Recently I had the chance to chat with Brentton Lowery, a Physician Assistant on the Nurx medical team who has a particular focus on HIV prevention and sexual health. As a college student still figuring out what my career path should be, I’m always really curious about how people discovered their callings. Brentton shared that and more. Read on to learn his very personal reasons for pursuing HIV prevention and his hopes for the future of LGBTQ+ healthcare.
Why did you get involved in the world of HIV prevention and sexual health?
My mom was an emergency room nurse, so when I was younger I always thought that I would want to work in the ER. At the end of my freshman year, however, my half-brother died from HIV complications. He was someone who I grew up and spent summers with, and he was only 22 at the time of his death. This is what drove me into a career focusing on both HIV prevention and sexual health, because you can’t separate one from the other. HIV and sexual health not only affected me, but I realized that it affected so many others, as well. During college, I had no idea about this — I was not the generation that saw the intense impacts of HIV. In 2010, when my half-brother lost his life, I knew I had to get involved in this world, so I could help educate people on how to protect themselves to prevent HIV infection.
When did you decide to really make that career decision?
When I was getting more in touch with who I was not only as a gay male but as a gay provider, I realized that the LGBTQ+ community brushes many important topics under the rug, especially crucial ideas surrounding sexual health. But, it is pivotal that sexual health is on the forefront of issues not only within the LGBTQ+ community but with every human being. It is fundamentally who we are — we are sexual creatures — so to deny that is to deny so much of who we are as people.
With each of my patients, I try to make sex something we talk about and something that we do not feel shame about. Sex is natural, and we have to be more willing to talk openly about it. This is the only way we are going to move forward with changing what’s going on right now with a rise in new HIV infections.
What do you think needs to change, and what is your hope for the future of LGBTQ+ health?
Most sex education that youth receive is extremely basic and usually does not go into much detail. There are people in the LGBTQ+ community who come out of the closet during high school and do not really even know what gay sex actually is outside of what their friends have told them or what they see on social media. This crucial learning is not happening where it should be: at home and in school. From a political standpoint, in many places, this is beginning to change. Many communities want to get better at implementing progressive and comprehensive sex education within their schools.
As a medical provider, I try and educate my patients on things that are important to keep in mind when practicing safe sex. As a whole, however, the entire medical community must be more open to facilitating positive conversations about sex with patients from all different backgrounds. If we are just treating a patient based on their normative image — as just a straight male or female, for example — then we are missing so much of their health and are not giving them the best care that we can provide.
And the most important thing about LGBTQ+ health is that you need to treat the person as an individual. At the end of the day, just like with any other patient we see, members of the LGBTQ+ community want to be seen and they want to be heard. If you do not see, recognize, or hear them, you are going to miss the mark every time because they will not feel safe disclosing personal information with you. Especially now, we need to be better at listening to people and offering them a safe space.
What is the biggest thing missing in LGBTQ+ health right now?
Even as our society continues to move forward and get more advanced, too many people still do not know that there is a daily medication to stop HIV infection. There is still so much work to be done at getting the word out about PrEP. The more people who know about the medication and share that information with their community the better. We need people to know that PrEP is for anyone sexually active and not just for the gay community. For too long it has been a drug targeted to the gay community, which leaves out all the other people who this medication would be great for. Any college student, for example, who may be in that experimental sexual stage in finding out what they like and do not like, should consider getting on PrEP, so they can ensure that they do not contract an infection that will last for life.
In a time when cities across the country, including my city Philadelphia, are seeing a spike in HIV infection rates, what are the best ways to combat this?
One of the ways to make PrEP more accessible is to have a company, like Nurx, come in and offer a safe space to obtain a prescription. Most medical providers do not practice LGBTQ+ health, so if you were to go into their office and say “I want PrEP,” many providers will not even know what you are talking about. You also may have a more conservative provider who does not believe in LGBTQ+ sex and health. In some instances, you can’t change everything at once, like trying to make every medical provider more open and understanding, but we can help by offering a service like Nurx, which can help people get this medication from the comfort of their home. This already is taking away a lot of barriers that people face.
What is the biggest misconception with LGBTQ+ sexual health?
We live in an era where HIV is on the rise, but we also see a huge spike in STIs. I do not believe that enough people are educated on sexually transmitted infections. There are common misconceptions in the general public, not just LGBTQ+ people, about how STIs spread and who gets them.
How often do you suggest getting tested?
Once every three months is ideal. Keep in mind, if you have a monogamous trusted partner, you may not have to get tested as frequently. I just believe that every single person should get tested at least once a year, and if you are able to get tested more frequently with your insurance plan then definitely every three months.
What is your hope for the future of HIV prevention?
HIV can be eradicated. It can happen! There are many steps that we need to take to continue making that happen, though. First, anyone that is positive for HIV needs to be on treatment. That goes back to U=U, undetectable means untransmittable. If I can get someone who has HIV on treatment, then they will no longer be able to transmit the virus to anyone else. The other pillar that we need to focus on is prevention: everyone who tests negative for HIV should take preventative measures, like taking PrEP, so that they are no longer at risk of contracting HIV. The two hand-in-hand will get us to where we want to be, so we can finally halt all new HIV infections. But, this all goes back to how each of us needs to begin getting comfortable with talking about sex. Until we are okay as a nation to openly talk about it, these issues of STIs and HIV infection will persist. I think we can achieve an HIV-free world, but I think we have a long way to go.
If you could go back in time and tell your college self one thing, now that you have all this expertise with LGBTQ+ sexual health, what would you say?
If you are experimenting and finding out what is right for you, you are more likely to have risky sexual behavior than protected sexual behavior. So, if I could tell my college-self anything, it would be to protect and take care of yourself and know that you are growing. I feel that young people struggle to negotiate safe sex, so I would also tell myself to make sure I am negotiating safe sex.
What is your hope for the future of healthcare & telehealth, especially in a post-COVID world?
As we move forward, we see that telehealth has opened the door for greater accessibility of healthcare from the safety of patients’ homes and their comfort zones. When I take my dogs to the vet, they immediately know where they are going and get instant anxiety. And, I believe this happens with humans, too! When many people go into the doctor’s office, they instantly have this unknown anxiety of being in this intense clinic atmosphere. I believe that telehealth allows that anxiety to fade away because you are doing it at home. It is on your time in your space, so in many ways it allows us to be more open with ourselves and our medical providers.
Nurx allows the patient to work on their time. There is no rush, like in the doctor’s office where you have 30 minutes to tell the doctor everything. With Nurx, it’s “let’s talk today and if you have any more questions let’s talk tomorrow.” If you forget to ask a question during your appointment, no big deal, just message me at any time and we can get that figured out for you. Nurx gives the patient the power over their own healthcare and, at the end of the day, I think each of us wants to have power over our own healthcare.
About the Author
David Garnick is from the Philadelphia area and is a rising sophomore planning to double major in political science and urban studies at the University of Pennsylvania, where he is also a representative on the Undergraduate Assembly and a member of its task force to promote PrEP on campus.
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