PrEP: The Bumpy Road to HIV Protection
PrEP, a medication that shields against HIV, is incredibly effective. Yet, many people face obstacles when trying to access it. These barriers range from medical bias to insurance complications and doctors who are not familiar with the treatment.
Medical Stigma and Lack of Awareness
In some places, like Kansas, medical stigma has kept people away from preventive care for years. This is a significant issue, as PrEP is highly effective when taken as directed. It is 99% effective in preventing sexual transmission of HIV.
Personal Experience: Matthew Hurley's Journey
Matthew Hurley, a resident of the San Francisco Bay Area, experienced these challenges firsthand. After a partner tested positive for HIV, Hurley started taking PrEP. However, when he switched doctors due to an insurance change, he found that his new physician was unfamiliar with PrEP.
Hurley had to explain the regimen to his doctor, who then did some research and agreed to prescribe it. But the hurdles didn't stop there. Despite insurance requirements to cover PrEP and related services without additional costs, Hurley spent months dealing with unexpected charges and past-due notices.
Eventually, Hurley found a more informed provider and has not had any unexpected bills since. However, he wishes his sexual health care was integrated with his primary care, rather than separated.
Recommendations for Accessing PrEP
To avoid some of these issues, it is recommended to:
Verify if PrEP is suitable for you.
- The CDC guidelines state that it can be prescribed to anyone who is sexually active, especially those who:
- Do not consistently use condoms
- Are IV drug users who share needles
- Are men who have sex with men
- Have partners living with HIV or whose HIV status is unclear
Do not assume your provider knows about PrEP.
- Check your state or local health department for a how-to guide you can share with your provider.
- The CDC also has PrEP guidelines, but some HIV/AIDS resources have been removed from federal websites.
Avoid unexpected bills.
- Ask your doctor’s office to be careful about coding required lab work and to send you to a lab that is in-network.
- If the office makes mistakes, share the PrEP billing and coding guide from NASTAD, a non-profit association representing public health officials who oversee HIV and hepatitis programs.
Consider telehealth and seek out affirming care.
- Roughly 20% of patients on PrEP used telemedicine in 2024.
- Online pharmacies like Mistr and Q Care Plus offer PrEP without an in-person appointment.
- Lab work can be done at home.
- The LGBTQ+ Healthcare Directory is a searchable nationwide database of health care providers who identify as queer-friendly.
