By: Ann Avery, Infectious Disease Physician at Metrohealth Medical Center
PrEP can pave the way to a healthy sex life if you’re HIV negative. But if you ask a doctor about a PrEP prescription, you might find out the doctor is unsure about it. This happens. PrEP is a fairly new treatment, and some doctors may feel reluctant to prescribe it if they are unfamiliar with how to manage a PrEP patient.
If you do your homework before you talk to your doctor about PrEP and arrive at the doctor’s office prepared, you’ll stand a better chance of walking out with a PrEP prescription.
The background on PrEP
PrEP is short for “pre-exposure prophylaxis.” It means something you take something prior to exposure an infection from happening. Simply put, a prophylactic prevents something. Birth control, for example, prevents pregnancies. PrEP is basically the “birth control” of HIV prevention.
You take PrEP before you’re exposed to HIV. That’s what “pre-exposure” means. If you’re already living with HIV, then you cannot take PrEP. So, getting tested is a key part of getting a PrEP prescription.
Don’t forget: PrEP does not prevent you from getting other kinds of sexually transmitted infections. You still need to practice smarter sex to avoid of STIs, like syphilis.
In its current form, PrEP is two medicines in a single pill, called Truvada. Next, let’s look over some of the things you should do to help your doctor decide to prescribe Truvada:
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Document your health history
Start by putting together a health history. Answer key questions about your health such as:
- What medications are you taking now?
- Do you have unprotected sex?
- Are you pregnant?
- Do you take injected drugs?
It helps to write all this down in advance, so you don’t forget anything at the doctor’s office.
Have an informed discussion
There’s a lot to talk over with your doctor. You have to be honest about everything — especially the sexy stuff you might not like to talk about. When you talk to the doctor:
- Take a notepad along and write things down so you won’t forget them.
- Get straight to the point about when you talk to your doctor about PrEP. There’s nothing to be embarrassed about. If the doctor cannot prescribe PrEP, ask to be referred to one who can. Don't let medical professionals make you feel shamed or stigmatized. If you feel they’re disrespecting you, ask for a different doctor (this is pretty rare, but it might happen).
- If the doctor can prescribe PrEP, ask about side effects. They’re usually not too bad, but most strong medicines have some side effects, so get the facts.
- If you’re pregnant, make sure the doctor knows right away.
Don’t leave the appointment until you feel comfortable that your questions have been answered.
Several clinics and medical practices in Northeast Ohio are well-educated on PrEP and ready to prescribe it. This link can help you find these resources.
Figure out the finances
Truvada can be extremely expensive if you have to pay full price. But, seriously…who does that? The good news is most health insurance policies cover Truvada.
If your insurance has expensive co-pays that make it tough to afford Truvada, help is available. Gilead, the company that makes Truvada, has a co-pay card that helps you cover your lab, visit, and medication co-pays to access PrEP.
The company that makes Truvada also has a program to reduce the cost if you have no insurance coverage or government assistance. Follow this link to find out more about Gilead’s co-pay card and medication assistance program (MAP).
Follow your doctor’s instructions
If you take PrEP once daily, as instructed, you can reduce your risk of getting HIV by up to 99%! You’ll need to revisit your doctor every few months for refills and a few labs.
Even with PrEP, it’s a great idea to use other safe sex practices to protect you from other STIs. It’s good practice to get tested for HIV and other STIs at each PrEP visit.
Need more help?
If you’re nervous about talking to your doctor about PrEP or if you want further help, Cleveland has patient navigators ready to assist. They can walk you through setting up appointments, talking to your doctor, accessing insurance or assistance, and much more.
Live in Cleveland? Call 216-714-2223 to speak to a PrEP navigator today. Outside of the CLE but still in Ohio? Call the Ohio PrEP Hotline at 1-800-332-2437. You can also visit www.clevelandprep.com or www.ohioprep.org.