WEBVTT - Bedside Manner: Do Sluts Keep Each Other Safe?

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<v Speaker 1>Our extra special bonus series diving even deeper into the

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<v Speaker 1>sublime world of sex, desire, cruising, and relationships.

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<v Speaker 2>This time, we are talking to a gay medical professional.

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<v Speaker 3>Bedside Banner feeds our bottomless curiosities with bite-sized episodes full

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<v Speaker 3>of sexual health advice that continues our conversation from season four.

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<v Speaker 2>I am Gabe Gonzalez. And I'm Chris Patterson Rosso.

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<v Speaker 3>In our episode about cruising history, we talked a lot

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<v Speaker 3>about the gay liberation movement's ties with basic access to

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<v Speaker 3>medical care. Now we're looking at how PrEP is reshaping

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<v Speaker 3>the cruising of today.

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<v Speaker 2>Today we're talking to our favorite daddy, Dr. Dimitri Daskalakis.

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<v Speaker 2>Welcome back, Dr. Dimitri. Welcome back.

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<v Speaker 4>Hello. Thank you.

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<v Speaker 2>Can we do some myth busting?

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<v Speaker 4>Sure, let's do it.

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<v Speaker 2>Amazing.

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<v Speaker 1>All right, I love to bust some myths about... We

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<v Speaker 1>all love to.

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<v Speaker 2>I think we all love to bust.

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<v Speaker 4>I think I just busted a myth.

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<v Speaker 5>Hey!

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<v Speaker 2>About the efficacy of HIV prevention. Yeah.

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<v Speaker 5>You know, people get really worried about, like, what sexual

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<v Speaker 5>activity am I having?

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<v Speaker 4>Like, where are people coming in me?

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<v Speaker 3>Like.

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<v Speaker 5>what is the effectiveness or efficacy of the drugs based

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<v Speaker 5>on like my activity? And the answer is it kind

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<v Speaker 5>of doesn't matter what the activity is. It matters that

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<v Speaker 5>you're taking the drug, right? So it's like, are you

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<v Speaker 5>taking your medicine as prescribed? Have you missed doses? If

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<v Speaker 5>you're using PrEP on demand, are you taking it right?

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<v Speaker 5>Are you doing the two doses before sex? Are you

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<v Speaker 5>doing the two days after? If you're getting injectable PrEP,

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<v Speaker 5>are you going for your appointments to make sure that

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<v Speaker 5>you stay on time? So really, in general, you think

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<v Speaker 5>of PrEP as being very effective, usually skimming around 100%,

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<v Speaker 5>not quite there, although some studies show 100% for some

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<v Speaker 5>of the drugs. So the answer is just you need

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<v Speaker 5>to stick to the regimen, whatever it is, and sweat

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<v Speaker 5>the details less about what the sex is.

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<v Speaker 1>So obviously, the science of the medication like PrEP is

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<v Speaker 1>linked to the emergence of the U equals U campaign.

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<v Speaker 1>How have you seen PrEP move the conversation forward?

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<v Speaker 5>Yeah, you know, with the introduction of PrEP and the

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<v Speaker 5>introduction of U equals U, this sort of great thing

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<v Speaker 5>happens where we get to literally say that people living

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<v Speaker 5>with HIV and those at risk are the same people,

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<v Speaker 5>not different. If you're living with HIV or someone who's

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<v Speaker 5>at risk for HIV, Y'all need the same things. And

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<v Speaker 5>they now also have medicines that address their HIV needs,

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<v Speaker 5>whether it's treatment or prevention. So we need to get

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<v Speaker 5>the system to catch up to the reality that these

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<v Speaker 5>aren't like two separate distinct communities.

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<v Speaker 2>What are your thoughts about HIV positive people disclosing?

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<v Speaker 4>Yeah, I mean, I think that the story is so

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<v Speaker 4>different now, right?

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<v Speaker 5>The right sort of healthcare, public health answer is it's

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<v Speaker 5>always good to talk about HIV, STIs, and your status, right?

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<v Speaker 5>But there's also something really empowering about knowing that if

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<v Speaker 5>you're living with HIV and you are on your medicines

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<v Speaker 5>and you're undetectable, that your risk of transmitting sexually to

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<v Speaker 5>a partner is zero. So, you know, I think it

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<v Speaker 5>changes the calculus. I mean, I always love the idea

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<v Speaker 5>of having a conversation, even if it's quick, about, you know,

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<v Speaker 5>like what you're doing to, you know, keep yourself healthy, right?

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<v Speaker 5>Like whether it's, you can look on the app, like if,

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<v Speaker 5>you know, people disclose what they're doing, that's great. But

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<v Speaker 5>also just saying, you know, like I'm, you know, undetectable

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<v Speaker 5>on meds or I'm on PrEP, like, you know, that's

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<v Speaker 5>like a great sort of communication thing. But frankly, you know,

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<v Speaker 5>just being honest is, It's not necessary. You know, I

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<v Speaker 5>think that at the end of the day, like the

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<v Speaker 5>most important thing is to look out for, you know,

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<v Speaker 5>your own health. And, you know, if you are living

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<v Speaker 5>with HIV and you're undetectable, you don't transmit it. So,

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<v Speaker 5>you know, you can have a really sort of philosophical discussion.

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<v Speaker 4>Of why it's important, but at the end of the day,

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<v Speaker 4>is it? Like there's a great equalizer, right?

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<v Speaker 5>There's something that's magic about the fact that people who

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<v Speaker 5>are taking care of themselves and living with HIV don't

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<v Speaker 5>transmit it. And it sort of creates like, you know,

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<v Speaker 5>this universe where people are just looking after.

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<v Speaker 4>Their own health.

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<v Speaker 5>And that just so happens to have the amazing side

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<v Speaker 5>effect of looking out for the health of others.

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<v Speaker 2>I do love that. So let's kind of keep each

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<v Speaker 2>other safe.

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<v Speaker 3>I'm sure I've mentioned this in the podcast before, but

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<v Speaker 3>I didn't learn about PrEP until I was working as

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<v Speaker 3>a porn editor. And both my boss and several people

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<v Speaker 3>I met on set were like, you should be on PrEP.

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<v Speaker 4>Listen, oral history.

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<v Speaker 2>Yeah.

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<v Speaker 4>Oral history.

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<v Speaker 5>It is like one of the most important things in

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<v Speaker 5>our community is, Because when government fails and the medical

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<v Speaker 5>infrastructure fails, we always talk to each other. And that's

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<v Speaker 5>how we spread the good.

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<v Speaker 4>Science and the good news.

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<v Speaker 3>Yeah.

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<v Speaker 5>That's what we've done historically, and we're not going to stop.

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<v Speaker 5>I mean, think about MPOCs.

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<v Speaker 4>Oh, yeah.

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<v Speaker 3>Oh my God, the way the line to get those

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<v Speaker 3>shots was like the hottest club in New York for

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<v Speaker 3>a while.

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<v Speaker 5>So like think about, you know, people take credit. I mean,

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<v Speaker 5>I ran the national response and people are like, oh,

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<v Speaker 5>the vaccine helped stop it. Okay, no, the vaccine was

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<v Speaker 5>a part of helping to stop it. What actually slowed

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<v Speaker 5>down MPOCs was that, you know.

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<v Speaker 4>Our community.

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<v Speaker 5>communicated with each other and temporarily did some changes in

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<v Speaker 5>behavior that before vaccine was available, started to bend the

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<v Speaker 5>curve on mpox and reduce the rates. When the government

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<v Speaker 5>fails and when providers fail, we don't fail each other.

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<v Speaker 4>We tend to rise to the occasion.

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<v Speaker 5>And so it's completely true that community of folks who

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<v Speaker 5>are sexually active will communicate to each other.

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<v Speaker 4>And like, that's how you actually make headway.

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<v Speaker 2>Chatty sluts are helping keep us alive. I love that. Yeah. Totally.

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<v Speaker 2>All the time.

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<v Speaker 5>Wait, but like, there was like some study, the two

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<v Speaker 5>most common things that people say to each other in

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<v Speaker 5>a hookup, in gay hookups.

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<v Speaker 2>You have to guess.

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<v Speaker 4>Thank you. Yes, it's fuck me and thank you.

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<v Speaker 3>Shut up.

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<v Speaker 4>Those are the two most common things.

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<v Speaker 2>People are saying thank you?

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<v Speaker 5>It's like the two things in the study were like,

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<v Speaker 5>thank you and fuck me were the two common things.

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<v Speaker 2>Oh my God.

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<v Speaker 4>And so like, I mean, that should make your heart

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<v Speaker 4>just like glow with joy.

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<v Speaker 2>It does.

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<v Speaker 4>Yeah.

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<v Speaker 3>So you are a physician whose expertise is infectious diseases.

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<v Speaker 3>When you first started working with HIV positive patients, is

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<v Speaker 3>there anything that you learned from the pause community that

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<v Speaker 3>hadn't quite clicked in medical school?

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<v Speaker 4>Oh my gosh. Do you have an hour?

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<v Speaker 3>Yeah.

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<v Speaker 2>Well, yes, actually.

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<v Speaker 4>I was like, I do.

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<v Speaker 5>I mean, at the end of the day, like, you know,

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<v Speaker 5>there's like the stuff that you learn sort of clinically

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<v Speaker 5>in science.

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<v Speaker 4>You know, you learn about like how to treat, how

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<v Speaker 4>to diagnose.

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<v Speaker 5>But, you know, learning how to like work with the

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<v Speaker 5>community in a way that's responsive to their needs happens

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<v Speaker 5>by working with that community.

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<v Speaker 4>So you learn.

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<v Speaker 5>So much of what I've learned has come from people

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<v Speaker 5>living with HIV in terms of.

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<v Speaker 4>You know, the way I counsel.

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<v Speaker 5>So like, you know, one of the things that I

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<v Speaker 5>used to say in the bathhouse when I did HIV

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<v Speaker 5>testing is, you know, people would get, would have a

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<v Speaker 5>positive test and I would look at them and say like,

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<v Speaker 5>you know, this is a moment of potential great creation.

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<v Speaker 4>And I didn't make that up. My patients living with

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<v Speaker 4>HIV taught me.

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<v Speaker 5>That, which is like, they, I remember like talking to

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<v Speaker 5>people who would say like, I wasn't really taking care

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<v Speaker 5>of myself. And then I had a positive HIV test.

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<v Speaker 5>And now I really look after my like health. I

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<v Speaker 5>look after my diet. I quit smoking. Like, I'm, you know, like,

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<v Speaker 5>I'm more careful about, like, all this other stuff in

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<v Speaker 5>my life. And so, you know, the best way to

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<v Speaker 5>learn how to counsel people about HIV treatment and prevention

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<v Speaker 5>is by listening to your patients. I also think it

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<v Speaker 5>is important to talk about the technology keeps moving forward.

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<v Speaker 5>Like there's new classes of drugs for people living with HIV.

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<v Speaker 4>It just means more options.

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<v Speaker 5>And thankfully, one of the big priorities with the folks

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<v Speaker 5>that are making these medicines are to make them easy

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<v Speaker 5>and tolerable. Not only that they work. but they work

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<v Speaker 5>and don't have as many side effects and are tolerable

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<v Speaker 5>and easy on people's lives. Like the drugs get better

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<v Speaker 5>and better and better. So it's always really important to ask,

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<v Speaker 5>are we still okay on the regimen that I started

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<v Speaker 5>in 2020? Or are there things in 2026 that may

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<v Speaker 5>be better for me based on my life or on like,

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<v Speaker 5>you know, any underlying medical conditions that I may have, right? Like,

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<v Speaker 5>you know, like there's plenty of people who take a

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<v Speaker 5>pill a day, but maybe that's not what they need.

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<v Speaker 5>Maybe they need like a long acting injectable. There's other

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<v Speaker 5>people who may not want to have three medicines and

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<v Speaker 5>may want fewer medicines. And so I think it's, you

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<v Speaker 5>don't leave well enough alone in HIV treatment. You always

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<v Speaker 5>ask the question, are we still on the right thing

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<v Speaker 5>for you today, even if it's working and you're undetectable?

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<v Speaker 2>All right, Dr.

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<v Speaker 3>Dimitri, this is our last episode with you, but I

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<v Speaker 3>want to thank you so, so much for covering so

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<v Speaker 3>many topics with us, with Nuance and Grace.

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<v Speaker 4>Well, thank you.

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<v Speaker 3>Thank you.

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<v Speaker 2>It's been such a pleasure. It's been such a dream

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<v Speaker 2>of mine to have you here.

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<v Speaker 4>Oh, stop. It's been my pleasure.

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<v Speaker 2>Thank you.

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<v Speaker 4>Amazing.

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<v Speaker 3>Yeah, I'm so glad we made it happen. Chris has

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<v Speaker 3>been teasing, edging us with your presence. So I'm really

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<v Speaker 3>glad that the timing worked out.

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<v Speaker 4>He was Daskalakis edging.

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<v Speaker 3>Ooh. I've never tried it that way. Offline. All right.

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<v Speaker 2>Offline.

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<v Speaker 4>We're offline.

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<v Speaker 2>We're taking it offline. We're taking it offline.

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<v Speaker 3>All right. Well, thank you again, as always, for the checkup, Doctor.

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<v Speaker 3>We will be back with another episode of Cruising Confessions

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<v Speaker 3>Bedside Manor very, very soon. Cruising Confessions Bedside Manor is

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<v Speaker 3>produced by Amanda Cowper and Cameron Femino with editorial direction

0:09:17.030 --> 0:09:19.630
<v Speaker 3>by Fran Tirado and executive production by Eli Martin.

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<v Speaker 1>Cruising Confessions is presented by Sniffies, the ultimate map-based cruising

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<v Speaker 1>platform for gay, bi, and curious people.

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<v Speaker 3>Ready to cruise?

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<v Speaker 1>Check out the map at sniffies.com and follow Sniffies at

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<v Speaker 3>Learn more about protecting your sexual health at healthysexual.com.