'Absolutely devastating': How Trumpcare would affect the fight against HIV.
Matthew Limpede takes a pill that gives him protection, peace of mind, and a reassuring sense of community.
That pill is the drug Truvada, more commonly referred to as "PrEP" (Pre-exposure Prophylaxis). And it's been a game-changer in the fight against HIV/AIDS.
"I think for the whole [gay] community and for me personally, [PrEP has] lifted us up to a place of being more responsible for our own health," Limpede explains.
If taken as directed, PrEP is 99% effective in stopping the transmission of HIV. It's mostly used by HIV-negative men and women who are more at risk of exposure to the virus.
Photo courtesy of Matthew Limpede.
From Limpede's own experiences, the drug isn't just about personal protection, either — it has encouraged more gay and bisexual men to have important conversations about staying safe with their sexual partners, building a sense of openness and honesty within the LGBTQ community. Those conversations have helped destigmatize those who are HIV-positive, too, he says — people who can live long and healthy lives while being sexually active.
The only way Limpede was able to get on PrEP was because of an insurance plan provided through the Affordable Care Act in 2014.
And he's definitely not the only one.
Jim Pickett, director of prevention advocacy and gay men's health at the AIDS Foundation of Chicago, says about 110,000 people across the U.S. started using PrEP between 2012 and February 2017. The ACA played a big role in making that happen.
"PrEP is quite a robust intervention," he says. "It's not just a niche thing for gay men."
Photo illustration by Justin Sullivan/Getty Images.
Making PrEP more accessible has become an increasingly important component of a broader strategy to prevent HIV among groups most vulnerable to the virus, such as transgender women, gay men — particularly gay men of color — and cisgender (non-transgender) black women, according to Pickett.
While PrEP accessibility has grown significantly in the past few years, it's just the tip of the iceberg, Pickett says. About a million more people living at high risk of HIV exposure are good candidates to go on the drug if we can just keep expanding efforts where they're needed most.
Under the current Congress and administration, however, that's shaping up to be quite the tough task.
If the Affordable Care Act is repealed, access to PrEP would take a blow, causing a major setback in our fight against HIV/AIDS.
Image via iStock.
Without health insurance, the price tag for PrEP is about $1,500 a month. With insurance, most people pay between $0 and $500.
Without significant help from an insurer, most Americans can't afford PrEP. Through the ACA's Medicaid expansion, which mostly helped low-income folks — notably, the same groups most affected by HIV/AIDS — PrEP was made accessible in 31 states plus Washington, D.C. Other patients, like Limpede, found the drug was available for free through their ACA plans.
This progress would be reversed under the American Health Care Act, the GOP's plan to "repeal and replace" the Affordable Care Act (aka Obamacare). In the new proposal — one that would cause an estimated 24 million Americans to lose their health care coverage over the next decade — the ACA's Medicaid expansion would phase out. As a result, thousands of people — again, mostly the at-risk groups who desperately need it — would lose access to PrEP.
Photo by Chip Somodevilla/Getty Images.
New HIV diagnoses fell 19% overall from 2005 to 2014, according to the CDC (although progress has been uneven depending on demographics, with some groups seeing increases). With repealing the ACA, we risk reversing this long-term trend.
"If Trumpcare were to be enacted as written, it would be a devastating blow to all of our HIV efforts, both care and prevention," Pickett says. "It would be absolutely devastating."
"If less people are on PrEP, we'll have more HIV infections," Pickett emphasizes. "HIV is forever — that's a cost forever — and that's an increased burden on a system that's overburdened."
Although living a long and healthy life while being HIV-positive is possible, that's only the case for people with access to ongoing health care and treatments that don't come cheap or easy.
For people like Limpede, who has even contemplated moving from Texas to Massachusetts if it means keeping his health care and PrEP access intact, tossing aside life-changing provisions isn't just politics as usual.
It's deeply personal.
"Repealing something like this — that's going to hurt minorities, that's going to hurt people who are low on the socioeconomic scale. It feels very pointed and purposeful," he says. "That's definitely a concern."
Image via iStock.
The HIV/AIDS advocacy community is getting ready for a battle because this is a fight they can't afford to lose.
"The community's main focus now is making sure that Trumpcare does not see the light of day and stopping these harmful provisions in the bill from happening," Limpede says. "We're fighting tooth and nail."
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There's a reason why some people can perfectly copy accents, and others can't
Turns out, there's a neurodivergent link.
A woman in black long sleeve shirt stands in front of mirror.
Have you ever had that friend who goes on vacation for four days to London and comes back with a full-on Queen's English posh accent? "Oooh I left my brolly in the loo," they say, and you respond, "But you're from Colorado!" Well, there are reasons they (and many of us) do that, and usually it's on a pretty subconscious level.
It's called "accent mirroring," and it's actually quite common with people who are neurodivergent, particularly those with ADHD (Attention Deficit Hyperactivity Disorder). According Neurolaunch, the self-described "Free Mental Health Library," "Accent mirroring, also known as accent adaptation or phonetic convergence, is the tendency to unconsciously adopt the accent or speech patterns of those around us. This linguistic chameleon effect is not unique to individuals with ADHD, but it appears to be more pronounced and frequent in this population."
Essentially, when people have conversations, we're constantly "scanning" for information—not just the words we're absorbing, but the inflection and tone. "When we hear an accent, our brains automatically analyze and categorize the phonetic features, prosody, and intonation patterns," writes Neurolaunch. For most, this does result in copying the accent of the person with whom we're speaking. But those with ADHD might be more sensitive to auditory cues. This, "coupled with a reduced ability to filter out or inhibit the impulse to mimic…could potentially explain the increased tendency for accent mirroring."
While the article explains further research is needed, they distinctly state that, "Accent mirroring in individuals with ADHD often manifests as an unconscious mimicry of accents in social situations. This can range from subtle shifts in pronunciation to more noticeable changes in intonation and speech rhythm. For example, a person with ADHD might find themselves unconsciously adopting a Southern drawl when conversing with someone from Texas, even if they’ve never lived in the South themselves."
People are having their say online. On the subreddit r/ADHDWomen, a thread began: "Taking on accents is an ADHD thing?" The OP shares, "My whole life, I've picked up accents. I, myself, never noticed, but everyone around me would be like, 'Why are you talking like that??' It could be after I watched a show or movie with an accent or after I've traveled somewhere with a different accent than my 'normal.'
They continue, "Apparently, I pick it up fast, but it fades out slowly. Today... I'm scrolling Instagram, I watch a reel from a comedian couple (Darcy and Jeremy. IYKYK) about how Darcy (ADHD) picks up accents everywhere they go. It's called ADHD Mirroring??? And it's another way of masking."
(The OP is referring to Darcy Michaels and his husband Jeremy Baer, who are both touring comedians based in Canada.)
Hundreds of people on the Reddit thread alone seem to relate. One comments, "Omfg I've done this my whole life; I'll even pick up on the pauses/spaces when I'm talking to someone who is ESL—but English is my first language lol."
Sometimes, it can be a real issue for those around the chameleon. "I accidentally mimicked a waitress's weird laugh one time. As soon as she was out of earshot, my family started to reprimand me, but I was already like 'oh my god I don’t know why I did that, I feel so bad.'"
Many commenters on TikTok were shocked to find out this can be a sign of ADHD. One jokes, "Omg, yes, at a store the cashier was talking to me and she was French. She's like 'Oh are you French too? No, I'm not lol. I'm very east coast Canada."
And some people just embrace it and make it work for them. "I mirror their words or phrase! I’m 30. I realized I start calling everyone sweetie cause my manager does & I work at coffee shop."
This article originally appeared in May.