As much as it’s touted as an effective prevention strategy, actually getting your hands on that expensive, blue pill is a giant pain.
I first heard about PrEP years ago while the first trials of it’s use as a preventative measure were underway. I had always considered taking it, but it seemed prohibitively expensive and was I even ready to divulge the most intimate details of my sex life in order to get it?
In 2016 it’s no longer relegated to the pages of obscure medical journals. PrEP had become kind of a big deal – at least in the queer community – and perhaps all that momentum could propel me into actually getting it.
My story begins a while back. Through serendipity alone I saw an ad on the subway for a pharmacy that was connecting people to PrEP in the village. If there was ever a time to believe that the universe was sending me a message this was it. Hastily, I snapped a pic on my phone with the contact info on it while avoiding some shady glances from a guy nearby. His stare seemed to say “Oh, you’re interested in that.” Clearly, word is getting out about PrEP, and by association I’m already a Truvada whore regardless of whether or not I’ve swallowed the pills.
Later that week I was referred by the pharmacy to a nearby clinic so that I could meet with a doctor who knew how to prescribe PrEP only to be told there was an eight week waiting list. I knew this wouldn’t be easy. Call me a masochist, but I enjoy the thrill of navigating bureaucracy and red tape so I was up for the challenge.
"But eight weeks is an awfully long time to sit on my hands. It really shouldn’t be this hard to access something so important in HIV prevention."
So how does one get PrEP anyway? There are a number of pretty large hurdles to clear. PrEP’s yearly cost is in the range of $12,000 – $15,000. For most of us that’s not an insignificant sum by any means. In fact, PrEP was only approved by Health Canada in February of this year. It’s up to the provinces at this point to decide if it’s worth making it widely accessible to at risk groups. For many economic, social, and political reasons I wouldn’t hold my breath on that decision. I’m lucky that my current insurance plan will cover the cost of the meds at all.
Secondly I need a doctor that:
A) knows what PrEP is and the associated protocols for prescribing it
B) believes I am “high risk” for contracting HIV, and is
C) sex positive, not homophobic, and won’t use their own prejudices as a reason to deny me
A doctor can refuse to give a prescription for any reason. For instance, if she is part of the camp that believes I will go straight from the pharmacy to the nearest bathhouse sling to become the power bottom I always dreamed I could be it will be entirely up to me to convince her otherwise.
It’s created a bit of an odd situation where I now have to simultaneously prove that I’m at an ongoing, high risk for contracting HIV, but not so much so that it paints me as a horny party boy with an unquenchable thirst for cock.
At this point I’m no longer navigating logistical hurdles, but I actually have to change the way people think. And that may very well be my breaking point.
I’m originally from a “third-world” country, so healthcare was at times a bit of a luxury. I still have to regularly remind myself that coconut oil won’t in fact cure every disease known to man. But eight weeks is an awfully long time to sit on my hands. It really shouldn’t be this hard to access something so important in HIV prevention.
I understand the concerns, but do I really need this many gatekeepers to secure my own sexual health?
This article by Alex Aviance previously appeared at DOSTI.ca here