Your Experience is a Gift

We feature real stories from people who have chosen to use PrEP as one way to protect themselves from HIV. If you have used or are using PrEP, we invite you to share your PrEP experience via audio, video, or in writing. Send video or audio links and/or text to myprepexperience@gmail.com and we will post them here. You can include your name, or you may contribute your story anonymously. This blog also contains helpful information on PrEP for users, potential users, and providers. Look for the links in the sidebar.

We have not heard of any insurance company or any Medicaid program outright denying coverage of Truvada as PrEP. Some companies and programs are requiring prior-authorization, however, which requires paperwork to be filled out. And the type of insurance coverage you have, including prescription drug benefits, will determine the cost to you as the consumer. To date, we have seen the biggest barrier to obtaining PrEP from providers who are unwilling to write a prescription.

If you have trouble getting a prescription for Truvada as PrEP from your provider, or getting a PrEP prescription covered by insurance or Medicaid, we are happy to troubleshoot with you. Send us an email to myprepexperience@gmail.com.

Friday, April 11, 2014

PrEP Facts Brochure for People and Providers

http://prepfacts.org/assets/PrEP_Facts_16-pager_brochure_mech_FINAL.pdf

Since we know one of the biggest barriers for PrEP access is providers who are resistant to providing a prescription, our friends at San Francisco AIDS Foundation developed a patient-provider brochure to help overcome this potential barrier to both learn more about PrEP and use it as a tool to talk with your medical provider. Print it off, or save it on your phone.

It features details on how PrEP works, what taking PrEP entails, cost and insurance information, checklists, as well as PrEP-related billing codes that will help your provider figure out how to submit your services for payment from insurance companies and Medicaid.

Check out PrEPfacts.org for more great resources.

Here is a direct link to a very helpful virtual library of PrEP materials.

www.prefacts.org


Thursday, April 10, 2014

VIDEO: Truvada: The HIV Prevention Pill No One Is Talking About

Fantastic reporting from Fusion TV, featuring a beautiful couple, one of whom does porn on the weekends.

One of our favorite exchanges is towards the end when the reporter asks a random guy in a bar about Truvada as PrEP. He expresses concern that it would make him more promiscuous - "I do feel that if I took PrEP, I would be prone to be more promiscuous- I do." Mitchell counters with, "But you already are promiscuous, so why don't, why not protect yourself?" To which the guy responds - "That's a very good point."


Tuesday, April 8, 2014

Anon in Texas: "Had I known it was going to be so easy..."

Appointment day came, and I was nervous.

I fully expected to have to go in there and plead my case to the judge: "why do you want PrEP?"... "why do you think you're at risk for HIV?"... "why are you having so much sex?"... "why do you have so many sexual partners?"  


by anon

I live in Texas. One of the large cities, but it's still Texas. Definitely not a hotbed for gay acceptance or progressive anything.

When the FDA approved PrEP back in 2012, I paid attention, but was really surprised about not hearing much buzz about it. But I kept paying attention. After a while, I found out that some friends on the west coast were on it, and I kept paying attention.

Finally, after a good talk with them about risks, "should I, shouldn't I," etc., I decided to go for it. And boy was I nervous.


A few months prior, I mentioned the idea to my primary care physician. I've gone to her for years, and she's handled everything I've ever thrown at her wonderfully (when she first saw my PA, she asked me if it hurt). When I mentioned PrEP, I said I wasn't ready to do it yet, but wondered if she'd heard anything about it. She had not, but she looked into it, and said that she could refer me to an infectious disease doctor if and when I decided to go on it. Her rationale was that she doesn't have any experience prescribing Truvada (if any of her patients test positive, she gives them the same referral to the ID doctor).

So once I decided to do it, I emailed her and asked if she had since changed her mind about prescribing it (she hadn't), and again she offered to refer me to an Infectious Disease doctor. She specifically recommended one she knew personally, and spoke highly of her. Before I accepted the referral, I asked if my doctor could contact the other doctor and find out if she had any patients on PrEP. My doctor agreed, and called me a few hours later telling me that the ID does have a few patients on PrEP. So I scheduled an appointment. It would be in a little over a week.

Appointment day came, and I was nervous. I fully expected to have to go in there and plead my case to the judge: "why do you want PrEP?"... "why do you think you're at risk for HIV?"... "why are you having so much sex?"... "why do you have so many sexual partners?" These were the questions that I'd been repeating over and over to myself for the previous week.

And when the doctor finally came in the exam room and spoke to me, she didn't ask me any of them. No sexual practice questions... no slut shaming... nothing.


When she came in the room, she handed me a pamphlet about PrEP. I brought up some other health concerns (which could be exacerbated by a known, but low occurrence, side effect of the Truvada), and she wasn't worried about it at all.

She agreed to the prescription without any hesitation. "It's risk versus benefit" she said. "In high risk individuals, the benefits outweigh the risks."

We chatted a bit more (she said she was impressed with my knowledge of HIV and PrEP) and said once my blood work came back, she'd call my prescription in to the pharmacy. As I left, I thanked her, saying that the visit went so much easier than I imagined it could have.

Later that day I get an email indicating that my blood work is back, everything looks good, and that she sent my prescription. I would have actually had the medication that night, but for some reason, almost every time they send a prescription to my pharmacy, it gets "eaten" by the system. It took a couple more days for her to resend it, but as soon as she did, the pharmacy filled it. I have CIGNA insurance, and my copay for it was only $40, which was brought down to $0 with the Gilead copay assistance program.

My appointment was on a Thursday, and I picked up my Truvada on Monday (it would have been quicker if it wasn't for the weekend and the issue getting the prescription to the pharmacy). 

 Had I known it was going to be so easy, I would have gotten the prescription months ago.

 [EDITOR: If you have a personal PrEP experience you would like to share, send it to myprepexperience@gmail.com. Words or video.]

Thursday, April 3, 2014

Leveraging ACA and PrEP for My Health

The Affordable Care Act is one new system I leveraged to my benefit (which has saved me over $5K to date as of March 29, 2014), and PrEP is a pretty new system I'm leveraging to my benefit as well.
I use PrEP as a fall-back plan, not as the only method of protection in my life.

by Kevin Plover
Minneapolis, MN

In 2009 through 2013, I was paying between $3K-$8K in out of pocket medical expenses. I had "amazing health insurance" through my employer, but I considered those kind of costs to be a major burden. Truvada cost ~$970 through my insurance - again, I considered that cost to be a major burden.

At the end of 2013, everyone on the news was complaining about ObamaCare, so I figured "I'm going to check this out for myself" so I hoped onto Healthcare.gov and selected my state.

I live in Minnesota, so we actually opted in to the Affordable Care Act (also known as ObamaCare for those that haven't watched the Jimmy Kimmel episode about the subject), so Healthcare.gov forwarded me to our state's marketplace exchange website MNSure.

The process was pretty easy - put in my birth date and zip code and answered a couple other questions, then I was whisked away to a list of tons of insurance plans. If I was going to enroll in an ObamaCare plan, it was going to be to save money (which I didn't think it could at the time), so I selected the platinum level plans.

A quick note: My deductible with my employer plan was ~$300. My maximum out of pocket with my employer plan was about $8K for 2014. Truvada for PrEP cost $970/mo through my employer plan - I'd be hitting that maximum out of pocket without any effort and it would be killing me financially.

So I saw a lot of high deductible plans on the MNSure website - like $3K deductibles before the insurance started paying anything... but the maximum out of pocket was also $3K, so once you hit your deductible, you paid nothing - my employer plan didn't do that - once I hit the $300 deductible with my employer plan, that's when I started paying $970/mo for Truvada for PrEP until I hit $8K.

I looked a bit more and found a plan that had $750 maximum out of pocket with a $750 deductible. And the premiums? $186/mo. My employer plan was $800/mo (I paid $200/mo, employer paid the rest).

It was one of those "this is too good to be true" moments - so I called up the insurance company and asked a lot of questions and gave them a lot of scenarios - it was true - they actually blew my employer plan out of the water.


I didn't "Qualify" for any subsidies or tax credits, because my income is too high, so I didn't register on the MNSure website - I registered on the insurance company's website - less paperwork, cutting out the middle man, etc. In January 2014 I got my prescription of Truvada for PrEP. It didn't cost me $970 like my employer plan would have - it cost me $550 because I had a $200 Gilead Copay Coupon from the GileadCopay.com website. And with that one prescription I met my maximum out of pocket for the entire year on my Affordable Care Act marketplace insurance plan.

I've gone to several doctor visits for various things, filled various prescriptions, and had other medical care since January - and it never gets old when the bill is .00.

PrEP is helping me achieve my health goals - one more layer of protection in my life - but it's also helped me towards my financial goals by reducing my medical costs dramatically thanks to the Affordable Care Act.

Sometimes you just have to leverage new systems to your benefit. The Affordable Care Act is one new system I leveraged to my benefit (which has saved me over $5K to date as of March 29, 2014), and PrEP is a pretty new system I'm leveraging to my benefit as well.

And I'm always asked, "Since you're on PrEP, does that mean you don't wear a condom anymore? Because you know PrEP only protects against HIV - it doesn't protect against all the other sexually transmitted infections"

And I respond "Yes, I am on PrEP which only protects against HIV. And my habits haven't changed - I don't have riskier sex because I'm on PrEP, and I use a condom with the same frequency I always have. Unless you can honestly say you use a condom 100% of the time, no exceptions, then you are at risk for HIV - and even condoms break. I use PrEP as a fall-back plan, not as the only method of protection in my life."

So that's my story - I wanted to add an extra layer of protection in my health maintenance plan, so I got on PrEP. I wanted to save myself money, so I leveraged PrEP to meet my out of pocket maximum on the insurance plan I leveraged through the Affordable Care Act.

No side effects, still testing negative for HIV as well as testing negative for those other sexually transmitted infections.

Still having .00 out of pocket for the rest of the year on all my medical care.

[EDITOR: If you have a personal PrEP experience you would like to share, send it to myprepexperience@gmail.com. Words or video.]

Monday, March 31, 2014

Road Blocks Didn't Stop Him From Getting PrEP

I finally got up the courage to seek PrEP in April 2013. 


by K.W.
Austin, TX

There's a lot of detail I'm going to spare you, but essentially in 2013 I moved to a different group practice in Austin, TX. I established care with a new Doc at the beginning of 2013. PrEP started to come into focus for me as I discussed it with friends and did a lot of research. I finally got up the courage to seek PrEP in April 2013.


I look back 11 months ago, and realize how difficult it was for me to do this. It was nearly on par with coming out to my family in 2005.


So I called to make an appointment with my new Doc and the nurse immediately shut it down, said I'd probably do better to find a specialist. I asked for a referral within the group, and was told they didn't have an HIV care specialist. Lovely.

The nurse did me a favor. I went back to my old group practice, researched their website and booked an appointment with a new Primary Care Physician, w/ HIV Speciality. One week later, sitting across from my new Doc, he looked at me and said "You're number 2"... meaning, I was the second to request PrEP. He began the discussion of all that was involved and quickly realized I'd done my homework. That was it, pending labs results, my Rx was written.

What prompted me to share this with you?

It's been nearly a year- and to my knowledge, my old group practice lost (first hand knowledge) 4 patients over denial of PrEP. Today I called the Administration office of my old group practice to share my story. Somehow the phrases "Issues regarding your Standard of Care" and "Possible Denial of Care" got my phone call forwarded to a very interested party on the other end of the line.

I was forgiving, and spoke highly of my previous Doctor. I framed this as a "missed opportunity" x 4 for very well established Clinic that prides itself in it's depth and breadth of services. The person taking down my information said the Medical Director will probably be calling me back.

So please, if you hit a road block, do what you can to get your doc in the loop.


[EDITOR: If you have a personal PrEP experience you would like to share, send it to myprepexperience@gmail.com. Words or video.]