Q&A with Nurx’s Jessica Horwitz

    Published on March 8th, 2018

    In case you missed it, Peer Health Exchange launched a pilot partnership with Nurx last month to increase sexual healthcare access to our Los Angeles area college campuses! Through April 15, more than 200 of our volunteers are spreading the word on Nurx’s services to empower their peers to make positive sexual health choices.  Keep reading to learn more, thanks to Nurx’s Jessica Horwitz .

    Jessica Horwitz is a board certified family nurse practitioner with a specialization in HIV medicine. She currently serves as the Lead of PrEP Services at Nurx and works on the provider team serving Nurx users in California, Illinois and Virginia. In addition to her time at Nurx, Jessica is the Clinical Director for HIV Prevention Services and is a primary care nurse practitioner for those living with HIV and at risk for acquiring HIV at the East Bay AIDS Center, in Oakland, California. Jessica has more than 10 years of clinical experience focusing on HIV treatment and prevention, women’s health, gender affirming primary care for transgender and gender non-conforming patients and comprehensive adolescent healthcare. She is a passionate healthcare provider and advocate at the local, national and international level for breaking down stigma and creating safe spaces to improve healthcare access and reduce barriers to care.

    Q: How can our health educators help inform their peers about the exciting things Nurx has to offer?

    A: We welcome your health educators to reach out to our team at Nurx anytime to learn about new services we are offering! Birth control and PrEP are just the beginning of reshaping healthcare access—and we would love to partner with Peer Health Exchange volunteers along the way! Be in touch with us and we will share all the new and exciting things we have coming. For example— we are about to launch a program where people who want to get on PrEP (a medication to prevent HIV) can have a lab kit mailed to their house where they can do all the labs necessary to safely get on PrEP— with a finger prick at home and after dropping the sample in the mail— a few days later a Nurx medical provider will review the results, reach out to the user with the results and prescribe the medication. We are working on a service line to offer STI testing and treatment in the same way! All at home— private, confidential and convenient.

    We want Peer Health Exchange’s health educators to tell us what their peers want too! If there is a part of healthcare that feels burdensome— and you think it can be done better—tell us! We are always open to exploring new service lines.

    For now—tell your peers that Nurx is an app where you can have access to our world class medical providers to discuss birth control and PrEP and within a few days a prescription for the medication that you decide is right for YOU— shows up in your mailbox. There is no service fee. And you do not have to have insurance. Nurx is radically reshaping healthcare— and we want Peer Health Exchange to join us on the ride!

    Q: How is Nurx changing the way we communicate with doctors and health providers?

    A: For one, Nurx is providing a safe and welcoming space for these conversations to even happen. Rather than consulting, Dr. Google, Nurx users can ask any question they want about their sexual health, their bodies and their choices. Our medical providers all have many years of experience providing this care in clinics across the country—and one of the things they love about working at Nurx is the opportunity to engage in counseling with people about their sexual health and provide a space to ask the questions that we all have but just have not known who to ask.

    You will find at Nurx—the medical providers also want to share the decision making. Our providers will ask— what do you want out of your birth control? Tell me what worked in the past? Or what didn’t work well? And together—they make recommendations for what birth control to try next.

    It is not a real-time chat— but our medical providers always answer— EVERY single medical question that our users ask—and this is all done without any charge.  It is not about making extra money. It is about providing good comprehensive sexual healthcare.

    Q: Why is communication important for our sexual health?
    A: Because healthy sexual health is part of being healthy. And without honest communication your healthcare provider can not fully support your WHOLE self. It is not the role of a medical provider to pass judgment on behavior or decisions—but rather empower people to have the knowledge to make healthy informed decisions about their sexual health. Our Nurx providers believe that sex is not taboo. And empowering people to have fulfilled and healthy sexual lives is part of our role as healthcare providers. We need our users’ honest communication so that we can fully actualize this ideal.

    Q: How is Nurx breaking down stigma in access to vital sexual health resources for young people?

    A. In many ways our country is a desert for most young people in regards to sexual health resources. Our sexual health education is an embarrassment in most settings. And—while some young people may have access to a forward thinking medical provider or adults in their life who empower them with sexual health resources (hooray for these healthcare warriors!)—young people are too often left to figure sexual health out for themselves— and often for themselves means turning to the internet, to each other and to education through porn—none of which are the ideal building blocks for creating healthy views of sexual health.

    Nurx is poised to give young people another access point. We follow state laws around contraception and PrEP access—meaning we will prescribe contraception and PrEP for young people as young as the states allow. And—through each of these provider interactions, our providers counsel and offer space for questions and stay available for all the questions that come up along the way. We may not be able to re-shape sexual education in every school across America (that’s your job – Peer Health Exchange!) – but we can break down stigma around sex and sexuality by giving young people access to judgment free and medically sound sexual health services.

    Q: Our health educators teach young people the importance of accessing resources for enhancing health, what are some barriers young people face in using services?

    A: Confidentiality is a big concern for young people and a big concern of ours! We will never share a young person’s medical history with anyone —even their parents, without their consent. But—we are also transparent that if a young person is using their parent’s insurance— in some states there is not much that can be done to ensure the prescription does not show up on an explanation of benefits that is mailed to the house. For states with protection, we work with young people to protect their privacy through websites such as www.myheathmyinfo.org in California.

    Cost is another barrier. We work hard to ensure we do everything possible to provide cost effective options. For birth control— we offer MANY options that are $15/pack. And— almost always our operations team can get people PrEP for free. Right now we require a credit or debit card for cash payment— but are working on alternatives for young people who may not have a credit or debit card.

    Q: What are some tips young people should know when considering birth control options?

    A: Everyone should know that there are many birth control options. And- despite what the google reviews say, most women tolerate almost all the options very well. The tricky thing with looking at reviews online is that too often people only take the time to post when they really did NOT like a birth control option – but rarely post when their chosen birth control is going great! So—take the reviews with a grain of salt. And know— that while it may take a little trial and error to find the perfect method for you—most women do really well with their pill, patch or ring.

    Tell us what you want out of your birth control. For some women this is just “please let this thing just keep me from getting pregnant”. If that’s the case—GREAT— this makes our job very easy- because all of the pills are >99% effective. But— for a lot of women who take birth control, there are other things they are looking for: acne control, regulation of hormones, controlling heavy bleeding or severe menstrual cramps. Tell us what you are hoping for your birth control to achieve and we will do our best to come up with an option that will work for you.

    Skipping your period is an option with most pills! Tell us if you want to do this and we can tell you how to do it. It is completely safe to do. But- do know that skipping your period can sometimes cause some spotting (light bleeding) – which is a little annoying! Your body does not have an On and Off switch 🙂

    Q: What about PrEP?

    A: Let’s start with – there is a pill that prevents HIV. Like really well. When taken every day, Truvada for PrEP is >98% effective in preventing HIV. PrEP is not for everyone – but for people who may be at higher risk for being exposed to HIV, PrEP is a really good tool to have in your toolbox of HIV prevention strategies.

    Right now – PrEP is not FDA approved for people <18. This is probably (hopefully) changing in the coming months – but for now getting PrEP covered for people under 18 is a bit tricky since it ‘off label’

    There are many programs in place to cover the cost of Truvada for PrEP. Despite the rumors that PrEP is REALLY expensive – which it is, cost should not be a barrier to getting on PrEP. There are many programs to help cover the out of pocket cost. Most people pay very little (or nothing) each month to be on PrEP.

    PrEP only prevents HIV. It does not prevent other STIs like gonorrhea, chlamydia or HPV. And it does not prevent pregnancy.

    Photos courtesy of Nurx





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