Like many immigrant daughters before me, I’ve known what career I’d pursue since before I stopped wetting the bed. Which, okay, was later than I’d care to admit, but my point stands—I was nine years old. I didn’t have a single armpit hair, and yet I was already terrified of financial ruin. My family had immigrated to America as Jewish refugees from Moldova seven years prior. I’m not going to play the “we pulled ourselves up by our bootstraps” card: my parents had professional degrees and spoke fluent English. Our whiteness granted us privileges that we were denied under the Soviet Union’s state-sanctioned antisemitism. Not that I was aware of any of this at the time. Mostly, I understood that it was because of my parents’ healthcare jobs—my mother was a pharmacist and my father a physician—that we went from living in a cramped apartment with my grandparents and great-grandmother to an apartment where I had my own bedroom to a house.
All this to say, the medical field—and specifically the “woman-friendly” field of pharmacy—was sold to me as a life-sustaining and noble career.
All this to say, the medical field—and specifically the “woman-friendly” field of pharmacy—was sold to me as a life-sustaining and noble career. It was a job where every day I could make someone’s life better and stave off the threat of returning to some shtetl (that I was born not in a shtetl but in the capital of Moldova didn’t occur to me until later).
During the summers and on weekends, I accompanied my mom to the pharmacy where she worked. Did I imagine the reverence with which her patients regarded her? That they seemed to genuinely enjoy shooting the shit with her while awaiting their prescriptions? I don’t think so. Did I find retail pharmacy unspeakably interesting and look forward to the day I could work a job just like my mom’s? I know I didn’t.
…I wanted a job that could tangibly improve others’ quality of life, but I didn’t want to talk on the phone with insurance companies or be on my feet all day.
That was the catch: I wanted a job that could tangibly improve others’ quality of life, but I didn’t want to talk on the phone with insurance companies or be on my feet all day. I feared repetitiveness and preferred to imagine writing novels before a giant window. But I also feared being broke; so, to pharmacy school, I went. What I didn’t know is that I didn’t have to choose, and that, in fact, one could feed the other.
It was in college that I received two blessings. First, I found community among other writers and committed to making up for all the reading and writing time I lost studying the Krebs cycle. Second, sensing my anguish about not being in love with pharmacy, my mom arranged for me to shadow an HIV pharmacist.
During my time at the clinic, there hadn’t been a baby born with HIV in over a decade.
I had no idea of the significant role that pharmacists play in HIV testing, treatment, and prevention, let alone that there were jobs for pharmacists outside of pharmacies. This pharmacist worked in an outpatient HIV clinic that focused on mothers and their children. She arranged HIV tests; monitored viral loads, CD4 counts, and resistant mutations; devised the drug regimen that best suited each patient; and problem-solved to improve their quality of life. She had long-standing relationships with her patients and was, for several, the most accessible member of their healthcare team. Many of her patients were pregnant. During my time at the clinic, there hadn’t been a baby born with HIV in over a decade.
I’m not very religious—unless your definition of “religious” includes attending sporadic Jewish high holiday services in the kind of Reform environment where the rabbi encourages the congregation to share what they’re atoning for and kicks us off by admitting he uses “pornography as escapism.” That said, I’ve often felt that some benevolent force in the universe had my back the day I discovered that HIV pharmacists exist and that I could be one.
As it turns out, getting to know someone’s core desires and conflicts and helping them build the life they want is also a valuable skill for writing fiction.
Here, in HIV pharmacy, was a field where my disinterest in working in an actual pharmacy was practically a prerequisite. Where my extroversion and desire for every day to be different would be rewarded. I could perform motivational interviewing, a collaborative clinical tool that involves shaping patients’ healthcare decisions around their priorities. As it turns out, getting to know someone’s core desires and conflicts and helping them build the life they want is also a valuable skill for writing fiction.
The AIDS epidemic is far from over, and this is especially true for Black and Hispanic/Latino men who have sex with men, for people living in the South, and for transgender people.
Then there’s the advocacy component. Prior to pharmacy school, I hadn’t thought of the profession as particularly political. But, as I argued in Harper’s Bazaar, HIV specialists have a moral obligation to fight for their patients, which includes naming the forces oppressing them and tackling them head-on. The AIDS epidemic is far from over, and this is especially true for Black and Hispanic/Latino men who have sex with men, for people living in the South, and for transgender people. Pre-exposure prophylaxis, a once-daily medication that nearly eliminates the risk of getting HIV through sex, is grossly underutilized in communities of color (13-24% of Black and Hispanic/Latino people, respectively, who could benefit from PrEP were prescribed it in 2022, compared to about 94% of eligible white people). An incredibly haunting statistic: per the CDC, about 1 in 8 people living with HIV in the United States aren’t aware of their status.
Having sex with someone undetectable confers a lower risk of HIV transmission than with someone who doesn’t know their status or believes they’re negative (since there’s a delay between acquiring HIV and testing positive for it).
We have incredibly effective preventative measures and treatments for HIV. People with HIV can become undetectable with medication, which means they cannot transmit the virus. This fact cannot be emphasized enough! Having sex with someone undetectable confers a lower risk of HIV transmission than with someone who doesn’t know their status or believes they’re negative (since there’s a delay between acquiring HIV and testing positive for it). Working in this field allows me to advocate against the stigmatizing misinformation that fills our national discourse about HIV and to advocate for my patients’ ability to live long full lives.
Our healthcare system is bureaucratic, confusing, and perpetuates racism, classism, and transphobia.
Our healthcare system is bureaucratic, confusing, and perpetuates racism, classism, and transphobia. To close these healthcare disparities, we need, among other things, HIV decriminalization and destigmatization; robust needle exchange programs; full-throated support of gender-affirming care; widespread free HIV testing; easy free access to PrEP, PEP (post-exposure prophylaxis), and HIV care; and robust insurance coverage for all.
We have a long way to go. But, from a prevention and treatment perspective, there’s never been a better time to find out you’re poz. People with HIV can live about as long as those without it, provided they’re diagnosed and get treatment in a timely fashion. There are many resources out there for living well with or without HIV. And it’s this HIV-pharmacist-writer’s honor and duty to share a few of them with you:
- You can order a free HIV-self testing kit here.
- You can search for a sexual health clinic (for testing, prevention, and treatment) in your area here.
- If you are uninsured, you can get free PrEP here.
- If you have insurance, PrEP should be fully covered under the Affordable Care Act (though some insurance companies are in violation of this mandate). You can look into financial support options here.
- You can look into options for paying for HIV care here.
- You can read more about U=U (undetectable=untransmittable) here.
