Hampton Roads has some of the highest rates of HIV and sexually transmitted infections in the state of Virginia, consistently exceeding national averages. Public health officials have tracked the trend for years, but the reasons behind it are less about recklessness than about gaps in access, information, and routine care.
Many people don’t know that free or low-cost testing is widely available. Others assume infections are rare, or that they only affect “other people.” And many still treat testing as something to do after a scare, rather than as a regular part of staying healthy.
The result is predictable: infections are often diagnosed later than they should be, and opportunities to prevent them are missed.
What’s changing now is not behavior driven by fear, but behavior driven by options.
Why Rates Stay High
HIV and STI transmission does not require extreme behavior. It requires sexual activity, which most adults engage in at some point. Yet many people underestimate their own risk or delay testing because they feel healthy, are in monogamous relationships, or assume they would “know” if something were wrong.
That assumption is often incorrect. Many infections cause few or no symptoms, particularly in their early stages. Without routine testing, they go unnoticed and untreated.
Another barrier is perception. Clinics are still widely viewed as judgmental or inconvenient, and care is often assumed to be expensive. For many people, that combination is enough to put testing low on the priority list.
More Tools Than Ever Before
The public health landscape has changed significantly over the past decade. Today, people have more ways to protect themselves than ever before, before intimacy, after intimacy, and through routine care.
One of the most effective tools is PrEP, or pre-exposure prophylaxis. Taken as prescribed, PrEP is up to 99.9% effective at preventing HIV. It is used by people across a wide range of situations: those who are single, partnered, dating, or experiencing changes in their relationships. It does not require anyone to fit a particular identity or category. It simply provides protection in advance.
Routine HIV and STI testing remains foundational. Not as a signal that something is wrong, but as a way to remove uncertainty. Regular testing allows people to make informed decisions and address infections early, when treatment is simplest.
Newer options are also becoming more widely available. One example is Doxy PEP, a medication taken after intimacy that can significantly reduce the risk of common bacterial STIs. Many people are unaware that post-exposure options exist at all, despite evidence supporting their effectiveness.
Together, these tools reflect a shift away from reactive care and toward planning, treating health maintenance as part of everyday life.
Where Access Comes In
Access is what determines whether these tools are actually used.
In Hampton Roads, organizations like LGBT Life Center have focused on removing practical barriers that keep people from engaging with care. Despite its name, nearly half of the people who receive services at the Center identify as straight. People come because of how care is delivered; nonjudgmental, private, and welcoming.
HIV and STI testing is offered free of charge. PrEP is available at no cost or very low cost for most clients. Staff assist with insurance enrollment, handle prior authorizations, and cover co-pays when needed. For those who prefer remote care, telehealth appointments are available.
For in-person visits, primary care and an on-site pharmacy are located in the same building. Prescriptions can be picked up immediately or delivered, reducing delays and additional trips. Follow-up is standard, not forgotten.
Equally important is the environment. Appointments are designed to be efficient, private, and respectful. Conversations are straightforward. There is no expectation that clients explain or justify their lives. People are treated realistically, and staff at The Center understand that you’re a real person navigating your way through life’s complexities and pleasures.
A Practical Reframing
What’s emerging is not a cultural shift toward caution, but toward clarity.
Routine testing, PrEP, and post-exposure options allow people to separate health decisions from anxiety. Care becomes something that supports daily life rather than interrupts it. Pleasure and responsibility are no longer framed as opposites.
For a region that has long struggled with elevated rates of HIV and STIs, this reframing matters. It replaces assumptions with information, and fear with access.
For many people, the most meaningful change isn’t the existence of new tools. It’s knowing that they are available, affordable, and offered in places designed for real life. You can learn more about these options, and LGBT Life Center’s services by visiting lgbtlifecenter.org/lifehealth.
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