 So, yeah, um, I'm just thinking about getting some filler, right? Oh Just okay. We're live. We're live. Are you live? Oh, wait, how natural? She said Hi everyone, thank you so much for joining my very first initial inaugural virgin life So glad you could be here today. I'm so excited to be doing this This has been a long time coming and I finally got the cahones to get together and do it and To hold my hand and do it with me is my very special guest and friend and many other things Mr. Dr. James Simmons I am doing very well. I am so glad that I'm I am your first like I'm the first of the First of many So so many and I love live. I love live so much because you never know like look at all these people coming in like Björk and jamare and wade and whatever like I love it I love interacting with people and I love being challenged with questions and just I really am actually super honored Would you ask me to do this? I'm glad to be here Yeah, same. I mean, I love doing my Um, my videos my edited polished videos But the best part is being able to engage and interact with the audience So hi everyone if you're joining This is going to be an engaging session. Um, we want your questions. We want your comments Please feel free. We'll get to as many questions as we can throughout but we're here to talk about hiv and we're here to talk about the experience of living with hiv and Pry into some of the concerns and questions that y'all have tada because People have lots of questions, right like people Yeah I've never I don't I never get to do this because I'm not live either. Where where are our where all are we live? Right where I'm my my youtube linkedin and twitter. I think for the first time ever Yeah, tell us where you're all hailing us from. I'm in los angeles You're you're in los angeles. Yeah, we want to see everyone and you're we're on one of your channels, right? Are we on your your instagram? I mean on youtube facebook linkedin twitch and twitter Wow, wow, okay, super fantastic. That is awesome. Hello Where are you? Where are you based? I don't even know I'm in LA. Yeah, okay. Yeah, that's what I thought Yeah, los angeles alabama richmond virginia. Yeah, boy um, hold on And the bamma this is fantastic. So I mean while we're we got some la folks here Glad everybody's shouting out. So just a little like context, I guess As we go in so I Am a hospitalist nurse practitioner So primarily what I do is work with like critical care patients in the hospital But I am also a clinical ambassador for the cdc's. Let's stop hiv together programs and have been for three years um And I do a lot of advocacy and activism work here in los angeles southern california around the world and whatever around Very much hiv prevention like prep. That's what my doctoral research was in but then also like u equals u so I like I'm running around You know standing on the soapbox of u equals u so a little bit of hiv primary care Sometimes so if you folks set saint lunatics in the house have Like hiv primary care very very specific questions Some of those I can answer some of those I can I will get back to you which I'm actually really good about Um, the other thing too just because you know, I have to say it y'all can ask me anything you want Honestly everything right did I tell you about this speaking engagement? I did on friday No, you did not and I got it was the what I got some of the best questions I have ever gotten at a live speaking engagement We talked about hiv. We talked about rio. We talked about whatever but I mean, I don't how crass can we be I mean we're on linkedin so I got Yes, we are on linkedin the linkedin folk are a little more buttoned up But you know some f bombs here and there are okay in my book. Well at the top. I mean there was a Let's just say there was some really really intense juicy quest sexual questions about like things being inserted with Drugs and other things inside of people and like what happens or whatever like that's great And I I just want y'all to know like tuning in like that is my So please do not be afraid that you want to Talk about and we will talk about it if I don't know I will tell you I don't know We will look it up and we will find the answer for you because this may be ready drum roll the first of a series of lives that Right for Ozzie and I are doing together for sure. Yeah, I would love to do that Um, so let me ask you a top of the line High-level bird's eye view question to start Sure. What is your current assessment of the global hiv epidemic? hmm such like a You're so serious. You had your like um your reporter Uh question voice on there, right? If you were like dr. Simmons. Tell us your current assessment of the It's a question that I'm going to be routinely asking everybody that I interview So that I can get it like a broad spectrum idea of everyone's perspective Yeah, um, you know, I think it is I think we do have to sort of separate what happens in countries with great healthcare access Predominantly to preventative care and then treatment so places like canada the you know, most of western europe Japan united states etc Some countries in south america. It's fairly easy Asterix I know not for everyone, but it's fairly easy to get your hands on treatment And fairly easy to get your hands on prep. And so This whole we're going to end hiv by 2030 um with u equals u and with uh treatment as prevention and prep as prevention It's an ostentatious goal, but possible in those parts of the world. I think I think we will be having a very fundamentally different conversation about hiv 5 to 10 years from now Um, kind of like we are now having a fundamentally different conversation about hiv than what we had five to 10 years ago um, that being said if you you know racism and Capitalism and imperialism and colonialism and all of those other isms have left many places like A lot of countries in africa a lot of countries in southeast asia behind when it comes to hiv hair in particular and then prevention so prep is much more readily available than it used to be even in the last kind of The tail end of the pandemic and some of these particularly african countries and then southeast asian countries. So that's helping a lot um, but we are still unfortunately saying Really high rates of transmission that are probably unnecessary and really high rates of Of opportunistic infections and illness and things like that In places that don't have access to the resources. So My my general push is sometimes people really ask me like what why are why are we doing so much? Why are you so much about hiv all the time and talking about hiv and aids and a lot of it is because we This I feel like why are you so obsessed? Why are you so obsessed with hiv? I feel like we are at this I don't know if there's sports people here or whatever, but like we're starting the fourth quarter We are At the 20 yard line marching towards our end zone, right? We are I used to run track like it's the last 50 meters like all of these things Where it's really really hard right mile 18 to 20 of a marathon for people who've done marathons Like it's we're in a really really hard part It's sticky. It's weird. It's gross. It's not getting a ton of headlines, but we're so close to what could be like solutions and Really drastically cutting the numbers And so now is the time we got to push even harder. I think So so from what I gather what you're saying, excuse me if I'm putting words in your mouth but it seems like you you feel that In 2030 with this initiative We could potentially Realistically end the epidemic but that but that it would be limited geographically because of differences in availability of of health care Basically in different countries. Um, yeah, I think that's the is that a privilege thing totally a privilege thing totally a a You know primarily capitalistic health care environment things primarily, uh, you know This is really I don't know if there's any drug companies on watching whatever but like They're really difficult push pull relationship We have with the gileads of the world who are fantastic and amazing and do all these wonderful things and spend a Lot of money and created these medications and are absolutely changing people's lives and and like some of the sole reasons Them and the research are some of the sole reasons why people are like living forever with hiv You know, we everyone runs around it's not a dust sentence anymore all that that's great also like they are beholden to their shareholders and That requires them to turn massive profits And so it is not profitable to just like give entire subcontinent of south of Sub-Saharan Africa You know a tripla like it just is not That's not profitable So, I mean if you really I know I just like went right there, but if you really want to get into it Yeah, that's part of it. We like to couch it. We like to sort of respectability pop politics it in In oh access and all of these things but when it comes down to it like healthcare I'm in and I'm in healthcare right healthcare is a business And people have to make money uh with the business and unless it was like a super nationalized sort of thing or globalized healthcare like Um You know well And that's something that I hear maybe I don't really hear like people living in different areas of the world saying We don't have any medication here available, but I will hear Oh, we don't have the latest and greatest drug that You know that I'm maybe talking about on youtube or something like that We have this generic and we have something that's similar But is it on the same level as the new drugs? We don't know but this is all that our government Can or is willing to Pay for or bring into the country so That's and that just so the kind of the people watching know there's generally with medications. There's a seven year patent Generally speaking at seven years sometimes the patent can be extended. It can be appealed There can be all different kinds of things that can go on with patents, but more or less you you have a patent for seven years and Once that seven years it's called the cliff once that patent goes that patent for a drug goes off the cliff after seven years It means that other drug companies can start Replicating that medication and then charging whatever they want for it. So that's generally when we find generics So part of the reason that a lot of places are not up to date on medications Or they're about seven or eight years behind Is because after seven years the drug companies have I'm really oversimplifying But after seven years or so the drug companies have essentially made what they're going to make on this medication By charging what they can charge everyone else can now make it cheap. So people go off and make generics So then it is a cost effective for them to offer it to everybody at that point. Yeah, yep Okay, so I do we do have a couple questions. Yeah, so let me put the first one up on the screen here I love that you I'm glad that you have to drive. I'm not a good driver This is this is a lot. It's a lot But I'm meddling through okay, borg has a question Can a co-infection with hepatitis a block the detection of hiv from fourth generation tests? And also rna pcr test over two-year needle assault. I don't know what the quarter of that means, but I hope you do Um, I don't know what Test over two-year needle assault so maybe the the potential the first Injury or the first exposure was with a needle two years prior. Am I interpreting that the correct way? Let us know in chat. I'm watching Yeah, we're looking. Okay, so I'll repeat it. Can a co-infection with hepatitis a block the detection of hiv from fourth generation tests? No um very separate We do see a fair amount of co-infection of the hepatitis is And newly diagnosed hiv Yes, often in populations of people who use needles for recreational drugs or otherwise Yes from two years ago. So No we're testing For something fundamentally different But I understand why you might have this question because we often will see Both together. So we will see a new hepatitis particularly a or b hepatitis infection and hiv Often we will see it with other sti sometimes with syphilis. Um, and then A lot of times especially in populations of people who use needles for recreational drugs or otherwise Sometimes we'll also see other things a sepsis a Immersa from the needle that is causing a pneumonia or some sort of skin infection, right? Like we'll see those these kind of opportunistic ones pop up But having a co brand new diagnosis of hepatitis a and a co brand new diagnosis of hiv together It won't block the test we can detect both Great on on that Same vein it that's often a concern that I hear from people is Is there a habit? Is there an action? Is there something that I might be consuming in my nutrition and my diet? Is there anything I'm doing that could lead to a false negative hiv test is in general? Is that an issue? um, and if is are there certain things that People should be cognizant of or aware of that might um So there are So the the easiest answer for this is no in terms of the things you're consuming over the counter or Or supplements things like that. Are they going to give you a necessarily a false negative? However, you can Ask for the most recent generation of tests. You can also ask for people are really familiar with like antibodies versus antigen Now because of cove it right so you can ask whoever's giving you the test Is this testing for like a p24 antigen and hiv antibodies? Is this a rapid test? Are you confirming with the pcr you can ask all of those questions? um If it's something that you're worried about so But generally speaking even the like third generation antibody tests are really good um Again, there's a window right so depending on which test you're looking at those generation tests generally couldn't two weeks was Rare that we would be able to detect but we're more looking at like four to six weeks Okay after exposure Now if you're looking at tests that are looking at antibodies antigens, you know, it's a pcr confirmation test that window of exposure can be smaller but A lot of times people will will say oh gosh. I had I think I had an exposure in the last five days Let me get my hiv test. Okay. It's negative few eh Get on pep regardless Get on that pep Get on that pep regardless and we're gonna need you to come back and test it a little while At least a couple of weeks probably more like six weeks to confirm Um, so it's a legitimate question for sure and you can just ask right I do not know what in all the years. I've been doing this. I do not know one person who is helping folks Test for hiv who is ever going to be mad at you For being like which test is this again? Is this like the pcr or the other one? Right, you don't have to know the names of the test just ask them like girl Which test is this can you do the one that's the pcr and antigen like can you give me both because I'm like super worried Just ask they'll be like. Oh, yeah, sure You know it's the same blood or the same mouse swab or whatever right so don't don't hesitate to ask In most places anyway Some some places it's I know that it's a difficult request Okay, um, oh, we got some more here. Let's see next up put it on the screen If that is a difficult request by the way, I want you to go to cdc.gov slash hiv and Have a test mailed to you or do their test locator I'm just thinking of people in other parts of the world Yes, that's true. I forget we right if you have such a global audience. Yes I'm I'm I'm quite us, uh, you know centric at this point Okay medicine There are many of them, but we need more doctors To have knowledge to treat patients with hiv conditions. We need more doctors Ain't that right sister True that not to put a gender on you and just calling everybody sister these days We sure do and I think one of the one of the biggest issues is that there are so many primary care providers Either in the hospital or in the clinic setting who just have zero hiv education And that's actually part of what not that i'm here to like just like super carry the fly for the cdc all the time But that is part of what the cdc is trying to do with their clinical ambassador program of which i'm a part of Like me Try to help educate other clinicians about like just ask the damn question like Hey, are you sexually active? Do you use needles in your drug use when was the last time you had had a hiv test? Okay, let's just check for hiv. Are you okay? Are you on prop? No, let's talk about see if it's right for you, right? um, and if you're doctor, um Demetriakis In new york really did this um The best starting you god it was eight ten years ago almost at this point There's status neutral Care so if you've not heard that status neutral means we talk to everyone about hiv Just like we're going to talk to everyone about like blood pressure The mole on your feet, right? Everyone that we always have a conversation with folks about everything We're also having a conversation with you about hiv regardless of your status If you're hiv positive We get you into care and we we have a conversation about it We start john meds. We do other tests. We keep it pushing if you're hiv negative great We talk about prep. We see if it's right for you if it is we get you on prep If you don't want to do prep we talk about your other options. We keep it pushing But everybody gets an hiv conversation. And so I think you're right even outside of getting more hiv prevention and care specialists it's about Educating the folks who are already in place to do just a little bit better job at their hiv care Yeah, because especially with hiv. It's not just Having a conversation about hiv. There's a whole continuum to the care and there's a way that you have to address patients or humans living with hiv recently diagnosed or or just going in for testing That's different than a lot of other things because of stigma because of so much surrounding the virus Knowing how to talk to people about it without making them feel judged or criticized look down upon It's so easy for health care professionals to do that Because of a bias because they're not trained otherwise Very very much so unfortunately that bias. I mean we we've learned so much about the biases in health care related to gender even the biases that that like cis gender women face Just starting there and then going on through all of us folks of color and all those queer folks and all gender fluid folks and sexually fluid folks and all that stuff right all those biases and then you add other sort of disease processes on that and this is no shade to physicians medical doctors But a lot of the compassion of talking to people like a human being Isn't taught as well in medical school as it is in nursing school So sometimes you will get people like me who are nurse practitioners Primary care providers. We have a doctorate or not, but sometimes people just like having conversations with us a little bit better Just because our core is as a nurse and our core is the whole person Now this is not all physicians, of course I'm not speaking and not all nurse practitioners either some nurse practitioners aren't great But like in general a lot of people are like, hey, I love my nurse practitioner because I feel like I can talk to them Like a human being and not be feel as judged Yeah, and to make a good example of a doctor who Handled it very well. I still remember to this day early on when I was diagnosed I was I met with a doctor and at some point he Consciously removed his glove and touched my hand and spoke to me and and that was very like it meant I was like wow like it was shocking in a way It seems like such a small gesture, but it was like in that moment. I knew he's not afraid of me Or afraid of getting hiv from me. So things like that did you Were you ever able to share with them how powerful that moment was for you? No, and I don't even remember what doctor That's all right, right? Did they say right you don't have to remember their name or whatever But you you will always remember how they made you feel. Yeah, it wasn't like a primary care I forget what situation it was But I I I'm so glad that you shared that and I hope that many others get the opportunity to have that That type of connection with their with their health care provider and my most recent Sorry, go ahead. No, I was just gonna say most people's Most people's experience with their health care providers is shitty. It's horrible Yeah, I was just gonna just oppose that with a recent Because I had to find a new doctor that and I'm not going to this doctor specifically And part of and a huge part of the reason for that is when I went in my first visit Um He was he kept his distance from me the whole time and that at the very end he did the elbow and this is like This is like post Lockdowns post covid's everywhere and I'm like bro Like how hard is it for you to just shake like I just met you you can shake my hand And you can literally walk out of this room and you can sanitize and and go about your day like That elbow Just even a even a fist bump Hey, this is how we're gonna sign off Let me leave. Okay. Good chat. Good connecting with all of you guys. Right. Thanks. Glad everyone Yeah, glad we hope you had a human connection here. Listen, even a fist bumps better Right, even a fist bump is like a little bit more personal than like Uh freaking elbow. Are you kidding me? Um, I'm sorry rife. I'm sorry that That that happened to you and I let please let me use this opportunity for a by watching If you don't like your healthcare provider Whatever they are providing with you If you are in a place not the elbow If you are in a place where you can change like if you have the privilege of that Switch it up on them. There are plenty of us I love what I do and I think I'm great But my sense of humor and my approach is not always appreciated by everyone right sometimes people are they want the boring Whatever very medical very stodgy whatever like this is how I am with my patients, by the way And most of my patients really appreciate it But sometimes they want no they want someone to come in and just like read the textbook to them. Cool I'm probably not your dude. So fire me and find somebody else. I promise you there's somebody else who would love to take care of you I love being an advocate But I you got to be your own advocate too on some level You don't you don't need to go on youtube's and you don't need to go in the socials and the interwebs and spread your Everything to the world like I do But when it comes to key things like getting a good doctor that you can connect with and feel vulnerable with and feel safe with You got to speak up for yourself Yes, okay We have a question Oh, does it not show the whole thing? Oh, it doesn't that's weird I would do that I can see it on the side. Can you see it there? Do practitioners at any poo? Hi guys, I work with geriatrics who could have been exposed to HIV at any time in their lives as they get older And I love talking about HIV and aging by the way They may show symptoms of opportunistic infections due to weakened immune systems and other chronic conditions Do Practitioners at any point or at what point would they recommend testing? Do they feel it's worth looking into? Yes always Oh my gosh Uh, I I think so many of us Um, Aisha Rogers, thank you for that a fantastic question. And I don't I don't On this little restream A rife and I are learning you're coming through at us through linkedin. I don't see your credentials there So if you are dr. Rogers my apologies, um, but thank you for the fantastic question. So Can you before you before you go into it? Can you rephrase that? Um As if i'm a five-year-old just so that I can understand and so some other people can understand what is being asked Yeah, I mean bottom line is how quickly do we jump to hiv testing? So in someone who is older And they have an infection That might be what we think of as an opportunistic infection when someone has HIV or it has progressed to AIDS, right? So their T cells are super low less than 250 all of that stuff She's an lpn. I don't know what that is lpn. Excellent a licensed Practical nurse very good. Thank you, Aisha So what we generally do is I think a lot of times when we were in school when we were younger It was like this big deal, right? A lot of states required you we had to consent For an hiv test and then they would put you in a registry And there was like a really big deal around testing even in the hospitals And so it was like this whole big consensable process like big big hairy elephant in the room to Get an hiv test for someone and it was like a big deal Now it is much less of a deal and partially because of that We would We we go to hiv testing really fairly early Now that being said in geriatric and I work a lot with geriatrics. So in elderly populations Lots of infections happen Because there's lots of weakening of the immune system for a multitude of reasons not just age But generally speaking older people have we call them comorbidities lots of health care stuff going on that could weaken their immune system Opportunistic infections Are somewhat specific So like there's a specific type of pneumonia. There's specific type of fungal infections There's specific types of things that we see That wouldn't normally happen in someone Even if they're a little bit older and even if their immune system is a little bit weak But then if we see like a pneumocystis, uh, you know a p pjp pneumonia Wow, that's really rare We usually only see that with people who have advanced hiv or AIDS Oh We better we better check for that, right? So I think hiv tests I issue to your question probably happened a lot more frequently than you might realize um In people who have what kind of I hate this word, but we kind of look like weird infections like oh This person's got kind of a weird infection. We're not sure what's going on Some things causing their immune system to not work super great. Maybe it's hiv. We should test for it Mm-hmm that kind of reminds me of when I went into the doctor initially and I I was in a relationship. I had For three and a half years at that point Duke are you whining? Oh, I can't hear well. Do you have pictures? Can we see dog whining at the door? Um, I'll try to put something up But when I I ended up going to the hospital and it was just like a blanket I don't know what's going on with me. My throat's hurting like crazy I thought that I had strep. I took an antibiotics. It went away for two weeks and then it was back And so I was like I got I got to see somebody and that was that they would looked and they're like Immediately they thought like maybe I have like an std or something like in my throat from Throw stds the way that happens and And then and then they went from there and just immediately gave me a whole Array of tests. We're just we're just going to test everything and hiv was in there and that's how they found it Oh A very a a fairly common story right a fairly common Oh my gosh Hello My little boy spoiled his name dukey said duke. Yeah. Hi duke Oh my god, so cute um Yeah, a lot of times there's a there's the We call it um like antibiotic failure or treatment failure So we someone was on something we gave them an antibiotic. They got a little better and then as soon as the antibiotic finished they got worse Sometimes that makes us go. Huh. Why is this person? Why did this antibiotic not work? Now normally it was the wrong antibiotic for the wrong infection or we didn't give it long enough for Right The patient didn't finish their antibiotic Properly Properly didn't take all of it But sometimes when someone who is maybe otherwise young and healthy or it's one of these sort of weird or looking opportunistic infections We're like, huh, we better check like you like your providers did for you, right? Like let's throw the kitchen sink. Let's just like test for everything And hiv is usually included in that. Yeah great Um, okay, I have another question here. I'm gonna pull up What's the best way to get involved in hiv? I did research in undergrad, but I'm wanting to do more to gain more experience. What a lovely question I really as someone living with hiv. I really appreciate whenever I hear things like that Yeah, well, I mean rife. What do you what do you think from your standpoint? With all of the I mean, we both we both are so active in the community But kind of a little bit in different ways. What um, what would you say to someone to this your answer to this question? I would say to start local And go for your local lgbtq center um hiv Organizations that are local. There's usually local organizations and there might be like a national Organization that has a local branch if you will That would that would be my And you can use that. What's that you you should know this? I'm gonna put you on the spot. What is that? I got google I got my keyboard right resource locator Website where you can go you literally just put in wherever you are in the u.s And it will tell you all the the pharmacies all the testing centers everything in your area cdc.gov slash hiv That's how they go i'm gonna do a commercial cdc.gov slash hiv or you can always google hiv testing locator Um, if you're looking for it or cdc hiv testing locator um I 100% agree with you right if that was going to be my first response Go local meaning pull up the the you googles and hiv organizations near me right and see What help they need the In terms of In most sort of philanthropic endeavors so either it's breast cancer or marches colorectal cancer awareness month Probably need to post that video tomorrow before the end of the month right colorectal cancer or cancer awareness all these things The bigger the organization usually the more corporate dollars they have and the more resources they have So these big national ones they need help too But they usually have a lot more resources and then as the organizations get more local and a little bit smaller They usually need more help A lot of these organizations At a local grassroots level Do that really heartwarming yummy amazing wonderful work that like you think that you're doing right like Like you're sitting down and you're having a comma kind of like my my speaking engagement on friday I think the organizers were hoping for a larger turnout But there were maybe about 25 people there and I thought that those 25 people were so and get like we it was the Best conversation we were super engaged Everyone was very there there were tons of questions. We ran out of time like it was fantastic I would much rather have 400 conversations with 25 people who are really engaged and want to be there and learning And i'm learning from them and all of that Then feel like I have to do everything on such a grand scale So that's why I say like local your local organizations probably really need your help. They probably have a great They probably already have ideas as to where they can plug you in Exactly your undergrad was in like graphic design They're like, okay design this fire for us really quick and then oh by the way You're gonna come volunteer at this event for the fire that this design in our chunky angel fire website from 1992 You remember those not Not angel fire. There's nothing angelic or fire about it. No She said it is not fire. What so ever I'm not being said if there is an organization that really speaks to you Uh, I I promise you they are never above an email or a phone call or a dm from Wanting to get involved so like, you know Color of change. I think is a really they're not an hiv specific organization they do more grassroots root a root around white supremacy and and anti blackness but Color of change is an organization that has a big big footprint but does some really really dope local stuff and I know that they have had really it's like celebrity involvement from celebrities who just literally dm them And they were like, yep, come on in same things with people who are non-celebrities. So yeah, just just dip in for sure Oh, hey, I want to call out zandra is my alter ego patricia Patricia is a good friend of mine. She's someone that I work with through the Hope Collaboratory um, it's Funded by the NIH and we work in conjunction with scientists and researchers who are working towards an hiv cure and And they're they're actively working to bridge community with Science and research She is our community engagement. Um coordinator. So patricia. Thank you for joining. She has a question for us. So let me put that up If you could change one thing in the way is research clinical trials are run, what would it be a good question? I don't necessarily have something for the way they run because I'm not really familiar with clinical trials to be honest But I do know that it is a challenge And it is a difficulty ongoing in finding and having proper representation and diversity in clinical trials and so onboarding those people to not just finding them but To establish trust with community Um, I think that's a huge hurdle and we we saw that with the pandemic to the amount of distrust of health care And anything related to the government Rooted in Reason Right rooted in real shit Real shit rooted in you have every reason to destruct the government and and big pharma and science big science Yeah That's part of the reason I sort of hesitated with this. I wasn't hesitating. I was more trying to be give a really thoughtful answer So same thing. I'm not running around like Doing tons of clinical trials or anything. Um But my familiarity with them is a little bit better than the average bear. Um So that being said, I same thing, right? Um I think we're moving in the right direction with this, but it sort of sometimes feels like let's design a A research study. Let's answer a question. Let's have a hypothesis. Let's answer a question And then it's an By the way, we should probably include some diverse folks in this So that almost more so that we can make our numbers more generalizable, right? Um to a to a to a mass population rather than What I think, um You know, you see a lay I have to tout them a little bit because that's where I got my doctor at full disclosure, but Right, sorry. Oh, there we go. See we're both friends. So the I think what the work the hiv research Work that ucla has has led Has been very queer and black focused From the beginning And they've sort of required when they're partnering with drug companies and others who are funding some of this research that that Those initiatives start they've started from the right place. They've started from the place of You know in the united states primary You know incidences of hiv are among 18 to 35 year old Black men who have sex with men in the southeast part of the united states So we're starting from there and building our trials around what the community needs By involving the community But that feels so novel and so fresh and so like And it shouldn't be right that it should sort of be the other way around rather than like Taking this novel approach And so I think there are institutions like ucla. I think hopkins is getting a little bit better about that I think some of the other big hiv researchers even uab Are starting to get a little bit better about Not it not being an afterthought about including The the right populations and actually being having their clinical trial designs being driven by the data and the data telling us Where the populations need the research in that makes sense exactly. Yeah logical How dare we be logical Yeah Well, great. Um, I we are over our 30 minute That we want to do How do we do everybody on our first live? This is let us know what you thought um, we want to keep doing these and I'm open to one more question if anybody has a last burning question. Otherwise, we'll wrap it up for today um Yeah, I think this was really good. We touched on a lot. We touched on a lot of topics And it will happen organically and Thank you everyone for all the amazing questions. This will live on my I don't know if it I don't think linkedin stores it or anywhere else, but for sure on youtube It'll be up there and you connected your youtube as well, right? I did my youtube linkedin and uh, twitter Oh Where can people go if they want to follow you and or your work? Oh, thank you. I everywhere on all social platforms at ask the word Ask the np on tiktok. It's ask the np underscore Oh, what I just realized I can um chat in the Ask and at Did you see there's an oh, there's an underscore on tiktok Just on tiktok at the end, but everywhere it's ask the np Wait, and I don't know how do I chat on the big board too? Can I or is it just you as the Oh, you as the host out there, but I can't oh, but facebook and linkedin linked it I can't for some reason. Okay. I gotta figure that out. Anyway, that's yeah, that's that so follow Dr. James Simmons. He has a lot of great content. He's always putting out um informative videos that I love watching that are cute and funny and educational which is you know, that's the holy trinity of Cute fun and educational that that's gonna be like my new tag line If you're watching it's after the live put those questions comments down On youtube in in the comments below I'll keep it for next time and we'll be back here. We can you want to do this again next week next thursday Um, yeah, can't let me make sure I'm putting you on the spot I look it looks like I can let's do it Okay, great. I'll put it my name thing as well. All right. Thanks everyone. Thank you for joining and we'll we'll see you soon ciao