How to talk to a young trans person about PrEP
Natale, a 19-year-old trans woman, comes to a clinic because she’s had unprotected sex with her new boyfriend and she thinks he might have HIV.
How not to do it
The receptionist tells Michael, the on-duty nurse, that she has been calling for the next patient Akello to come forward but no-one has. Michael notices Natale coming towards them with an embarrassed look on her face. “So you are Akello?” he says. She nods. “Follow me,” says Michael.
He takes Natale to a side room does not shut the door. “So Akello, what is the reason for your visit?” Michael asks. When Natale explains, Michael shakes his head. “Do your parents know what their son is up to?” he asks. Natale says she is not in touch with her mother anymore and does not live at home. Michael asks Natale what ‘he’ is doing to make a living, then asks: “Are the men you have sex with paying you? What you are doing is dangerous and it could land you in jail. Is this really the life you want for yourself?” He tells Natale that ‘he’ must take an HIV test.
After speaking to the receptionist, Michael notices Natale coming towards them with an embarrassed look on her face. “Are you my next patient? The one we have been calling for?” he asks. Natale nods. “Follow me,” says Michael.
He takes Natale to a side room and closes the door. Michael says: “Before we begin, can I ask what your name is?” Natale tells him her name then Michael asks if Natale would like to be addressed “as a she”. Natale says yes. Michael asks why Natale has come and she explains. Michael tells her that whatever they speak about is between them.
Michael asks Natale if she has been feeling ill recently and to describe any symptoms she might have. Natale says she has been feeling fine but she is worried about HIV as she suspects her new boyfriend is unfaithful. Michael suggests Natale has an HIV test and also tests for some STIs as well. He explains that condoms and lubricant are important to use for anal sex as they protect against both HIV and STIs. He asks her how she feels about speaking to her boyfriend about having safer sex. Natale says she is not sure about this. So Michael talks to her about PrEP. He asks if she might be interested in trying it if her HIV test comes back negative.
