Story No. 260: Dr. Gale from New York

I practice in a school based health center in an area of Buffalo, New York with high poverty, high sexually transmitted infection rates, and high unintended pregnancy rates. Many students struggle academically and seem distracted by stress at home.

I have one patient who stands out. Sam* is a 17-year-old male student who came out to us that he has sex with other men. He frequented the clinic for sexual health and mental health concerns and had multiple STIs. His mom was not supportive of him. We encouraged him to go to a clinic that offers PrEP (pre-exposure prophylaxis), a way for those at very high risk for HIV to lower the chances of infection. But Sam said, “My mom won’t help with that part of my life. I am alone with this.”

One day, my Nurse Practitioner reported that Sam was admitted to the Pediatric Intensive Care Unit (PICU) and they did not know what caused his illness. I called the PICU and asked if they ordered an HIV test and that if it was negative, to order another more sensitive test. The HIV test was negative, but no follow up test was done. Sam eventually recovered and returned to the clinic where we tested him for HIV. He was positive. If Sam had access to PrEP or if the PICU had performed a more thorough HIV evaluation, Sam may have escaped this fate. We need to increase legal access to PrEP for all youth at risk. The law should not be a barrier to health.

*Name changed for privacy