Raising Awareness About HIV, STIs, PrEP, and PEP: Breaking Barriers and Building Healthier Communities

Sexual health remains a critical yet often overlooked aspect of public health. Despite advancements in medical science, misinformation, stigma, and systemic healthcare barriers continue to hinder access to life-saving prevention options, particularly in underserved communities. RND Associates, leading a collaborative of university and community-based organizations, is working to address these challenges through the “Promoting Healthy Relationships and Sexual Health” initiative, supported by the Baltimore City Health Department’s HIV/STI Prevention Program through a CDC grant.

This campaign aims to increase awareness of HIV disparities, dismantle barriers to sexual health, and promote prevention strategies like PrEP (pre-exposure prophylaxis) and PEP (post-exposure prophylaxis). Through compelling stories and expert insights, the initiative fosters a culture of health literacy and empowerment.

Understanding PrEP and PEP

PrEP (Pre-Exposure Prophylaxis) is a prescription pill taken daily or as a twice-a-year injectable to reduce the risk of contracting HIV. It provides effective prevention for individuals who are at high risk of exposure to the virus.

PEP (Post-Exposure Prophylaxis) is a prescription pill used to reduce the risk of HIV immediately within 72 hours after unplanned sexual interactions or in cases of sexual assault. PEP must be started as soon as possible after the exposure to be most effective.

The Urgency of Awareness: Insights from Experts and Community Voices

Brenice Duroseau, MSN, FNP-C, RNC-OB, AAHIVS

Pronouns: She/Her
PhD Candidate
NIH NIMH, NEF, NLN & ISSWSH Scholar
Infectious Diseases & Addiction Medicine Nurse Practitioner
Johns Hopkins School of Nursing

Brenice Duroseau has dedicated her career to dismantling health disparities and increasing access to HIV prevention tools. Her work highlights the importance of culturally responsive and equitable care.

What motivated you to become an advocate in sexual health, specifically regarding HIV prevention and PrEP/PEP education?

“My motivation is deeply personal and professional,” shares Duroseau. “As a Black Haitian-American woman, I’ve witnessed firsthand how structural, social, and political determinants of health undermine HIV prevention efforts. Growing up, I heard the stigma Haitians experienced during the early days of HIV, being unfairly blamed and labeled. These experiences, combined with my work as a clinician at a Ryan White Clinic, drove me to pursue a PhD to address sexual and reproductive health disparities.”

Her experiences reveal the deep-rooted challenges many face when accessing healthcare, particularly for marginalized groups. This passion has fueled her commitment to increasing PrEP awareness and developing interventions that prioritize the needs of the most vulnerable.

Uncovering Barriers and Strategies

Rebkha Atnafou, Founder, Founder, RND Associates, is leading efforts to advance sexual health in Baltimore.

“What we are trying to uncover through these interviews with diverse people representing physicians, advocates, and PrEP users from the LGBTQI and straight community are the barriers to knowledge, healthcare, and stigma on PrEP, as well as promising strategies to dismantle these barriers,” said Atnafou.

Personal Testimonies on PrEP

Miss X, Baltimore (Heterosexual Female, PrEP User)

What inspired you to start taking PrEP, and how has it impacted your life?
“I talked to Keith, who is like my brother. I asked if he knew some of the trans women I found in my (now ex-) boyfriend’s phone. He didn’t answer my questions, but he talked to me about PrEP to stay safe, which I had never heard of before. No one knew I was taking PrEP because I didn’t think it was anyone’s business. I didn’t want questions or judgment. I took it with my vitamins and didn’t experience any side effects.”

Do you share being on PrEP with a partner, and if so, how do you discuss it?
“We broke up, so it wasn’t something to share. I no longer have contact with him. My current boyfriend and I do not have a need for PrEP anymore, and we never talked about it. My last relationship was a dark period—I lost weight, went through depression, etc. I just didn’t and still don’t understand why he lied so much.”

What challenges, if any, did you face when accessing or deciding to take PrEP?
“My doctor didn’t know much, so we kind of learned together. She never offered PrEP to me until I asked.”

What advice would you give to others considering PrEP as a prevention option?
“I wasn’t sure what it was, so I googled it. There’s not much information on straight people and PrEP. None of my friends knew about it. I’m a young professional, so I think PrEP would be looked down upon in certain circles because what I did find online made it sound like it’s for people with multiple sex partners—which I didn’t have. I had one man, but my one man had more than one woman.”

Brit M. Williams, Ph.D. (She/Hers)

Assistant Professor of Higher Education and Student Affairs Administration

How did you hear about PrEP?

“Through a friend (MSM). I talked about dating around and ending up on dates with people who disclosed their status to me. He said, ‘You should get on PrEP,’ so I pursued that avenue.”

What inspired you to take PrEP, and how has it impacted your life?

“Dating multiple people living and thriving with HIV. I never wanted to let something like HIV get in the way of me finding love. So PrEP has positively influenced my life because I can date with fewer worries, and more importantly, I can have high-quality sex with fewer worries. PrEP makes it possible for me to have my best sex life.”

What challenges, if any, did you face when accessing or deciding to take PrEP?

“Negative medical provider attitudes. My first provider (GYN) said they wouldn’t provide it for me. Then the next provider I saw asked me, ‘Are you a sex worker?’ which feels very something (derogatory). And while I believe that sex work is work, I’m not one. I know women being asked that question would deter them from PrEP. Luckily, I’m hardheaded and strong-willed.”

What advice would you give to others considering PrEP as a prevention option?

“Just try it. Worst case scenario is you try it and don’t like it. Best case is you do and you love it. You can find low or no-cost ways to access it, and it’s an easy way to add another thing into your toolkit.”

Hakeem “Camrym” Benson, LGBTQI Member, PrEP User, Baltimore Resident, and Father

Hakeem “Camrym” Benson, a PrEP user and father from Baltimore, shares his positive experience with PrEP and his approach to raising awareness about sexual health. Hakeem works at a local non-profit organization that conducts HIV testing five days a week. On Tuesdays and Thursdays, an outside clinic partners with them to provide additional resources. The organization is also closely affiliated with the University of Maryland, further expanding its reach and resources.

“I’ve had a positive experience with PrEP, and I’m comfortable talking about it with anyone—whether they’re LGBTQI or heterosexual,” says Hakeem. “When I have conversations about PrEP, I show people the statistics for our city and how unprotected sex without a backup prevention tool can harm them in the long run. It’s all about ensuring people understand that taking control of their health and safety is crucial.”

He continues, “I talk to everyone, whether it’s a stranger, a friend, or someone in my community. It’s about education and empowerment. I bring up my work at the non-profit and the services we provide in a way that doesn’t make anyone feel uncomfortable. If someone asks me more, I tell them about the testing opportunities and how we’re partnered with the University of Maryland. But I keep it intimate, focusing on the conversation at hand to respect their privacy and comfort.”

Hakeem also shares how the recent PrEP injection options have simplified the process for him. “It’s so much easier now with the injectable form of PrEP. You only need two shots a year, as opposed to taking a daily pill with food. This has made a big difference in terms of convenience and peace of mind for me.”

Insights from a PrEP Advocate

Ashley Cobb (@sexwithashley on Instagram) is a PrEP champion, advocate, sexologist, author, and influencer. She shared her experience with PrEP and its importance in sexual health awareness.

How did you hear about PrEP?
“I heard about PrEP because I work in HIV. I work at an HIV non-profit here in Atlanta as a program coordinator. So I heard about PrEP through my job.”

What inspired you to take PrEP?
“I wanted to take PrEP when I realized that PrEP was actually for women. I thought it was a good thing to take because I talk about sex and sexual health, and it’s easier for me to talk about something that I’m on. I wanted to be the guinea pig and lead by example.”

What challenges did you have, if any, in accessing or deciding to take PrEP?
“I didn’t really have any challenges. Again, I work in HIV, so I got PrEP pretty easily. I know that’s not everyone’s story, but because of where I work, I don’t have any issues getting PrEP.”

What advice would you give to someone considering PrEP as an option?

• Do your own research.
• There are various types of PrEP available.
• Being monogamous is not a prevention method.
• PrEP puts you in control of your own sexual health.
• Just do your research and talk to a doctor.

Addressing Misconceptions

A significant barrier to PrEP uptake is misinformation. “A persistent misconception is that PrEP is only for men who have sex with men (MSM),” says Duroseau. “In reality, PrEP is a powerful tool for anyone vulnerable to HIV, including Black women, who have often been overlooked in outreach efforts.”

Another misconception is the belief that PrEP negates the need for other preventive measures like condoms or STI screenings. Duroseau emphasizes that a combination approach offers the most comprehensive protection.

As for PEP, she notes that awareness is still shockingly low. “Many people, including clinicians, don’t realize that PEP must be started within 72 hours of potential HIV exposure. This lack of awareness leads to missed opportunities for prevention, particularly in communities with limited healthcare access.”

A Call to Action

Ending the HIV epidemic and promoting comprehensive sexual health requires collective effort. Communities, healthcare providers, and policymakers must come together to break down barriers and ensure equitable access to prevention tools.

“It’s not just about making medication available,” Duroseau reminds us. “It’s about creating a system that prioritizes the needs of underserved communities and ensures that prevention efforts are truly inclusive and comprehensive.”

Stay tuned for more insightful articles and content as RND Associates and its collaborators continue their mission to transform lives and promote health equity through the “Promoting Healthy Relationships and Sexual Health” initiative.