with SHEL on the PrEP Well project, is the first organization dedicated exclusively to providing resources to the Trans and Non-binary community. “Learning from them has been an incredible opportunity,” Carrie reflected. “All of the collaborators that the SHEL works with are brilliant, talented, and are all kind people.”
National HIV Testing Day is on June 27th and this year’s theme is “Take the Test & Take the Next Step.”
San Diego’s Pride Festival is July 15-16 and this year’s theme is “Thrive!”
