The stats tell part of the story: While pre-exposure prophylaxis (PrEP) has made significant headway in patient adoption since its introduction in 2012, massive access gaps to the HIV prevention medication remain for the people who could benefit from it most. More than 1.2 million people across the U.S., to get specific, among them members of the Black and Latinx communities, females, young adults, those living in the South, and other populations who historically face disparities in healthcare access due to stigma, discrimination, and social determinants of health.
Eric Morrow feels lucky not to be one of them. But that doesn’t mean he didn’t face a frustrating, not to mention awkward, PrEP journey prior to becoming a patient of Avita Pharmacy, Q Care Plus, and their covered entity partner AVOL Kentucky, which work together to provide sexual wellness support for individuals across the Bluegrass State.
Read on to learn why getting on PrEP was initially challenging for Eric, how that all changed once he found the right provider team and community support, and his top tips for patients looking to self-advocate for compassionate sexual healthcare.
While pre-exposure prophylaxis (PrEP) has made significant headway in patient adoption since its introduction in 2012, massive access gaps to the HIV prevention medication remain for the people who could benefit from it most.
An initial PrEP encounter clouded by stigma
Avita: Tell me a little bit about your experience when you first started on PrEP. Did you face any challenges?
Eric: I initially got on PrEP through my primary care physician at the time. It was awkward because the physician was not a queer-specialized PCP. So, I had to educate them about what PrEP is, what I needed, and why I needed it. The testing I had to do was very invasive, and it just made my broader experience with that primary care physician more uncomfortable because sex became a regular discussion every time. He seemed very unprepared to have those discussions, but very compelled to keep having them.
I’m disabled, and I don’t work full-time, but I train people to teach sex education programs, and I teach sessions as well. I’m very educated about how to take care of my body. I’m probably more comfortable than the average patient in terms of how to talk to a physician about sex and HIV prevention. But it’s still awkward to have to do that yourself, especially as a queer person.
Avita: So, you faced stigma at first when you were just trying to protect your sexual health.
Eric: Yes. There’s still that stigma you get when you’re not dealing with somebody who’s educated, because it’s like…why don’t you care enough to be educated?
Later, I switched providers because it became so uncomfortable for me to continually educate this person. I would go in to talk about my blood pressure or cholesterol, and it would become a sexual discussion. And I was thinking, “I’m not here to talk about sex. I’m here to talk about blood pressure.”
I'm very educated about how to take care of my body. I'm probably more comfortable than the average patient in terms of how to talk to a physician about sex and HIV prevention. But it's still awkward to have to do that yourself, especially as a queer person.
TelePrEP to the rescue
Avita: How did you access PrEP after that?
Eric: Then I started getting PrEP through telehealth (Eric initially used a telePrEP provider that was not Q Care Plus). The testing was more comprehensive and less invasive than before. But the service was less personal. At the time, I was okay with that because I needed a break from my experience with my former primary care physician. I felt like, “If this is what it takes to get what I need, then that’s what it takes.”
Then I learned that AVOL would start offering PrEP services, partnering with Q Care Plus and Avita Pharmacy. I love AVOL. I’d volunteered for them before and wanted to support them. So, I switched over, and it was a breeze.
It’s been such a joy because the experience with Q Care Plus has been so much better than with the other telePrEP provider. Q Care Plus also offered Doxy-PEP (doxycycline post-exposure prophylaxis for syphilis, chlamydia, and gonorrhea), which I had never even heard of before. The other telePrEP provider wasn’t offering it at the time; Q Care was on the cutting edge.
The service I get from Q Care Plus is better — more personal and inquisitive, without being invasive — and now I’m not just pushed through a program where I get 90 seconds on a video call, and they’re not even looking at me on the screen. It’s been amazing to be part of it.
And getting my prescriptions by mail through Avita Pharmacy has been seamless. I’ve not had any hiccups; the whole process has been smooth. It’s my one reliable pharmacy experience.
The service I get from Q Care Plus is better — more personal and inquisitive, without being invasive. And getting my prescriptions by mail through Avita Pharmacy has been seamless. It’s my one reliable pharmacy experience.
Helping others with their PrEP journeys
Avita: Tell me about your role as a sex education trainer and teacher. How does that intersect with your PrEP journey?
Eric: I have the opportunity to work with AVOL to talk to more people about PrEP, which is nice. A big part of my journey of being on PrEP was not just taking care of myself but also gaining knowledge as a sex educator. I’m also able to talk to people from the perspective of having a disability, which affects how my body processes calcium.
There are horror stories out there about what it’s like to be on PrEP: About what the testing and side effects are like, and that it’s not worth it. But that’s not been my experience at all.
When I’m talking to other people about PrEP, I tell them that if they have other health conditions, they need to be upfront with providers and be able to advocate for themselves.
A big part of my journey of being on PrEP was not just taking care of myself but also gaining knowledge as a sex educator.
Avita: It’s fascinating to me that you’re a sex educator, and yet you were still susceptible to the stigma and shame that sometimes surrounds conversations around sex and sexual health.
Eric: There’s an expectation internally and externally for people who are involved in sex education to be more perfect about barrier usage and to be automatically more knowledgeable about risk. But we’re just as human as everybody else. And sometimes things just happen when you’re sexually active. I had to give myself a little more grace about my sexual activity. And PrEP helps me take better care of myself.
I grew up in the ‘80s. The AIDS epidemic was in full swing, and the government was doing nothing for that population for a long time. Sometimes, sexual activity still has that mental barrier of risk that is not necessarily as much of a reality today as it was when I was a kid.
For those of us who grew up in the ‘80s and ‘90s, having PrEP in our toolbox can help us relax and have a more satisfying sex life. PrEP and Doxy-PEP allow us to be more relaxed and have more fun, which is what we should be doing as human beings. Taking PrEP and Doxy-PEP is an act of not only taking care of my body but also taking care of my mind.
Avita: Okay, so what are your top three tips to help people be their own health advocates during their PrEP journey?
Eric: My first one is know thyself. Know what’s going on with your body and know what it needs. The second one is: Don’t take any… well, a nicer way to say it is, trust yourself. If someone isn’t listening to you, don’t waste your time. You don’t have to stay with that provider. It’s meant to be healthcare. And if someone’s not listening to you, they can’t care for you.
Third, make sure that your provider knows and understands what is going on with your body, too. Because it has to be a relationship.
Sometimes things just happen when you’re sexually active. I had to give myself a little more grace about my sexual activity. And PrEP helps me take better care of myself.
The power of community-based compassionate sexual healthcare
Avita: What’s next for you? What are you excited about these days?
Eric: I’m super excited to see where things go next with HIV prevention. Despite the current political environment, the science of what’s happening today is very exciting — not just in the U.S., but globally as well. I’m excited to see where vaccine research takes us.
I’m hoping to see community healthcare organizations, like AVOL, continue to grow, because I think we’ve really pulled together over the last few years to advocate for one another in ways I wasn’t sure we’d be able to. It’s heartening to see what community organizations can do. AVOL is one that has shown what’s possible. And that makes me very hopeful.
I’m hoping to see community healthcare organizations, like AVOL, continue to grow, because I think we’ve really pulled together over the last few years to advocate for one another in ways I wasn’t sure we’d be able to. It’s heartening to see what community organizations can do.
