Discussing pre-exposure prophylaxis (PrEP) easily and openly with someone while maintaining confidentiality is the first way you can help. Informing them about PrEP, and how it may be of use for them, will help build information and knowledge levels about PrEP in the communities that could benefit from it.
You should include PrEP in discussions about:
- Emergency contraception.
- Sexually transmitted infection (STI) diagnosis and treatment.
- C-Card discussions and condom supply.
- Contraception and pregnancy.
- Substance use.
- In-need reviews around homelessness and economic stress.
- Sex work.
Any interaction around a person’s sexual health and wellbeing needs, whether an enquiry, discussion or a treatment is a chance to discuss PrEP and refer people onto both sources of further information and sexual health services.
Understanding people’s concerns
People may be concerned about using PrEP and what they feel it may say about them. We have seen from the PrEP Protects campaign that many people link the usage of PrEP to a promiscuous sex life and sex work.
It’s important that we all recognise the concerns and barriers that a person may face without becoming a barrier ourselves. It’s a good start to recognise and understand your own attitudes about PrEP. Some of these concerns include:
- Do you wonder why people don’t ‘just use condoms’?
- How do you feel about unmarried people having multiple sexual partners?
- What if someone you are talking with comes out as gay or bisexual, trans or non-binary, and asks about PrEP?
- What if you are talking with someone you know is a married woman and they ask you about PrEP?
- Is it okay for men to have more than one sexual partner at a time, but women should be ‘faithful’ to one person?
It’s very important that we recognise and challenge our own thoughts, feelings and attitudes that could prove to be a barrier to a tool that stops the onward transmission of HIV.
It may help to consider the following four areas when thinking about our feelings and attitudes around issues:
Awareness
Examining our own values and beliefs in order to recognise any deep-seated prejudices and stereotypes that can create barriers for the people trying to access information and services through us.
Many of us have ‘blind spots’ in our understanding of other people and their lives and experiences, and how they fit with our own beliefs and values. It’s important that we do not negatively impact on the people for whom we are providing services.
Attitude
Our values and beliefs can impact upon the effectiveness of our work and often show the extent to which we are open to differing views, opinions, experiences and choices.
The stronger and deeper rooted our beliefs and values are, the more likely we are to react emotionally when they are challenged. Having our own beliefs and values is not wrong; it’s when they impact negatively on other people that they become problematic.
Knowledge
The more knowledge we have of people from different backgrounds, cultures and life experiences to us the more likely we are to be open to them and avoid mistakes when we are working with them.
Remaining aware of how culture impacts upon our personal interactions, our problem-solving skills and our ability to ask for and offer help will help us remain mindful during all our interactions with other people.
Skills
Someone can have the right attitude, considerable self-awareness and a lot of knowledge around cultural differences, but still not have developed the skills to work effectively across these differences in their interactions. If we haven’t had the chance to learn these skills or to practise them, attitudes and knowledge will not be enough to avoid potential difficulties that may arise in our interactions.
Using the daily interactions with your customers and considering your past relationships with customers will help you to highlight how your knowledge, awareness, attitudes and skills have impacted, and continue to impact, on those interactions.
Some questions that may be useful to consider are:
- How does your service monitor that people are able to ask for and receive what they required?
- How easy is it in your service for people to ask to speak with you or the service lead?
- How do your colleagues interact with the people that use your service? Have you ever felt uncomfortable with how people have experienced your service?
- How easy is it for people to have a confidential talk with you in your workspace and receive support, information and good service?
- Could your own beliefs and attitudes, or those of your colleagues, be preventing people from accessing services and feeling able to ask for information or help on potentially difficult to discuss subjects and issues?
- How easy is it to have confidential discussions with people who use your service in the space/s you work in?
Answering someone’s questions
Hopefully the information contained here and the knowledge skills and experience you have already gained will equip you to answer the majority of questions anyone who is a potential user of PrEP will have.
There are online resources you can signpost someone who would like more information about PrEP to, provided in a range of languages alongside English.
Being open, and giving clear, precise answers to people’s questions is the best way for them to feel heard and not judged for those questions. We’re trying to increase knowledge about and uptake of PrEP, so helping to remove any potential barriers to that aim is important. Think of how you would want to be treated if you were someone asking for information or a service, and use that knowledge to help inform your interactions.
Referring people onto sexual health services
One of the main aims is to increase access to PrEP for currently underserved communities, so referring people onto sexual health services so they can access PrEP is a large part of that. It’s likely that you will have experience of referring or signposting people onto other services. It’s also likely that many of the people you will be talking about PrEP with are aware of some of the local sexual health services available to them.
It could be that someone may be apprehensive about accessing the local sexual health service for fear of being seen by a family member or friend and having to answer questions they may find difficult. Many people access services outside of their local area for a number of reasons and we have to remain as supportive of those choices whilst still encouraging those that would benefit from PrEP to consider accessing it, at whichever clinic they feel most comfortable using.
If you’re talking with someone who does not want to access local services you can refer them onto the online information provided on Prepster or Better2Know so they can find a clinic they feel more comfortable using and that may suit their needs better than the local service.
PrEP is available at sexual health clinics across the UK. Before PrEP became available via the NHS many people brought their own supplies online via trusted sources. Now that PrEP is available on prescription via local and national clinics, this knowledge helps us encourage people to find out more about it, use it, and bring HIV transmission down to zero by 2030.
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