This session explores how sex-positive, pleasure-centered approaches enhance HIV and STI prevention – especially for people living with HIV and communities greatly impacted by HIV. We discuss the benefits of this approach and highlight an innovative initiative based in community voices and engagement: San Francisco Department of Public Health (SFDPH)’s Have Good Sex campaign, which promotes sexual empowerment, inclusivity, and self-directed care through home-based testing. Centering the needs of communities disproportionately impacted by HIV, this program affirms sexual health and well-being through messaging that centers pleasure and autonomy.

This presentation will provide an in-depth overview of our agency’s innovative street outreach strategies for HIV prevention and treatment across Texas. We focus on connecting with populations often labeled as “hard to reach” through a combination of trauma-informed care and peer navigation, designed to foster trust and engagement. Our approach prioritizes immediacy—once we identify individuals in need, we work to link them to HIV care or initiate PrEP within 24 hours, and often on the same day. We are leading the effort for prompt diagnosis and linkage to care in Texas when individuals in many areas have to wait days, even weeks, for a doctor's appointment.

Participants will learn “how-to” techniques for initiating and guiding conversations about sexual history through a lens of prevention, risk reduction, and patient-centered care. The presentation will emphasize creating a safe, respectful, and non-judgmental environment that encourages patients to ask questions and engage openly. Special attention will be given to the unique challenges faced in rural communities, where stigma, limited resources, and lack of formal education can further inhibit discussions about sexual health.