Resolutions: Taking Charge of Your Health

Most people think of Latinos Salud as the place to go for PrEP or HIV treatment. However, many patients have found unexpected benefits that go far beyond the initial purpose for the visit, as this month’s stories reveal.

Patient experience as told by Kensy Chavez, DNP, APRN, FNP-C

I attended to a 34-year-old man from Honduras who had come to our clinic after a painful breakup. He had just ended a three year relationship after discovering his partner had been unfaithful, and fear set in. He wasn’t feeling sick, but his trust had been shaken. He wanted STI testing and to start PrEP so he could protect himself moving forward.

During his initial visit, something unexpected happened. As part of our routine intake, we checked his blood pressure once, then again. Both readings were high. When we asked about his medical history, he admitted he hadn’t seen a doctor in years. He felt fine, so he never thought he needed to.

Further evaluation confirmed the diagnosis: Essential Hypertension, which is when someone has high blood pressure without any single cause. He was shocked. He had come in worried about HIV, but instead learned he had a silent condition that, left untreated, could lead to heart attack, stroke, or kidney disease. That day, we didn’t just talk about PrEP; we talked about his life, his stress, his future, and his health beyond one test result.

We started treatment, adjusted his lifestyle, and followed him closely. Today, his blood pressure is controlled, he remains HIV negative, and he feels stronger and more in control of his health than ever before.

He often says he’s grateful he didn’t choose an online PrEP service with no in-person medical providers able to actually evaluate him, because a simple visit for HIV-prevention ended up catching an unexpected condition that could have quietly impacted his life forever.

Patient experience as told by Guillermo Navarro, APRN, AGNP-C

My patient, a 52-year-old Latino man living with HIV, came to Latinos Salud for his routine follow-up. He had been doing well on treatment, with a stable viral load and no major complaints. He mentioned feeling “a little tired lately,” but like many patients juggling work and life stress, he didn’t think much of it. What he did not know was that something far more serious was quietly developing.

As part of his routine labs, we checked his metabolic panel and A1C (a blood test that measures average blood sugar in the last three months). His results showed significantly elevated fasting glucose and an A1C high enough to confirm diabetes, yet he had no idea he was diabetic. In fact, based on his numbers, it was clear that the condition had been progressing silently for some time.

Because unmanaged diabetes can worsen rapidly, especially in patients living with HIV, we immediately started him on medicine and connected him to a specialist and coordinated his care. Within days, he started on appropriate diabetic medications and received education on nutrition and glucose monitoring. We worked closely with him and his endocrinologist to adjust his treatment plan as needed.

Three months later, his labs told the story, his A1C had dropped sharply, his glucose levels were improving daily, and he reported feeling more energetic than he had in years.

He had come in simply to stay on top of his HIV care, but by being engaged in care, he discovered a condition he never knew he had. And getting him connected early in this way likely prevented far more serious complications down the road.

Patient experience as told by Daikel Martinez, DNP, APRN, FNP-C

A 22-year-old Latino gay man came into our Miami SW clinic, hoping to start on PrEP. He had recently ended a long-term relationship and anticipated becoming more sexually active with new partners. He explained that he wanted to “stay protected from the start.” During the intake, I asked the usual screening questions—were there any recent symptoms, exposures, or concerns? He shook his head and repeated that he “just wanted the PrEP medication,” nothing more.

We completed the consultation and reviewed what to expect with the testing. As I wrapped up, I told him, “Once all your results are ready, I’ll call you.” He hesitated for the first time. “I’m sure something’s going to come back bad,” he said quietly. When I asked why he felt that way, he confessed that he had noticed a small, painless sore on his penis about a week earlier. He had been too embarrassed to mention it, and part of his motivation for starting PrEP was to get tested for STIs without having to bring it up directly.

I asked if he felt comfortable letting me examine the area. The moment I saw the lesion, the picture became clear: a classic, well-demarcated chancre—highly suggestive of primary syphilis. I immediately counseled him on how syphilis is easily transmitted, and provided treatment right away with Bicillin injection to prevent progression and complications. He also left that same day with his PrEP regimen initiated, feeling both relieved and supported.

Had he walked out without speaking up – or if he had used one of the mail-order PrEP providers that does not include STD screening in its service – his infection would have progressed silently. Instead, a simple conversation prevented a more serious stage of the disease—and reminded him that having a trusted care provider and feeling safe to speak about his concerns truly matters.