How to Get PrEP on the Cheap

It is unfair and downright stupid that we should worry about other diseases while the pandemic rages across our country. But life goes on, like all other things that threaten it, including HIV. It is not always easy to find a medication to prevent HIV transmission, but if you know a few tricks, it can be done.

The good news: HIV can be prevented with pre-exposure prophylaxis or PrEP, which are currently available through Truvada and Descovy. When taken correctly, these daily medications are 99% effective in preventing sexual transmission of HIV and 74% effective in preventing injecting drug transmission of HIV.

In other words, Truvada and Descovy are miraculous drugs (although it has not yet been proven that Descovy can protect people assigned to a woman at birth during vaginal intercourse). In a country with a shoddy healthcare system, where more than a million people are living with HIV (over 36,000 new cases were reported in 2018), they are the best post-vaccination remedy.

“PrEP is very effective in preventing HIV from sex or chronic injecting drug use,” said CDC Medical Officer Dr. Nathan Furukawa, author of a study showing that many people who should take PrEP do not do it because of concerns. about the cost . “If enough people at risk of HIV infection take PrEP, we can stop new HIV infections and end the HIV epidemic.”

But because of capitalism in general and because of Gilead Sciences, Inc. – the company that owns the controversial Truvada patent – in particular, PrEP has a monthly price tag of $ 2,000, although preventing the spread of deadly viruses is a priority in many other places. …

The good news is that while PrEP is usually very expensive, there are currently loopholes that allow most people to pay almost nothing for their prescriptions. So, if you are a sexually active non-millionaire in America who wants to protect yourself from HIV / AIDS, how can you get PrEP?

First of all, do you need PrEP?

PrEP is intended for people who are HIV-negative, weighing at least 77 pounds, and at risk of contracting HIV. People who are considered “at risk” of contracting HIV include:

• CIS gay or bisexual men having anal sex without condoms.
• People who inject drugs with other equipment.
• People who have multiple partners, a partner with multiple partners, or a partner whose HIV status is unknown.
• People in serodiscordant (or mixed) relationships, which means that someone has HIV and someone does not.
• People who have had or are currently sick with sexually transmitted infections (STIs).

While I have found that they are not specifically included on the PrEP websites, there are other risk factors for HIV transmission, including race – Blacks, Hispanics and Indigenous peoples are disproportionately affected by HIV – age, class, and location to consider. If the sites are not geared towards health care for transgender people, the discussion of our risk factors for HIV infection is also excluded. It is unclear if trans women are considered separate from “gay and bi-men”.

How can I get PrEP?

First, you must get a prescription for Truvada or Descovi from your doctor. Last year, I got a prescription for Truvada from the family planning office in my community where I explained that I am sexually active with more than one partner. My oddly asserting doctor (a really rare creature) happily prescribed it for me.

The hardest part was filling out my prescription. Even though I was insured, my insurance company only covered a percentage of the co-pay, which meant I had to use the Gilead Advancing Access program , which offers a coupon that covered what was not covered by the insurance. With the coupon, I ended up paying roughly $ 15 a month for a daily pill. I had to sign up for a coupon and get a card, which was inconvenient, but nothing serious.

The real problem was that my insurance company said it needed to re-approve my Truvada prescription on a monthly basis, which meant that I had to spend hours on the phone between Planned Parenthood, my insurance company, and my pharmacy to top up my prescription. every time I needed to restock. After a few months, I stopped writing the prescription. It was too troublesome.

Those unfortunate enough to have insurance can also take advantage of the Gilead Advancing Access program, which can bring Truvada and Descovy costs down to $ 0.

What if I need more help?

Even if you know how to work around costs, many people can still use additional resources to get and stay on PrEP. This is partially due to the fact that some people do not know that this is available or that someone like them might need it. A recent Gallup study found that only half of transgender people and only 35% of transgender women knew about PrEP. There are organizations that provide training and support for PrEP , such as PleasePrEPME.org , for those who may face major barriers to their medication.

In addition, there are companies like Nurx , a medical startup that streamlines the process for people looking for sexual health cures, including PrEP. Like Capsule or ZocDoc, companies like Nurx are resellers created to meet the needs of people tired of navigating the system on their own – for a fee, of course.

The future of PrEP

The power struggle between Gilead and the federal government for control of PrEP patents continues even after the Trump White House announced that it will distribute free PrEP to those who are not insured – a program that will be funded by taxpayers who, by the way, are the same the people who funded the development of PrEP in the first place .

Until the day comes when healthcare is free and on demand for everyone, we will have to continue to fight for access to drugs like PrEP. Must love capitalism.