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Better PrEP Conversations: What My Experiences Can Teach You

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Released: September 27, 2026

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As a person taking pre-exposure prophylaxis (PrEP), my experience having conversations about HIV prevention will help you examine how communication, assumptions about HIV risk, stigma, and responses to disclosure can shape patient trust, honesty, and willingness to stay engaged in HIV prevention care.

Kevin Chadwin Davis
Kevin Chadwin Davis, MPH
Better PrEP Conversations

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As a person who prioritizes HIV prevention, I have had pre-exposure prophylaxis (PrEP) conversations with different healthcare professionals (HCPs). Some have made me feel judged, and others have made me feel respected, safe, and willing to be completely honest.

In each case, the HCP’s response affected more than that one appointment. It influenced whether I trusted them, returned for care, and felt that PrEP was truly meant for me.

When I Received PrEP but Felt Judged
When I was first prescribed PrEP, it was from an HCP I had seen several times before for sexually transmitted infection (STI) screening and treatment for syphilis, gonorrhea, and chlamydia. Those visits with the HCP were brief and felt transactional. I never disclosed that I was doing sex work or using drugs because he never asked. He never offered me PrEP, even though I came in repeatedly for STI treatment.

The appointment I made to ask for PrEP was different. He asked about my sexual history and drug use. I was honest and shared that I used drugs recently and that I was having unprotected sex for money. I remember feeling that, if I were honest, he would give me the care that I was looking for. However, I noticed his eyes changed, his face tightened, he stopped smiling at me, and he suddenly acted cold and distant.

What I needed that day was very simple. I needed him to keep the same warmth after my disclosure that he had before and not to make me feel like I had made a mistake by sharing.

He did not need to have a perfect response for me, but I wish he had said, “Thank you for trusting me with that. That helps me take better care of you.”

Although I walked out with a PrEP prescription, which was my goal, I did not have a great experience getting it.

When PrEP Conversations Affect Whether Someone Returns
My best friend is a Black woman, and her experience with that HCP was no better. When she asked him for PrEP, he told her she was not at risk because she was not actively having sex.

But her reason for wanting PrEP was not about her current sex life. She had been experiencing sexual assault, and PrEP felt like a way to protect herself in case she was assaulted again. In that moment, she was trying to reclaim some power over her body.

She did not get a prescription that day, so I encouraged her to go back and request a female HCP who I thought would be affirming. She did, and when that new HCP gave her a prescription, she was very proud and we took our PrEP pills together every day.

However, she did not go back for her follow-up. She could not overcome the shame from her first interaction.

So, although I walked out of that HCP’s office feeling judged, but still with a prescription for PrEP, my friend walked out feeling judged and without PrEP and, later, without follow-up. The shame affected both of us, but the outcome was different: She stopped taking PrEP; I continued—all because of that one little window of acceptance that my HCP gave me (even though he was still judging me).

That made me think about who is believed when they ask for PrEP, who is questioned, and who is told they are not at risk. My friend was a Black woman asking for PrEP. Her asking should be all that matters. HCPs need to be very careful not to decide who is or is not at risk based on what they assume from the surface. They need to ask better questions. They need to understand trauma. They need to understand that PrEP can be about someone reclaiming their autonomy, their safety, and that it is not just about sexual activity. There are other ways you can contract HIV that make PrEP necessary.

What an Affirming PrEP Conversation Felt Like
My best experience was also with an HCP who I disclosed everything to, but this HCP approached it differently. From the moment we met, she treated me like a human being. What made her feel different to me were the conversations we had about my sex work and my husband’s positive HIV status. She allowed my husband to come to my appointments, and they would hug each other. It felt very family oriented, and my reasons for being on PrEP never felt shameful with her.

She made me feel normal. She gave me affirmations and offered appropriate physical touch in a way that felt comfortable and human. She did not make my life feel shocking or hard to understand.

She also treated my experiences as information that helped her care for me better. She really respected not only what I had gone through, but also where I was currently. She was also really comfortable talking about sexual health. It felt like I was talking to my husband or a friend.

Of most importance, she made sure to let me know, “You do deserve this. This is for you and we are going to make sure you get it.” I think that experience is what made me feel more honest again.

Your Thoughts
What questions do you have for me about my and others’ experiences discussing PrEP with HCPs? Share your questions or reflections in the comments. I hope to respond to questions and continue the conversation about how HCPs can make PrEP discussions feel safer, more respectful, and more supportive.

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