Buckle Up – Getting PrEP A Very Bumpy Ride

Published: March 21, 2014

 [Editor’s note: S’s experience illustrates, among other things,  the lack of knowledge about PrEP amongst a number of healthcare providers. He was told inaccurate information in a number of cases. We have highlighted in red the instances where providers gave incorrect or inaccurate information and provide a few editorial comments. After you read his story, check out this video that busts three common PrEP myths. And prepare yourself if you are interested in getting PrEP for yourself. Your doctor may need some education. Here is a handy brochure from CDC that can help you get ready for a PrEP visit to your doctor. Download and print or have it ready on your phone when you go. Do not assume your providers will know about PrEP. It is better to actually assume they know nothing. We are happy to help troubleshoot with you. Just email us.]

My journey to get PrEP started in June of 2013. Before that time, I had not even heard of PrEP. 
by S.
I was at a conference, and one of the speakers was giving a presentation on PrEP and TasP (treatment as prevention). Both of these were unknown to me, although I was aware of PEP (post-exposure prophylaxis).
At that time, I did not think Truvada was a viable option for me due to cost. But the seed had been planted.
 In January of 2014, I read several articles praising PrEP from sources like Slate and Huffington Post. I started to do some research on my own, and decided to investigate this option further. I took two initial steps.
First, I contacted my insurance company to find out if my student health insurance would cover Truvada. It took several weeks, but they finally said it would be covered, but that I might need an authorization.
Second, I scheduled an appointment with my doctor on campus. Due to my student health insurance,
I need to visit the campus health center to be covered. My doctor was very friendly, and open to the idea, but was not familiar with PrEP. She agreed to allow me to get the kidney, liver, and HIV test I would need before starting Truvada, and said she would research PrEP and talk with the other doctors at the health center.
My test results came back, and I was HIV- and had healthy kidney and liver functions. Meeting with the doctor, however, did not go so well. She informed me that neither she, nor any of the other doctors on campus, felt comfortable prescribing this medication for the purpose I intended. She did refer me to an infectious disease specialist though.
It took a week to get the appointment, and the appointment was for six weeks later. So I was back to waiting.
 Finally, the day of the appointment arrived. I was meeting with the Director of the Division of Infectious Disease for the state I live in. I waited 45 minutes to go back, and then, after meeting with the nurse, a resident came in. She verified that I wanted PrEP, and then started asking me questions.
"Do you have sex with men, women, or both?" she asked in a staccato manner. "Men" I replied.
"Do you have anal or oral sex, or both?" "Both" I replied.
 "Umm .. do … " "I’m the receptive partner" I answered for her.
 "So your partner is HIV+?" "No" I replied. "I don’t have a steady partner."
 At this point, she put her pen down and stated "We don’t prescribe this to people like you." [Ed: She is totally wrong. You do not need to have a steady partner, HIV+ or otherwise, to be prescribed PrEP.] 
Huh. Two months of waiting, and a flat-out no. I asked her "Just like that? No?"

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