If you have ever watched TV's The Doctors, you know that Dr. Rachael Ross, a family physician and sexologist, likes to have frank, honest talk about sex. That's why she sat down with us to chat about why she's at a higher risk for HIV, how she's promoting the rapid, at-home test for National HIV Testing Day, and why there's nothing more liberating than walking through the streets knowing that you don't have an STD.
You’re a family medicine doctor. How often do you encourage your patients to get a HIV test?
I actually encourage patients, at least once a year — and these are recommendations based on the CDC and the U.S. Preventive Services Task Force — that everyone between the ages of 13 and 65 to be tested for HIV. I really encourage anyone who is sexually active in that age range, to get an HIV test at least once a year, whether you're married or not.
Is that across the board, both gay, bi, and straight patients?
The patients that I encourage to get tested more than once a year, are the ones who are engaged in what some may call "risky sexual behavior." That's anyone who is having unprotected sex of any type with anyone. I think in recent years, among the African-American and Latino communities the HIV transmission rates have increased significantly, to the point that minorities are the picture of HIV. If you're sexually attracted to people who are in the high risk groups, that means you might want to be a little more diligent about it. And since I'm an African-American female, I'm at risk to contract HIV when it comes to women, so that being the case, I get tested at least twice a year, and I encourage other African American-American women to do the same. And that's not because I'm out there having sex with lots of different people but studies and statistics are showing that this is where the virus is concentrated, and that the groups of people I am most attracted to, tend to be infected as well, so it puts me at a higher risk.
Can you tell me about your first HIV test and how you felt before, during, and after?
My first one was when I was in college, actually. And when I was in college, it was more of a thing for white gay males, and it was marketed as such. So at that time, when I went to get an HIV test, it was more of a symbolic thing. I didn't think I had it, and no one would have thought I had it. It's interesting to contrast that with college-age people now, because it's completely different. They're having sex and sexual intimacy around 13 or 14, and when I was a kid, that really wasn't the case. So, when I think about that first HIV test, there wasn't a lot of anxiety around it. I wasn't worried about it. But fast-forward to now, where the face of HIV has shifted some. It's interesting. There's more fear now when I take one, versus when I first had one.
How can we make HIV testing part of healthy, comprehensive sexual education, especially among those teenagers who are sexually active.
I think our conversations around sex need to be more casual, and they need to start earlier. Particularly parents and school systems are really scared about the issue because of the backlash. When you think of comprehensive sex-ed, and Oh they're giving out condoms. But we really have to remember that young people are exposed to sex at an earlier age now, because of the internet, and television, and for what our songs say, so we have to use those instances as teachable moments, as opposed to letting them just interpret it through their own lenses, or their friends. So I think sex ed and sex conversation and sex education — since sex is everywhere, in every every advertisement that you see — we need to start integrating that into our dialogue and stop being so afraid of it. These talks really need to start in infancy, and when kids are toddlers, and evolve with time, as opposed to just being a 20-minute talk at age 13.
How does something like the at-home HIV test change the landscape? Are more people testing now that it’s private?
Just because something becomes more available, doesn't mean that society necessarily thinks there's a need for it. HIV is becoming what's considered a chronic illness. Studies are showing you can live into your 60s, which is as long as anyone else would, while living on HIV meds, but back in the [1980s] and '90s, this was killing a whole generation of people. Now you can catch it, and take your medication, and live happily ever after for some years. So I think what that's done has decreased awareness and decreased the perceived need to test. And you have people out there who think they really don't have it, and they really don't need to get tested. But what I'm really excited about OraQuick coming on the scene is that it is reintroducing the conversation around testing, and who needs to come in for testing. In my own practice it's not the prostitutes who get HIV, it's not people who go out to Vegas every weekend, and hook up with someone different every time. It's people in nice, safe, stable relationships, it's people doing "respectable behaviors." So, when you think of it in those terms, there's more people at risk than we're willing to think. I'm hoping that with OraQuick being on the shelves and being everywhere, it' reintroducing a conversation we need to have on what is risky sexual behavior, and what isn't, and you need to know your own status just as well as your partner's status. OraQuick is helping couples who would otherwise have to figure out when to take off work to go into a clinic together, and get tested together. What I'm so excited about OraQuick is that you don't need to be on anyone else's schedule, you don't need to be off from work.
Can getting tested for HIV improve your sex life, or at least your relationship with your partner?
Absolutely! There's nothing more liberating than walking through the streets knowing that you don't have an STD. When you feel free like that, it's going to make you feel sexier, and knowing whether your partner does or doesn't have HIV will make you feel better. Knowing your status can free you to go to other limits that you can't, when you're sitting there worried about your partner's status. I encourage all couples to get tested together for STDs. You want to make sure about chlamydia, gonorrhea, herpes, and everything, because at the end of the day, it's not just HIV that you're worried about, but HIV tends to be the one that can take you out the quickest. So, really being aware of what you're carrying around in terms of viruses or diseases, can help you feel sexier, and there's nothing like that feeling during sex, because you can then orgasm, you can be free, you can scream louder, sweat doesn't bother you, someone's juices don't bother you. It removes these hangups that we have during casual sex, like, "Oh no! Don't spill the condom!" or whatever. There's all these things that you're worried about — "Where's the dental dam?" — that can be removed when you're in a monogamous relationship and you're both 100 percent sure of each other's statuses.
Check out our interview with Ross Mathews, host of Hello Ross, who also talked about why gay men should be getting tested today.