Metro’s new medical director talks PrEP, primary care and trans health

By : Jeremy Williams
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Metro Health, Wellness and Community is expanding its umbrella of services by opening the doors on primary care and LGBT health services in its Tampa and St. Petersburg locations.

Metro Health hired Dr. David W. LyterM.D. as its new medical director in July, because it felt there were services specific to the LGBT community in Tampa and St. Petersburg  that the general medical community was ignoring.

“I moved here in 1999 and I was personally looking for a physician that was gay friendly and there just aren’t big practices in town that are marketing to the gay community,” Dr. Lyter says. “There are some that are gay friendly but they’re hard to find, as opposed to Chicago or Wilton Manors, where I lived before, where you can go through a whole list of gay-oriented practices.”

Metro started more than two decades ago to fill a need in the community by providing HIV/AIDS related care and services at a time when many medical professionals in the area weren’t willing or able to provide them.

“Metro got started addressing the health and wellness of those with HIV in the community, and as it has expanded through the LGBT community center and behavior health services, it has always been the goal of addressing the health and wellness of the LGBT community as a whole,” Chris Rudisill, Metro’s director of LGBT community center services, says. “How do we make healthcare more accessible to the community? We know that people feel like they can’t access adequate healthcare; we know that LGBT people, more specifically older adults, may not access healthcare because they may not have a gay-friendly doctor. So how do we address those needs?”

Extending Metro’s services outside of HIV care for the same concerns they had 22 years ago just seemed like a logical step, so starting back in July, Metro expanded service to include LGBT specific primary care, Pre-exposure Prophylaxis (PrEP), Post-exposure Prophylaxis, Non-occupational (nPEP), trans health, STD screening/treatment, and psychiatric care and medication management.

“Gay primary care has some unique aspects to it, specific screenings, tests and vaccinations that are more needed in the gay community,” Dr. Lyter says.

One ofthe services that Metro will be offering,PrEP, has been controversial since coming on the market a few years ago.

“There is some resistance in some physician communities to PrEP,” Dr. Lyter says. “But we have gotten numerous calls, and in the few weeks I have been here, we have had six or seven patients sign up for it, and we are expecting a lot more as we do more marketing and talk to the press about it.”

PrEP is the process of taking the medication Truvada once daily as a preventative measure from getting HIV. The controversy that surrounds PrEP has led many doctors not to prescribe it to high risk patients.

“I think there have been one or two practitioners who have been offering [PrEP] to their already existing patients, but in general, here, and in certain places around the country, PrEP has not really taken hold,” Dr. Lyter says.

Moreover, nPep is another service offered by Metro that many medical professionals in the area are either unaware of or uncertain of in terms of how to address the issue with the patient.

“We’ve had one or two people actually go to a local emergency room and report that they just had a very high risk sexual exposure, and the ER’s in this area didn’t seem equipped to handle that, and they actually came here instead,” Dr. Lyter says. “It’s another addition that we are doing that isn’t readily available with most general practitioners.”

If the pool for gay- and lesbian-friendly doctors is not very big in the Tampa Bay area, the pool of doctors that understand and provide transgender care is even smaller.

Metro has specialists trained in transgender issues and will provide care respective of personal journeys, gender identity and hormone therapy assessments.

“We are going to be doing hormone replacement therapy for our transgender clients,which is very difficult to find in town,” says Dr. Lyter. “Most physicians just do not offer that.”

Metro’s primary care services have been available for about a month now and seem to be well received.

“We have already had patients come in for primary care, and [they]were surprised that a doctor was asking them about their sexual health and their sexual behavior,” says Dr. Lyter. “Just finding someone you are comfortable with is a hit-or-miss thing, but if we’re letting people know in advance that we are here to discuss any of those LGBT specific issues, that is something new to Tampa and St. Petersburg.”

For more information on the services that Metro Health offers or to schedule an appointment with Dr. Lyter, contact the clinic at 727-321-3854 or visit www.metrotampabay.org.

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