Many people think of sexual health as a separate component of their overall physical health. Testing for STIs and STDs are, in many instances, left for only after engaging in sexual activity, where one partner believes that they may have been exposed to an infection or disease, rather than incorporating the testing into their annual or bi-annual physical checkup. Outside of major, progressive, and often liberal cities like New York and Los Angeles, where conversations on sexual health are more open, discussing the activities associated with sex, including testing, is still taboo. Biem is an app that allows sexual partners to share their status in a safe and verified way, after going through a convenient testing process either at a medical office, or at home.
In my conversation with Bryan Stacy, Co-founder of Biem, we discuss sexual activity in New York city, the app, and communicating with sexual partners about our status, to help reduce the transmission of STIs and STDs. The interview has been edited and condensed for clarity.
Khahlil Louisy: Do you refer to BIEM as a sex health app or sex tech app?
Brian Stacy: Usually what I say is we have a digital sexual health startup. I typically don’t say app because it kind of cheapens it a little bit. The magic isn’t in the app, the magic is what you do with it, what it empowers you to do. I feel like New York is at a low with sex more so than other cities in the country and I feel like the reason for that is because we’re always up to something. We’re always busy. And so we tend to fill that void by engaging in sexual activity because at the end of the day we’re all looking for the same thing – companionship, but because of how much we work, we choose to prioritize work, then just fill that void with sex. I understand that is a really big generalization, but it’s my experience within my peer group, personal relationships, and professional relationships.
I was reading an article a few days ago which listed the top ten cities with the highest risk for HIV transmission, and I was surprised to see New York was not one of them, considering we have 8 million people in the city. I think a big reason for that is New York is a very progressive and liberal city. We have access to medical care and free clinics where you can get tested, but very importantly, we’re more receptive to engaging in conversations around sexual health. I want to know, does this surprise you, that we’re not part of the top 10? And what are your thoughts on that?
Do you remember by any chance what were the top cities?
Florida, Jacksonville, Baltimore… mostly cities in the south.
I think you hit it on the head as far as the why. I came from Chicago and the Midwest where we don’t really talk about sex. I’ll say from my perspective, in my family, we didn’t talk about sex that much. It’s a not safe topic to talk about and you tend to do things in the shadows. When things happen in the shadows, usually precautions aren’t taken. New Yorkers have that well known personality of being upfront and I think that goes along with the healthier lifestyle. The other thing I’ll say is, when we look at who’s attracted to our business or our app, for example, from our Facebook ads, it’s groups that are in the mindfulness area – Yogis and meditators. They’re really attracted to us and I think having that sexual health consciousness is part of their lifestyles. The “I eat food therefore I brush my teeth,” or “I want to have a healthy heart therefore I work out”. It’s the exact same thing with “I enjoy sex and therefore I’m going to be healthy and protected”. And I think it’s less taboo in New York to talk about these things than it is in other places. So, what it comes down to ultimately is, are we talking about it and do we have the confidence to bring it up?
But how do we communicate that message with people in the south and in the Midwest? Because we also want to decrease those rates of transmission of HIV in those places. I think another reason why it spreads so rapidly is because people don’t want to be “outed” in any way. Not necessarily in terms of sexual preference, but maybe they’re involved with someone who isn’t the person they’re committed to or in an exclusive relationship with. So how do we communicate that regardless of their circumstances, they should get tested and should be more careful?
I think to answer the question of how we get over the “hump” of this being a taboo subject, there is an intervention that needs to happen now with all age groups. If you look at our history, what did we learn about sexual health in school? We were taught that STDs are going to kill us, sex is going to kill us. We hear all these things that aren’t necessarily true. They may be true from a value standpoint, but the reality is that most STDs are less harmful than the flu. You can treat all STDs and you can get rid of most of them. What is it that we’re really scared of? The sex part, I’ll tell you a personal story.
Five years ago, I started to feel pain in my left testicle, but decided not to get it checked out. Why? I was scared of potential results and scared of talking to someone about my sexual history. I also didn’t quite know where to go, so I let it go for three months. It wasn’t until I got on the phone with a friend who is a Urologist, that the comfort level was there. I told him what was going on and he told me I was an idiot for not telling him earlier, and connected me with another Urologist that day. I was diagnosed with both testicular cancer and Chlamydia. Of course, then, I had to talk to my family and tell them that I had cancer and needed surgery and chemotherapy. I specifically left out the part about the Chlamydia. Cancer is a big deal and I didn’t want to ruin my perfect cancer experience with chlamydia, because cancer is something people can get behind and support you for, but Chlamydia? Shit, that’s your fault, you did something bad, right? You had sex to get Chlamydia, whereas cancer just happened. So, I think that’s the big difference. Testicular Cancer is way worse. I mean, I’m running around with one nut. The chlamydia is gone, but the shame associated with it was way higher.
It wasn’t until I started Biem and until I started doing some talks on sexual health transparency, that I realized, ‘holy shit, I haven’t been transparent myself.’ And it was during one of the first talks I gave, someone recorded it, and I sent the recording to my family. They asked me “What was that word you said after testicular cancer?” I said ” Oh, that was Chlamydia.” It was an interesting way to tell the family I had an STD and they weren’t happy about it, which is fair. It goes to show you the attachments that we have to the stigmas of STDs. I took three pills and was fine, in regards to the Chlamydia, but there was a lot of shame involved with that.
So, how do we get over that? We start talking about it, parent to child which I think is a huge one. I have talked to so many parents that just don’t know how to have the conversation, because in they think they’re advocating for their child to have sex. Other times it’s just awkward because the child doesn’t want to have the conversation. But that’s where it starts. I have also looked at two different people, where one grew up in a household that talked about sexual health and sex and one did not. Inevitably, the person that grew up in the household that talked about it,have an easier time being open with partners, which keeps them safer. So, I think it starts there, at homes and in the schools, and it certainly starts with us individually and making sure we’re asking partners “hey, have you been tested?”
Do you think it’s easier to have this conversation now, opposed to say, five years ago?
I think we’re seeing a cultural revolution when it comes to sex. In the 1960s, we talked about free love, we talked about sex, and how many partners. And I think the revolution is moving from that to mindful and conscious sex and partnerships. With that, we cut to the real conversation, and I do think it becomes easier.
Now if you look at dating apps, Grindr was out way before Tinder. I look at the LGBTQ community as a leading indicator in this space. Today if you’re on Grindr, a lot of people are actually putting their sexual health status on there. “I’m HIV positive,” or “I’m HIV negative”. I think the heterosexual community is way behind with openness. So, I certainly think it depends on where you come from, what your parents talked about, what culture you’re a part of, and what groups you’re talking to now, which determines the ease of having the conversation. Here’s the ranking:
People that have the easiest time talking about sexual health are polyamorous groups and play parties. They are hyper-focused, and for good reasons, on sexual health. They have orientations purely dedicated to sexual health.
Group two is the LGBTQ community. They’re talking about sex as part of their lifestyle and open about what they love and want. The stigma around sexual health is reduced, or at least they’re already talking about it.
Group three is heterosexual females. They have more to lose because they can become infertile if they don’t take care of an STD.
The last group and the worst by far are heterosexual males. A lot of times, they don’t have symptoms, therefore they don’t think it’s a big deal. I’ve heard guys say things like “well females get tested every year, so they’ll tell me if they have something,” or “they look healthy, so I’m not worried about it.” So I think, again, it depends on what group you’re in and where your comfort level lies, as far as it being easy to have the conversation.
We’re seeing spikes in sexual activity because you can get on an app that will tell you how many feet away someone is from you, who may also be interested in sleeping with you. How do you think that affects or changes the way people have sex in the city? But also, do you think it has affected the way we communicate about sex and STIs?
Prior to launching BIEM, I ran an experiment on Tinder and Bumble. My first profile photo was me smiling – the regular profile photo. The second one was a round picture of me with a white background that said “TESTED FOR STDS” on the back, and underneath the photo, it said “not looking for hookups, just thought you should know.” I wanted to see if it would make the conversation easier in the future, if you broke the ice there. Anytime I connected with somebody, or matched with somebody, my first question to them was, “hey, did you swipe right because of my STD status or in spite of it?” About 70% of people were really positive about it. They probably saw the message and swiped right. Some said it didn’t necessarily influence them one way or the other, but its great we can talk about it. About 10% of the people told me I was an idiot but swiped right anyway and about 20% said they didn’t really care, or they didn’t see it. So, I do think that it has absolutely changed the way we communicate and the speed in which it can happen.
So, that brings us to BIEM. Tell us what BIEM is and how you came up with the concept and the name, especially.
I think I’ll start with the concept and the name since they go hand in hand. I talked about my experience before with testicular cancer and Chlamydia. When I wrote the blog, “One Big Nut,” about the testicular cancer, I didn’t realize this was going to happen. I only wrote it as a way of updating friends and family, but people started reaching out to me to talk about their sexual health situations. Over the last five years, I’ve talked to hundreds of people about their own sexual health. When I moved to New York, I got together with my friend whom I mentioned earlier, the Urologist, and asked him what his experience was in the office, when it comes to sexual health. What he said to me was both funny and shocking. He said “Bryan, I have more dick pics in my phone than any woman in New York, hands down.” I asked him why and he said “well, friends, friends of friends, and family members, send me pictures asking what’s wrong?” And so, we started to realize that people aren’t comfortable going to the doctor, taking time off from work, and getting checked for STDs, or potential STDs, in the cases of those photos. What we wanted to do was create something that spurred the sexual health conversation. And what that started was not an app, it had nothing to do with technology. What we decided to do was to take a condom, put a medical grade adhesive on the back of it, stick it on our chests, and go to parks, restaurants, and bars, to see what happened. We called it “Break in Case of Emergency” and that’s where the name BIEM comes from, it’s a loose acronym. The first conversation, the first time I talked to a woman while I had the condom on, she looked at me and asked “do you have a heart disease, what’s going on with your chest?” I said “no, it’s a condom” and she asked, “well, why do you have a condom on your chest?”
Was it on your shirt?
It was literally on my skin. The shirt was open a little bit and there was some skin showing, so it was kind of peeking outside of the shirt. So she asked why I had a condom on my chest and I replied, “well you never know, to start talking about sexual health conversation early in the conversation.” She called me a douche bag, but the conversation continued for about 15-20 minutes and at the end, I asked why we were still having the conversation if she thought I was a douche bag. She said “Yeah, I know that you’re looking, you’re single, and I’m not going to have to negotiate condoms with you.” I thought that was interesting, because I didn’t know it was a thing. She said “you have no idea, a lot of times I’ll go home with a guy or he’ll come home with me, and I’ll have to beg him to put a condom on.” In the end though, we realized that it probably wasn’t the best business plan in the world.
How old was the girl?
Estimate, let’s say about 28, maybe. And by the way, she was just the first conversation I had. I had hundreds of conversations like that afterwards, or very similar. We started to see that there was a theme of sexual health anxiety that we all feel, but never really talk about. Whether that anxiety is me, like my left testicle is hurting, what’s going on? Or maybe it’s a woman thinking ‘hey, I wonder if he’s going to give me a hard time putting a condom on.’ So, what we wanted to do was create a company that eliminated that sexual health anxiety. That’s why we ended up creating BIEM as an app, not just as a sticky condom to facilitate the conversation between people and medical providers. They can get the real medical information, talk to a doctor, facilitate easy and confidential STD testing, and verified results that come to your phone, which are easy to share with a partner. That’s the core of what we’re doing right now. And what we’ve heard from people is that they love the education component from the doctor, the fact that they can do it from their home is super easy, and they now have confidence to talk to their sexual partners about their sexual health because they have their results right in front of them and can ask, where are yours?
So, you download the app and then set an appointment with a medical professional near you…
Actually it’s slightly easier than that. You download the app answer a few questions, setup a virtual consultation with a doctor. So, you can do it from the comfort of your own home, ask all kinds of questions that you don’t want to have to do in person. At that point you can select whether you want to go to a local lab, or you can have the test done at home. They will literally send someone to your home to do the exact same lab quality test.
Will it cost you more?
At home will cost you $45 more. Two to three days later the results come to your phone. They’re verified to you so you can easily show them to a partner.
How has the response been?
The response has been good. We’re working on making the user experience on Biem a little bit better,because it can be a little difficult to get through the app. But overall, yeah, the response has been fantastic.
What about restrictions or hurdles?
Well, we’re doing medicine. This is not a box test to do at home. So, we have to be compliant with regulations, like how we use our technology and information. It is also high trust compliance, as far as data and security goes. We had to get through those hoops. Also, licensing, what can actually be done with telemedicine, and what states can you do it in? So, we’re in New York only right now. We’re going to perfect that market and go out from there.
What information are you guys collecting from users, how are you protecting it, and what are you doing with the data?
We ask the basic information we need to provide great medical service, and if you go through the app, you can see on the first five or six questions, that they are on demographics. Questions like, male or female? Do you have any symptoms? What kind of medications are you on? Do you have any allergies? That kind of stuff. All the information is stored in an electronic medical record system, which is the exact same thing a doctor uses. So, from a data security standpoint, your information, even if you go to a doctor’s office, is already put out there. We’re not doing more in terms of making it risky, we meet all of the technology high trust for keeping data as secure as you possible can.
Do you have a private server?
We do. It’s a secure platform as a service. So instead of doing our own security and kind of relying on one person to be good at it, we hire a company where that is all they do. 24/7 they’re on, looking at any type of intrusion. That’s the way a lot of large corporations do it. They used to do it on their own, but realized it’s expensive and not as good as using a company that only does it.
So, to wrap up, I just want to know what the next moves will be for Biem, what you guys planning?
We’re focused on the entire user experience and providing confidence in any part of sexual health.We started with STDs and the confidence in getting those tests done and sharing the results with a partner. We’re going to be quickly moving into other parts of sexual health. Part of it, on the male side of things, is erectile dysfunction. We’re moving into that. We’re also going to be moving into education, whether it’s around skill based stuff like tantric sex, or just questions about sexual performance. Finally, we will be moving into the social side of things, having users be able to communicate with each other and adhesive content.