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Case #25

If I Can't Talk To You About This, Who Can I Talk To?


For the LGBTQ+ community, marginalization is deterring some from accessing medical care. Nearly one in five avoid seeking care due to fear of discrimination, and studies show disparities can lead to poor health outcomes. For one gay man in Northern Nevada, navigating the health system has been a daunting experience. Two years ago he had gone out with a male acquaintance, who wanted to have sex at the end of the night. Robert refused several times. “And then he just did it anyways. That’s really what happened,” Robert explained. “There was no dramatic, like, violence involved. But it was interesting just because I have always read about things in terms of people freezing or not fighting back when these things are happening. And I was like, ‘Oh, that’s ridiculous.’ ”

But he did freeze and was raped. Robert managed to get away after the attack. “So, I went back to my car, and then that was when I immediately went to the ER though ‘cause it was dark," Robert said, "and I didn’t quite see if the sex was protected at all.” Robert was scared and decided against pressing charges, but he was worried about possible STD infections, especially HIV, since he has friends in the gay community battling it. That’s why he sought immediate medical attention at Northern Nevada Medical Center. “I had known about post-exposure prophylaxis, or PEP,” Robert said. “And that was what I was hoping to seek out immediately after that had happened.” During his ER visit, Robert says he asked for the HIV prophylaxis, and had to insist, which prompted the doctor to call a national hotline. “She did finally call the PEP Hotline and they told her that, ‘Yes, it is definitely a high-risk exposure,’” Robert said. Some of the questions that came up in the ER were based on assumptions about him because of his sexual orientation. “They tested me for many other STDs and the implication the whole time was that one of them was going to come back positive,” Robert explained. " ‘It’s very likely that you have an STD based on what you’re telling us.’ 'I didn’t tell you anything except the fact that I’m gay, and that I was sexually assaulted, and that I’m sexually active.' ” Since PEP is a 28-day regimen, Robert needed to schedule a follow-up with another primary care doctor. “I remember the first thing that she said to me was, 'Well, don’t put yourself in situations where this is going to happen again,' ” Robert said. “I was like, 'How could you even say that?' I thought that we had moved past that sort of thing, like, 'Well, what was she wearing when this happened?' or anything like that.” This experience, he said, further alienated him from the medical community.

*Original Story - https://www.kunr.org/post/lgbtq-health-care-struggles-one-mans-story#stream/0