I’m a bisexual Latino, 23M, who is pretty sexually active and has been getting tested every 3 months as a precaution since I started college. However, the clinic I go to is about 35-40 minutes from my house, so I thought, why not start getting tested with my PCP (a 10-minute drive from my home)? I practice safe sex, but there has been an increase in HIV cases in my city, and I would like to start taking PrEP as another preventative step.

During my physical a few weeks ago with my PCP, I brought up wanting to get tested and start PrEP, and my provider seemed almost offended by my request. Their entire demeanor changed, and I could tell they were put off by it. They responded with “What is PrEP?” and said that if I’m sexually active and requesting testing, I should be seeing an infectious disease provider. If it’s completely necessary, I wouldn’t mind, but again, it’s about a 35-minute drive, and I would prefer the convenience of just going to my PCP. From my understanding, PCPs are capable of testing for STDs and prescribing PrEP is within their scope.

I want to get a provider's (especially a primary care provider's) opinion on this. Do you routinely test for STDs and prescribe PrEP to patients who request it? Or would you feel more comfortable referring the patient to an infectious disease specialist? If that’s the case, I’m completely fine with it and open to going, but I just want to see what you are doing when you encounter these cases.