“You wear a seatbelt not because you expect to crash, but because you want to be protected if something happens. PrEP is the same.”
Dr. Kara Chaudhary, an internal medicine physician at Intermountain Health’s LDS Hospital, specializes in LGBTQIA+ affirming care. She often uses this analogy when talking about PrEP: HIV prevention shouldn’t be controversial – it should be routine. Yet for far too many people, it’s still not.
Even though PrEP (pre-exposure prophylaxis) has been around for over a decade and can reduce the risk of getting HIV through sex by up to 99%, it’s still underused, misunderstood, and for some, totally unknown. Why? One word: stigma.
Protecting your health shouldn’t come with shame
PrEP is a preventive medication that helps people take control of their sexual health, just like birth control or vaccines. But despite how simple and effective it is, many people still hesitate to ask about it.
They're afraid of what it might say about them, how they’ll be judged, or what a provider might assume. That silence is harmful. It costs us real opportunities to prevent HIV – and leaves too many people unprotected when they don’t have to be.
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Let’s start with what PrEP is and who it’s for
PrEP is a daily pill (and now, also available as a bi-monthly injection) that helps prevent HIV before you’re exposed to it.
And you don’t need to check a specific set of boxes to be eligible. “PrEP is not just for gay men or people who inject drugs,” Dr. Chaudhary explains. “It’s for anyone who wants to stay safe.”
That includes people in monogamous relationships, people who are dating, and people who don’t consider themselves at high risk – but still want to protect their health. It can also include people who:
- Have sex with partners whose HIV status is unknown or positive
- Don’t consistently use condoms
- Have had a recent STI (which can raise HIV risk)
- Share needles or injection equipment
- Live in or belong to communities with higher rates of HIV
Or simply – anyone who wants to feel more in control of their sexual health, no matter what their situation looks like.
Why aren’t more people using it?
Some patients feel shame or fear about asking for PrEP. Others have been judged or dismissed by previous healthcare providers. And in many cases, people simply don’t know PrEP exists.
“I’ve had patients come in and say their doctor told them to just ‘be abstinent,’” Dr. Chaudhary shares.
One group especially overlooked: straight women. In Utah, 84% of women diagnosed with HIV got it through heterosexual contact. Yet most of them were never told about PrEP or offered it as an option.
Lack of awareness is the biggest barrier
Dr. Chaudhary shared that many providers skip taking a full sexual health history during routine visits – often because it’s still seen as awkward or uncomfortable. “So many people don’t ask about sexual health because it’s so stigmatized in our country that people would rather skip over it,” she explained.
She also noted that in many schools, especially in states like Utah, sex ed tends to focus on abstinence and often leaves out HIV prevention entirely.
“The biggest support we can offer is education and awareness,” she says. “If you don’t even know PrEP exists, how can you ask for it?”
When care is affirming, everything changes
At Intermountain Health, the LGBTQIA+ care team is working to change that.
Dr. Chaudhary provides gender-affirming hormone therapy, HIV prevention services, and primary care that welcomes the full identities and experiences of her patients.
And when patients feel seen and safe, they’re more likely to engage in other parts of their health too: like vaccines, screenings, and chronic care.
“Patients are more likely to stay on top of their health when they feel safe being themselves in a clinic,” she says.
Getting on PrEP at Intermountain Health is simple
To make PrEP access even easier, Intermountain Health launched an on-demand service for patients older than 18 in Utah and Idaho:
- Complete an online health form
- Talk to a pharmacist by phone
- Get your prescription shipped to your door
There’s no provider appointment needed, and the service costs $49 plus the cost of medication and lab work. It’s FSA/HSA eligible and available to anyone 18 and older.
“We wanted to remove as many barriers as possible,” Dr. Chaudhary says. “So, people could get the care and medications they need without feeling ashamed.”
And what about PEP?
PEP stands for post-exposure prophylaxis. It’s emergency HIV prevention for when you may have already been exposed – like after unprotected sex, sexual assault, or sharing needles. It must be started within 72 hours, and the sooner, the better.
PEP is a 28-day course of medication. When taken correctly, it’s highly effective. If you think you might need it, don’t wait. Go to urgent care, the ER, or contact your provider right away.
Progress is picking up, in science and in conversation
Dr. Chaudhary is optimistic. New forms of PrEP are on the way, including a once-a-year injection. Younger generations are asking better questions with less shame. And more healthcare providers are learning how to talk about HIV prevention with openness and respect.
“HIV is a completely preventable disease,” she says. “With education and access, we can eliminate it for future generations.”
Let’s break the stigma together
It starts with talking. With asking. With making sure no one feels ashamed for wanting to stay safe.
At Intermountain Health, you’ll find affirming care, providers who listen, and easy access to PrEP through our on-demand program. Learn more about our LGBTQ+ services and PrEP options today.