Ready to start PrEP? Some Quick Videos
Where to get PrEP
Transcript:
Dr. Raffaele Bernardo:
I think the first place to go is if you feel comfortable, is having a conversation with your primary care provider, a point of contact, somebody, presumably, you know, and trust somebody you can probably have easy access to
if you feel comfortable having these conversations, you can easily bring up this conversation with your primary care provider. Now, having said that, more often than not, I’m getting patients in my office, for example, who are coming to me specifically for sexual health because they don’t feel comfortable having these conversations with their providers. So one of the things you could do if you aren’t comfortable is to go online, see if there are any sexual health clinics nearby. If there are any infectious diseases offices nearby. There are plenty of online resources where you can search for providers.
Now, if there was an issue, for example about disclosure, or perhaps being seen in public, there are also several online services as well that can help set you up for PrEP. These are still run by healthcare providers who will perform an intake visit, and will check in every three months or so, and still require testing. But it is an alternative to in-person visits, if there is any limitation in that regard.
So I would start with your PCP. If you already have an established relationship. If not, and you feel more comfortable, you can do some searching online looking for a sexual health clinic or an infectious diseases office nearby. Or there are several online services as available as well, which are accessible through apps as well, that you can download through your phone.
One of the other one of the other options as well, is, if you do find a local provider or your provider that you’ve already established with, they may offer the opportunity to do telemedicine services as well. So what’s nice about telemedicine is that you can obtain medical care without leaving home. There are some limitations. You, as a patient, need to be located in this, in in the state that your provider is licensed. But it is an option to expand availability if distance is an issue
What to Expect at Your Doctor Visit
Transcript:
Dr. Uriel R. Felsen:
At your first appointment, where you might be speaking to a provider at PrEP, I’m sure that the provider is going to have questions for you about what kind of sex you have, who you’re having sex with, to try to get a sense of what is your risk for HIV, and how can, and whether PrEP might be a good option for you to protect yourself against HIV.
It’s also going to be important to know just more about you as a person, and whether you have other medical issues, because that might have an impact on which PrEP medication is appropriate for you.
So a lot of questions about yourself, and about your sex life. Some questions about your about your medical history.
One of the most important things is to have an HIV test before you start PrEP. To make sure that you don’t already have HIV. Some of the other tests that that are going to be done are looking for other sexually transmitted infections, just routine care, so gonorrhea, chlamydia, syphilis. Some of these infections might cause infections of the genitals, but sometimes they can also cause infections of the throat or infections of the rectum. So your provider may be asking you, maybe collecting specimens, you know, from your throat a throat swab as well as a rectal swab. Rectal swabs are things that patients can even do by themselves. It’s really just a q-tip where you get a little swab in the area and it gets sent off to the lab. So some some blood tests, some swabs. We talked about syphilis, which would be a blood test. And another important one is going to be hepatitis B.
So people that are starting on PrEP, we need to know whether you have hepatitis B or not, because some of the medicines for PrEP will also treat hepatitis B.
And so, if there is a small risk, that if somebody with hepatitis B were to stop their PrEP medication, it could cause a flare of the hepatitis B virus, which is something that affects the liver. So there’s just some routine labs that are going to be done at your 1st visit, along with getting a thorough history.
Paying for PrEP
Transcript:
Dr. Raffaele Bernardo:
So one of the messages I like to convey to both patients and and providers, healthcare providers who may be offering PrEP services, that anyone who needs PrEP, whoever wants PrEP, can get PrEP, and finances should never be an issue. Whether you’re insured, uninsured, underinsured, there’s a mechanism to get some form of PrEP.
Now, the USPSTF, that’s the United States Preventative Services Task Force. This is the Federal organization that makes recommendations for certain screening tests – for example, when we’re supposed to get our colonoscopies, our mammograms, pap smears, etc. That same organization has given PrEP a grade A recommendation.
Now, this is important for many reasons. But one reason in particular is that any recommendation that’s given a grade A is supposed to have, those services are supposed to be provided to patients with no cost sharing on the side of the patient. In other words, if a patient wants or needs PrEP and is insured, they should have no out-of-pocket expense when they go to the pharmacy to pick up these medications.
If a patient is under or uninsured, there are programs that are available to assist people in obtaining these medications
For people who do have coverage, but, let’s say, have a large out-of-pocket, the pharmaceutical companies also have what’s referred to as Copay assistance. So let’s say your insurance does cover PrEP whatever form it is but you have a large out-of-pocket. These pharmaceutical companies do offer Copay assistance up to a certain amount per year, which very often will cover the bulk, if not the entire, out-of-pocket cost for the year. So, in other words, ability to pay should not be a limitation for getting HIV pre-exposure prophylaxis. It is available at little to no cost in one way, shape or form.
