Phumlani Kango: Flying the flag for the PrEP generation

With more than 20,000 followers, writer and content creator Phumlani Kango is using social media as a platform to promote the use of PrEP to men who have sex with men (MSM).

Research has shown that MSM are among those at highest risk of contracting HIV, (in large part due to stigma and discrimination). But PrEP (post-exposure prophylaxis), a powerful pill that prevents HIV, is a game-changer for this community. At this stage it’s only available for free at a handful of clinics in certain cities, such as Johannesburg, Cape Town and Pretoria, but there are hopes it will be rolled out nationwide.

Inspired by his own experiences, Phumlani has become passionate about the impact that PrEP could have in keeping MSM free from HIV. The 28-year-old influencer is now a prominent proponent of the pill on Twitter and he’s also an ambassador for the Me1st campaign; a project helping MSM prioritise their health.

Here, Phumlani shares his PrEP journey with MambaOnline.

“I started with PEP, which is post-exposure prophylaxis, while I was still in Cape Town. I went to [the Ivan Toms clinic in Greenpoint] and the nurse asked me if I knew what PrEP was. This was a year and two months ago. I said I didn’t and after she explained to me what it was, I started asking myself why we were never told about this because it’s a very important pill. No one was talking about it. They even told me about the number of people who were on PrEP at that time, which was extremely low. The fact that a country of more than 50 million people only had 9,500 people on PrEP was an issue for me. So, from that day on, I started talking about it.”

PEP is different from PrEP: PEP is a short term emergency dose of HIV medicine taken within 72 hours after you are exposed to HIV (eg, after a burst condom), while PrEP is ongoing daily medication that you can use to stay protected from HIV for as long as you wish. Some people see it like taking a daily vitamin to avoid HIV.

“We are in a digital age right now; almost everyone is using social media and that’s where I started. I looked at my following on Twitter and the kind of engagement that I got and I decided to start there. So, I took that little influence that I have, to start alerting people about this great pill. And with the power of social media, word of mouth also comes into effect; if I tell you, you either retweet for the next person to see or you tell the next person and the other person tells their friend and so on and so forth.”

PrEP works best if taken every day but you don’t need to take PrEP for the rest of your life – you could choose to only take it for a period during which you are at risk for contracting HIV. Studies have shown that PrEP is highly effective in preventing HIV if it is used as prescribed but that it is less effective when it is not taken consistently or as prescribed.

“So, before you go on PrEP you have to go for an HIV test and your results need to be negative. After doing your test and counselling, if there aren’t any issues once your blood has been tested, then you start going on PrEP. You have to pick a time that you want to take it at and you only take it once a day. You also need to be consistent with the time you take it at so it can be effective. Back then, I started in the morning, but now I take it every night at 8pm. After the first month, you have to go back to the clinic to test again. Then if everything is okay then the nurse, or whoever, puts you on a three-month supply.

PrEP reduces your risk of contracting HIV by 90% or more, but it doesn’t protect you from other types of sexually transmitted infections (STIs). While condoms might not be popular for many people, they are effective at preventing both HIV and STIs.

“As a person who consumes social media a lot, I really saw a gap in the conversations we were having; no one was talking about this a lot so I saw that there is a need for a conversation around it. Also, a lot of us, especially members of the LGBTQIA+ community, grew up without having anyone to speak to about practicing safe sex and conversations around HIV/Aids. I mean, the first time I had sex, I never used a lubricant because I was not aware of what that was and its importance in anal sex. I then wanted to be that person who changes this narrative because I have this information, so why not share it?”

PrEP can cause minor side effects like nausea in some people but these generally subside over time. No serious side effects have been observed, and these side effects aren’t life threatening. If you are taking PrEP, tell your health care provider about any side effects that do not go away.

“The point of my social advocacy for PrEP was to also be that big brother I never had, because if I had someone I could speak to then I possibly would have used lube when I had sex for the first time. We also have issues of stealthing, and a lot of people don’t know what that is or how to react after that. So I wanted to be that helping hand in informing people that if they go on this pill, they can avoid contracting HIV: whether a condom breaks or not; whether stealthing happens; or if they don’t use any other protection.”

Stealthing refers to the removal of a condom during sex without the knowledge of the other person. This is a gross violation that potentially exposes people to HIV and other STIS. Some believe it constitutes a form of rape.

“The reaction that I have been receiving from this has been extremely positive. People now reach out to me to find out where they can get PrEP. I know there is already a stigma of promiscuity around people who are on PrEP, but I honestly encourage people not to focus on these stigmas and do what’s best for their health. I have worked on campaigns throughout the country to encourage more people to get on PrEP. We already know that people don’t use condoms often, so I even advocate in communities where not a lot of people have access to social media so as to not exclude them because they also need to learn about the importance of this pill. We need to get to the point where we allow for people to have the sex that they enjoy and get rid of the stigma.”

PrEP is available for free for MSM at OUT’s TEN81 clinic in Pretoria (012 430 3272), the Ivan Toms Clinic in Greenpoint, Cape Town (021 447 2844) and the Health4Men Services Clinic in Yeoville, Johannesburg (011 648 7979 or 072 654 0816). The new Engage Men’s Health clinic in Melville, Johannesburg will also start offering free PrEP for MSM in April 2019.

For more information about HIV and sexual health and to chat online, visit the Me1st website at me1st.co.za. You can also WhatsApp Me1st on 072 637 6212 for support, any time, 24/7. Look out for Me1st activations in Bloemfontein, Kimberly, East London and Durban.