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Interview

How PrEP Helped One HIV-Negative Woman Become a Mother

November 25, 2014

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Heather Boerner

Heather Boerner

All Poppy Morgan of San Francisco wanted was to see her husband, Ted, reflected in their child's face. Unfortunately, for many years, this could not be a reality. Ted was HIV positive, and Poppy could not find a way to conceive safely. After many disappointments, including a brief hope for sperm washing that was quickly dashed, Poppy found pre-exposure prophylaxis (PrEP).

Poppy's story was captured by journalist Heather Boerner, who I interviewed last year when she was raising money for her new book Positively Negative: Love, Pregnancy, and Science's Surprising Victory Over HIV. I sat down with Boerner and Morgan to discuss why Boerner wanted to tell the story, whether Morgan will pursue PrEP again for a second child, and why you should always remember doctors are people.

[Editor's note: Both Poppy and Ted Morgan are pseudonyms that Heather Boerner used to tell their story.]

Mathew Rodriguez: Poppy, can you walk us through how you met your husband? Because it's a great story.

Poppy Morgan: I met him on my second day in San Francisco. I moved there straight after college. We both worked at the same place. I was going to this luncheon, and he was one of the greeters. He had like the bluest of blue eyes. He told me his name and I was like, "Wow. You look like a Ted."

I just knew immediately when I met him, this is the one. He's the guy.

I was dating somebody else at the time, so it was kind of weird. But, yeah. So, that's how we met.

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Heather Boerner: I'll add to that, if you don't mind. I spoke to Ted [recently]. We had a nice, long conversation and I asked him about when he met her. He said, "I saw her and my first thought was, I'm going to marry her." I was like, "Are you kidding?"

He was like, "No. I am serious." He said he didn't say anything to her at the time, but he said he knew. He said it wasn't anything specifically physical about her; it was just something about her energy, or something.

Has he told you that, Poppy?

Poppy Morgan: Yeah. We didn't talk about that till years later. But I really knew. I knew he knew. And we kind of avoided each other for the first year and a half that we knew each other, just because. It was chemistry that we had.

Mathew Rodriguez: So you're still in San Francisco now?

Poppy Morgan: Yes.

Mathew Rodriguez: In one part of the book there's that moment of hope when California lifts the sperm donation ban for HIV-positive people.

Can you talk about the emotions that you went through -- hearing about the lifting of the ban, and then realizing that that wasn't an option?

Poppy Morgan: When I found out that the legislation had passed, I was so excited. We had already been looking at options for, I think it was, seven to eight years at the time. So I was really excited because I felt like this was the first real option that we have that's affordable, that would be a viable option for us.

I had talked to my doctors about it, and they were like, "Sure, yeah. We'll do the sperm washing." I thought that they knew. I thought that they were on the same page as me. And then we had this consultation with the doctor.

He's like, "This is the consultation. This is how it's going to work. Your husband will give us the sperm sample, and we'll send it off to New York."

I was like, "Wait. What? Why are we sending it New York if it's legal to do it here?" And then he told me that the CDC [U.S. Centers for Disease Control and Prevention] still hadn't established guidelines, and that it would be three to five years. So that was blow number one.

I was like, "OK, well, we can't wait three to five years, so let's continue with this plan." Initially, the plan was that they would send the sperm off to get sperm washed, and then they would inseminate me in the clinic.

Then he told me, "His sperm probably won't be viable because of all the thawing, and freezing, and thawing." He said it could have an impact on the mobility of the sperm. I had gotten my hopes up so high, because it felt like every other door had been shut, and then, finally, the gods who decide the legislation worked in my favor -- and then it was still beyond my control. The fact that his sperm wouldn't be viable -- it was like it didn't matter if I had money, or time, or anything.

Mathew Rodriguez: One of the most powerful moments in the piece was the moment you tell your doctor, "Let me take a risk. I know myself. Let me take a risk."

I just want you to talk really quickly about what it meant to talk to your medical provider -- and this was before PrEP was approved -- and ask to use PrEP.

Poppy Morgan: I have to tell you that every time I talk about this, or read it in the book, I get emotional. It makes me angry and sad, all at once.

I had taken this article on PrEP with me to the doctor. I had emailed it to her, too -- I can't remember if I emailed it before, or after. She knew my husband was HIV positive. My first appointment with her, I talked to her about that. And at that first appointment, she actually asked me if I wanted her to prescribe me Xanax [alprazolam], because she imagined that it would be a really stressful situation to live with a husband who was HIV positive.

I asked her, "There's Truvada [tenofovir/FTC] that I can take to try to get pregnant. Here's this article that talks about how safe it is." She told me absolutely not, "that's unethical, for me to ... " Basically, she felt it was condoning risky behavior.

Again, it was one of those things where it didn't matter. I could have all the money in the world, all the time in the world, and the door was closed, because it was her opinion. How can you change someone's mind?

It was frustrating because, at that point, we were going on 10 years of trying. And the only thing that stood in my way was her prejudice about whether or not, or how I should be, having sex with my husband. That was the lowest point for me of the whole journey. Because now it was like the road was paved for us to do this and then it was just one person's opinion standing in my way -- and it happened to be my doctor. She has to prescribe the medication for me to take the medicine. So it was another door slammed in our face.

I did talk to Shannon at Bay Area Perinatal AIDS Center (BAPAC). She found a doctor for me that would take my insurance, and that would prescribe it. Within 30 days, I was on it, after Shannon set it up. But that was the most heartbreaking and lowest point of the journey, for sure. Because, again, it's like stigma and prejudice. What can you do? You can't buy that away. So it was frustrating, because it was just totally out of my control.

What made it worse was that she had just come back from maternity leave. And so, it was really upsetting to me. I wanted to say to her, "It's really easy for you to just say no and decide this is unethical. But you get to go home to your 3-month-old baby girl." So it was upsetting, yes. Lowest point.

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