Count on Us: Your Questions Answered

Latinos Salud’s healthcare providers answer some of the community’s most pressing concerns. This month, Latinos Salud’s provider in its Miami SW location, Daikel Martinez, DNP, APRN, shares the real-world challenges some patients may face staying on their PrEP to prevent HIV.

OutClique: We’d like to talk about the real stories behind PrEP use. Can you share a case that really stayed with you?

Daikel Martinez, DNP: One recent story stands out, about a patient in his early 30s who came in very motivated to start PrEP. He was in a stable relationship but also very aware of the risks and wanted to protect himself.

OutClique: How did his experience with PrEP go at first?

Daikel Martinez, DNP: At the beginning, it went really well. He showed up to his appointments, got his labs done, and took his medication every day. He was very committed. But over time, life started to get more complicated. He worked rotating shifts, was the primary caregiver for his sick mother, and his partner began to express jealousy and mistrust about him being on PrEP.

OutClique: How did all of that affect his ability to stay on PrEP?

Daikel Martinez, DNP: He started missing appointments, forgetting doses. When we spoke, he told me he was overwhelmed and didn’t have the mental space for everything. Even though he knew how important it was to stay on PrEP, it started to slip through the cracks.

OutClique: What happened next?

Daikel Martinez, DNP: A few months later, he came back to the clinic. He had experienced a potential HIV exposure. Thankfully, we were able to act quickly with emergency protocols, but it was a very difficult moment for him. He was shaken—not just afraid, but also disappointed in himself. I reminded him of something I always say: this isn’t about failure. It’s about learning and knowing when to ask for help.

OutClique: What did you learn from that experience, as a provider?

Daikel Martinez, DNP: That adherence isn’t just about motivation or discipline. Every patient has a full life behind them—pressure, emotions, responsibilities, fears. If we don’t take that into account, we’re not offering true care. I always try to ask more than just, “Are you taking your meds?” I ask how they’re doing, what’s going on in their life, what’s making it harder or easier to stay on track.

OutClique: What options do your patients have to overcome these real-world barriers to consistent PrEP for protection?

Daikel Martinez, DNP: There are several options, and it starts with understanding that everyone’s life circumstances are different. For some, taking a daily pill is simple and manageable. For others, it’s a challenge due to work schedules, housing instability, or mental health concerns. That’s why we educate our patients on all available PrEP options, including the long-acting injectable option that replaces daily pills. This has been a game-changer for individuals who prefer fewer medical visits or struggle with daily adherence. We also make sure patients are aware of assistance programs to cover medication costs, and we collaborate with community organizations to address issues like transportation, stigma, and access to care.

OutClique: Stigma is often a barrier—how do you address that in your practice?

Daikel Martinez, DNP: Stigma is still one of the biggest obstacles, unfortunately. Whether it’s fear of being judged for taking PrEP or concerns about how it might be perceived by partners, family, or employers, it can deter people from starting or continuing PrEP. In our practice, we make it a priority to create a safe, affirming space. We normalize conversations around sexual health and HIV prevention, and we remind our patients that taking control of their health is something to be proud of.

OutClique: How important is flexibility when it comes to helping patients stay on PrEP?

Daikel Martinez, DNP: Flexibility is essential. Life isn’t static— people move, change jobs, lose insurance, or experience personal challenges. We try to build a relationship with our patients, so they feel comfortable coming to us when something changes. That way, we can adjust their care plan accordingly—whether it’s switching to a different PrEP option, helping them re-enroll in insurance or patient assistance programs, or offering one of our clinic locations closer to their new home.

OutClique: What role does technology play in improving PrEP access and adherence?

Daikel Martinez, DNP: Technology has been a huge asset. Our website allows patients to make their next appointment without having to phone. Our patients can also see all their prior lab results directly on our app. There are also mobile apps that remind patients to take their medication and track doses. And with electronic prescriptions, we can make sure medication gets delivered to their home or a nearby pharmacy, often eliminating the need to take time off work or travel far. It’s all about making it as easy and accessible as possible. Lastly, if one of our patients cannot make it into the clinic, we can offer a Telehealth, appointment.

OutClique: For someone considering PrEP but unsure where to start, what advice would you give?

Daikel Martinez, DNP: Just take the first step, and make an appointment to talk to us. You don’t need to have it all figured out. Our job as healthcare providers is to listen, provide information without judgment, and work with you to find a plan that fits your life.