I sat in my medical provider’s office on April 29th, exasperated. I had called in advance about the purpose of my appointment. In about a month I was traveling to Senegal with品酒制造商非洲, a Black woman-owned travel company to celebrate one of my friend’s life achievements and to meet someone I’d been talking to online for years. It had turned romantic in the last year and I knew that I wanted to have sex after a year and a half hiatus. I’m over forty, we love each other, have the mutual desire to conceive and know my biological clock is ticking. I knew that we’d likely have unprotected sex and I wanted some assurances. I inquired with my provider about Pre-Exposure Prophylaxis (PrEP), the medication that prevents contracting艾滋病病毒。我从中读了疾病控制网站的中心that “these medicines can work to keep the virus from establishing a permanent infection in populations at high risk by up to 92%” and that I needed to take it for a minimum of 20 days to be effective. I knew that people in my demographic (assigned as Black women) at birth are one of the最快的种植群体新的艾滋病毒感染为“more than 90% of women diagnosed with HIV in 2016 were Black and Latina. But surveys show only 21% of sexually active Black and Latina women know about PrEP, compared to 85% of gay and bisexual men.” Our providers need to know this and support us in getting the care we need.
我过去的合作伙伴和我最后一次看到这位护士从业人员一年前见到了我们的积极妊娠试验。在他与另一个女人度过圣诞节之后，六年的关系急剧和悲惨地陷入困境，而我自己在急诊室里的怀孕。他告诉我，他和他的母亲一起度假，我会休息一周的工作，并在前一个月内通过开放的心脏手术，并在前一月内完成。我后来吸取了他和他在一起的女人还his girlfriend on and off of nearly twenty years. We had all gone to the same college. I thought she was an ex. The miscarriage was the last straw for me after six years of confusion and emotional abuse, the sum of which landed me in twelve weeks of inpatient and outpatient trauma rehab. I explained to my provider that his level of disregard for me left me unable to ever trust mutual monogamy again, no matter how much I love someone or believe that they love me. She nodded sympathetically and said, “That’s completely understandable. The doctor and I take a conservative approach to PrEP. It’s not for you.”
I just want to thank#blackwomentwitterfor teaching me that when I go to the Dr. & request testing or medication & they say no, ask them to document refusal in the chart. I just tried it & IT WORKED. Provider came back & said, “I’ve reconsidered” you know your body/life best.
— yamani yansà hernandez (@yamaniyansa)April 29, 2019
I was surprised to hear this from my provider and asked to know more. I said, “Really? There’s a whole public health campaign in New York City for straight Black women to take PrEP.” She didn’t seem to know anything about it and replied, “PrEP is not for straight women.” I was flustered. I remembered that I had seen someone write on Twitter regarding theBlack maternal mortality crisis在拒绝医学或治疗时要求医疗提供者记录。我说，“你否认我的药物？”她说是。”我说，“你能在我的图表中记录吗？”她说，“是的，但它会带我一分钟写下笔记。”我说，“我会等。你对我的性行为做出了假设。我一直在这里近十年。我不是直的。性和性别不确定我的景点。“ She replied, “So you would have sex with a woman?” I said, “I have, and would have sex with a person of any gender I choose.” She apologized and left the room. When she returned she said, “You’ve made me reconsider. I didn’t mean to disregard your sexuality and I will write the prescription.” While I waited for her to write it, I sent my friend a text and wrote a Tweet that would go viral before talking over the pros and cons of the medication.
单独的处方并不意味着我得到了药物。我最后一次跳过：付款。以“好保险”the co-pay cost of PrEP was $1K。我打电话给我的保险公司，因为我确信它是某种错误。他们告诉我，它没有错误，但制造商有一个co-pay assistance program每年支付高达7万美元的药物，它适用于保险免赔额。我能够在他们的网站上下载此优惠券，并在没有任何个人成本的情况下获得药物。我通过这一集学习，几乎每种药品制造商都有类似的共同支付援助计划，没有人应该难以支付药物。
I ran a youth性健康education and advocacy organization for four years. I know the stigma about sex and sexuality begins nearly at birth. There is not adequate sex education and it is hard for many people to talk about sex, what they like, what they do, what they need. I have tried to cultivate a space for honesty in my relationships because I would much rather have conversations about what is really going on and have choice and negotiation in it rather than be an unknowing and unwilling victim of lies and non-consensual exposure. I know people who are HIV positive and living a healthy life with the advances in medication and that I can be one of those people if I were ever to become HIV positive. In the meantime, I feel really good about being on PrEP. It gives me some sense of control over my health.
As we have done for generations, Black women taught me how to get what I need.