As the world prepares to observe World AIDS Day on December 1, it is essential to acknowledge the significant advancements made since the inaugural World AIDS Day in 1988. However, despite these medical improvements, many individuals still encounter obstacles when attempting to access sexual health care, particularly in transient and remote communities such as Provincetown.

In response to these challenges, registered nurse Jeffrey Schaffer launched an innovative program at Outer Cape Health Services named testNtreat. This initiative aims to provide comprehensive sexual health services to individuals who may struggle to find adequate care.

Jeffrey Schaffer initiated the testNtreat program in 2019, recognizing the unique needs of Provincetown, a popular destination that experiences a high turnover of visitors. “I started this program because Provincetown is a very transient and visited place. I would see people trying to access services for sexual health and run into issues with insurance coverage, whether they didn’t have it or it was based in another state,” Schaffer explained. His goal was to ensure that sexual health testing and treatment are readily available to everyone, regardless of their insurance situation.

The testNtreat program offers a range of services designed to address various aspects of sexual health. These include sexual health testing and treatment, as well as access to PrEP (HIV pre-exposure prophylaxis). PrEP is a vital medication for those at risk of contracting HIV, which can include anyone who is sexually active or involved in injection drug use. Schaffer emphasized the effectiveness of PrEP, stating, “PrEP is 99 percent effective. It’s a pill, or now there’s also an injection.” This preventative measure allows individuals to protect themselves against HIV.

In addition to PrEP, the program also provides PEP (post-exposure prophylaxis). This regimen is crucial for individuals who may have had a potential exposure to HIV, such as during a sexual encounter where barrier protection may have failed. Schaffer noted, “If you have a sexual encounter where maybe barrier protection like condoms were used, but then maybe not completely used or failed, and you might be at risk for acquiring HIV, then there’s a post-exposure regimen which we can provide access to as well.” This proactive approach to sexual health is vital in preventing the spread of HIV.

Moreover, the testNtreat program offers HIV case management, which is an essential component of reducing HIV transmission rates. One of the most significant advancements in HIV treatment is the understanding of the concept known as U=U, which stands for undetectable equals untransmittable. This means that individuals living with HIV who maintain an undetectable viral load—indicating that they have been on medication for at least six months and their lab results show no detectable virus—cannot sexually transmit the virus to others. Schaffer highlighted the importance of this approach, stating, “It’s a way of looking at treatment as prevention.”

Despite the progress made in HIV treatment and prevention, Schaffer identified ongoing challenges in addressing the stigma surrounding the virus and accessing adequate care. He emphasized, “The way we as a society talk about and deal with HIV has changed a lot over the years. Now that we have these treatment options like PrEP and PEP, what would you say is the biggest issue with HIV today?” This question reflects the ongoing need for education and awareness to combat stigma and improve access to essential health services.

The testNtreat program stands as a beacon of hope for individuals in Provincetown and surrounding areas, providing vital sexual health services while addressing the barriers that many face. As World AIDS Day approaches, it is crucial to recognize the importance of such initiatives in the fight against HIV and the ongoing need for accessible healthcare for all.

As communities come together to observe World AIDS Day, the stories of individuals like Jeffrey Schaffer and the work being done through programs like testNtreat serve as a reminder of the importance of accessible sexual health care. The commitment to reducing stigma, improving access, and providing comprehensive care is essential in the ongoing battle against HIV and ensuring that everyone has the tools they need to protect their health.