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Author Topic: PEP, or Where's the ARV fairy when you need him?  (Read 2459 times)

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Offline oksikoko

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PEP, or Where's the ARV fairy when you need him?
« on: August 28, 2013, 12:29:47 AM »
This is a shot in the dark, but does anyone know if it's ever possible for someone with low income to get a PEP prescription if he's the negative partner in a serodiscordant relationship? Are there programs for that kind of thing?

I assume there aren't but you never know... He's from Philadelphia if that matters.

Lee

PS - This isn't for me. I wouldn't be caught dead in a relationship.
Code: [Select]
2014-11-14: CD4 Wars Episode II: Return of the Stribild (released in Europe as Stribild II: Werewolf Bitch)
2014-11-06:                ☣ VL (→) 12,627      ☣ CD4 (→) 639
2014-??-??: off treatment  ☣ VL (?)              ☣ CD4 (?)
2013-10-03:                ☣ VL (=) undetectable ☣ CD4 (+) 1105
2013-05-23:                ☣ VL (=) undetectable ☣ CD4 (-) 945
2013-02-25:                ☣ VL (-) undetectable ☣ CD4 (+) 1123
2012-12-16: Enter Stribild
2012-11-20: HIV+           ☣ VL (→) 132,683      ☣ CD4 (→) 920
2012-04-01: HIV-
Dates in this signature file conform to ISO 8601. ;-)

If no one complains, nothing will ever change.

Offline jkinatl2

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Re: PEP, or Where's the ARV fairy when you need him?
« Reply #1 on: August 28, 2013, 12:44:57 AM »
This is a shot in the dark, but does anyone know if it's ever possible for someone with low income to get a PEP prescription if he's the negative partner in a serodiscordant relationship? Are there programs for that kind of thing?

I assume there aren't but you never know... He's from Philadelphia if that matters.

Lee

PS - This isn't for me. I wouldn't be caught dead in a relationship.

He could call his local ASO - perhaps they could find someone with extra meds?

The AM I INFECTED moderator in me wants specifics, but if you don't have them or don't feel comfortable giving them, thats ok.



"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

-Kimberly Page-Shafer, PhD, MPH

Welcome Thread

Offline BT65

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Re: PEP, or Where's the ARV fairy when you need him?
« Reply #2 on: August 28, 2013, 05:52:53 AM »
At the ASO I work at, someone came in yesterday asking for PEP.  I had to tell her to get it from her doctor.  We don't give out meds to someone who is not a client (and obviously she wouldn't be).  We do have extra meds that are donated, but cannot give them out to people who come in asking for them, when they are not clients.  We don't know that they are telling us the truth, they could be asking for someone else etc.   
I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

Offline Habersham

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Re: PEP, or Where's the ARV fairy when you need him?
« Reply #3 on: August 28, 2013, 06:38:13 AM »
I'm surprised anyone would need these two names again.

http://fight.org/fight-programs/hiv-counseling-and-testing/

Philadelphia Fight/Jonathan Lax Center

I was looking at their website and if you get tested on a Wednesday nite you also receive a free slice of pizza and admission to Woody's dancefloor. Good to know.

Mazzoni Center

Their website features a "Job Readiness Workshop for Trans"  I'll peruse that tomorrow.   

Perhaps I'm naive (nah - grandpa) but if it's Pep shouldn't he get to a Dr or ER stat?

Wouldn't these or an ASO be better for Prep?

Please be sure and let him know the front office at Mazzoni is staffed by sober people and can be in disarray. As I lived around the corner in Society Hill I found it easier to go in personally rather than call.


Again, more specific info might lead to someone with extra meds.
« Last Edit: August 28, 2013, 06:48:53 AM by Habersham »
Because I Can

Offline Ann

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Re: PEP, or Where's the ARV fairy when you need him?
« Reply #4 on: August 28, 2013, 07:54:49 AM »
This is a shot in the dark, but does anyone know if it's ever possible for someone with low income to get a PEP prescription if he's the negative partner in a serodiscordant relationship? Are there programs for that kind of thing?

I assume there aren't but you never know... He's from Philadelphia if that matters.

Lee

PS - This isn't for me. I wouldn't be caught dead in a relationship.

Non-insured people can obtain medical hiv care at Philadelphia's Mazzoni Center on a sliding-scale. The website talks about the importance of PEP on several pages and they have an in-house pharmacy, so they probably offer PEP. http://mazzonicenter.org/programs/medical-care

According to The Body, some states offer PEP through local health departments, but you'll have to ring to find out what the deal is in Philly. http://www.thebody.com/content/art41075.html#get

Pharmaceutical assistance programs might help. This PDF focuses on NYS, but the phone numbers for the assistance programs would be the same. http://www.hivguidelines.org/wp-content/uploads/2013/06/npep-payment-options-05-22-2013.pdf

You might like to have this site bookmarked - http://www.pep411.com/  It doesn't list places in Philly, but it does have a good list of places in NYC that offer PEP and testing that you may need for someone else down the line. 

This friend of yours - is this an emergency situation or is he just wanting the back-up of a PEP prescription? I'm sure you probably know that PEP must be initiated within 72 hours at the latest, but within 36 hours is best. I hope the clock isn't ticking for him.

And really, if his partner has an UD viral load and no concurrent STIs, he probably doesn't need PEP.

It's also worth throwing it out there that he can keep his cost down by only taking Truvada as PEP. It's been proven effective not only as PEP, but also as PrEP.

You know, I often wonder how some of the WWs in Am I manage to afford PEP. I realise that some insurance companies will pay for PEP, but do they really pay for it when their client is taking it over a no risk situation, situations in which the guidelines clearly recommend NOT taking PEP? I can't see any of the other programs paying for it either, in those situations.

I just don't get it. And it pisses me off that some people manage to get and pay for PEP when they absolutely don't need it, and other people can't possibly afford it when they really DO need it. Grrrrrrrrrrrr........

Anyway, rant over. I hope some of the links I gave you prove useful. Let us know, ok?

Habersham posted while I was googling and writing, with some of the same info, but I'll post anyway.....
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline Habersham

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Re: PEP, or Where's the ARV fairy when you need him?
« Reply #5 on: August 28, 2013, 10:30:43 AM »
It does make me wonder though what is his partner's role in this?
Because I Can

Online Miss Philicia

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Re: PEP, or Where's the ARV fairy when you need him?
« Reply #6 on: August 28, 2013, 11:29:20 AM »

I was looking at their website and if you get tested on a Wednesday nite you also receive a free slice of pizza and admission to Woody's dancefloor. Good to know.

Child please. You lived here once, you know the deal -- Wednesday's at Woody's is the underage crowd. Officially called "College Night" it's really known as "Kiddie Night". As the Lax Center is literally around the corner and knowing what we do about new infections and that age group it makes sense don't you think?

As an aside, Woody's now serves sandwiches provided by the Italian Market's Paesano's.

And yes, Mazzoni is and always has been massively disorganized in the front office. But if any places will offer PEP it will be one of those two, but also maybe the HIV clinic at Temple University.

ps: The AIDS Activity Coordinating Office of the City's Dept. of Health is 1101 Market St., 9th Floor Telephone: 215-685-5600 If there is an "official" city run program for this that is the place that will know. There is also a city hotline at 215-985-AIDS. You might also find information on resources at the AIDS Library http://www.aidslibrary.org/ which is part of Philly Fight/Lax Center but on the 2nd floor as opposed to the 5th.
« Last Edit: August 28, 2013, 11:35:55 AM by Miss Philicia »
"Iíve slept with enough men to know that Iím not gay"

Offline oksikoko

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Re: PEP, or Where's the ARV fairy when you need him?
« Reply #7 on: August 28, 2013, 11:48:56 AM »
Hey, everyone. Thanks for the information. I'll follow a couple of these leads. It can't hurt to ask.

You had some questions. I have some answers.

It's PrEP I'm thinking of, sorry I mis-abbreviated, and that really is quite a difference. So it's not an emergency situation, but rather an ongoing thing.

I have a couple of friends who just started dating (or at least having lots of sex, but what's the difference, really?) and who are serodiscordant. The negative one asked me some questions because I'm always going off ad nauseum about HIV this and AIDS that (He may be the only HIV negative person I know. I probably frightened him).

It was clear he was a little more worried than he lets on and wanted more information, so I told him all the basics (fluids of transmission, condoms, blah blah blah) but I didn't bring up the possibility of PrEP because I don't know anything about its availability.

I just want to be sure he has all the info. If PrEP were possible and if he were interested it would be a shame for him not to know that - in the event of an accident. And if it's available and he's not interested, at least it would have been a choice.

And, by the way, it's surprising what some people *don't* know about how not to get HIV. I figured that message had trickled through to everyone by now. Nope.
Code: [Select]
2014-11-14: CD4 Wars Episode II: Return of the Stribild (released in Europe as Stribild II: Werewolf Bitch)
2014-11-06:                ☣ VL (→) 12,627      ☣ CD4 (→) 639
2014-??-??: off treatment  ☣ VL (?)              ☣ CD4 (?)
2013-10-03:                ☣ VL (=) undetectable ☣ CD4 (+) 1105
2013-05-23:                ☣ VL (=) undetectable ☣ CD4 (-) 945
2013-02-25:                ☣ VL (-) undetectable ☣ CD4 (+) 1123
2012-12-16: Enter Stribild
2012-11-20: HIV+           ☣ VL (→) 132,683      ☣ CD4 (→) 920
2012-04-01: HIV-
Dates in this signature file conform to ISO 8601. ;-)

If no one complains, nothing will ever change.

Offline Ann

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Re: PEP, or Where's the ARV fairy when you need him?
« Reply #8 on: August 28, 2013, 12:15:03 PM »

If PrEP were possible and if he were interested it would be a shame for him not to know that - in the event of an accident. And if it's available and he's not interested, at least it would have been a choice.


Is that a typo again? PrEP (PRE-exposure prophylaxis) is taking Truvada daily, without missing doses, for however long you're in a position where you may be at risk for infection. It needs to be taken for around a week before it's considered effective. I believe some insurance companies are paying for PrEP. Otherwise, I would imagine you'd have to pay out-of-pocket.

PEP (POST-exposure prophylaxis) is what you'd need in an emergency/accident. It should be started within 72 hours, ideally within 36, and it is taken for 28 days following a risk, such as unprotected anal or vaginal intercourse - particularly when the person proposing to take PEP is the receptive partner.
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Online Miss Philicia

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Re: PEP, or Where's the ARV fairy when you need him?
« Reply #9 on: August 28, 2013, 12:18:59 PM »
I seriously doubt that the city of Philadelphia, which is undergoing such a financial crisis that it just had to borrow money to open public schools for the current year, is going to be doling out Truvada free of charge.
"Iíve slept with enough men to know that Iím not gay"

Offline Ann

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Re: PEP, or Where's the ARV fairy when you need him?
« Reply #10 on: August 28, 2013, 12:24:41 PM »
I seriously doubt that the city of Philadelphia, which is undergoing such a financial crisis that it just had to borrow money to open public schools for the current year, is going to be doling out Truvada free of charge.

I agree. They might offer PEP for a clear case of risk, but not ongoing Truvada as PrEP. Not when much cheaper condoms have also been proven to prevent transmission.
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline BT65

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Re: PEP, or Where's the ARV fairy when you need him?
« Reply #11 on: August 28, 2013, 12:30:01 PM »
Working at an ASO that has undergone serious financial cuts, and knowing that  ASO's all across the country are undergoing financial cuts, I would check with the ER or personal doctor, even with PEP, prior to depending on an ASO.  Not that I am an expert on policies of all ASO's, just saying.
I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

Online Miss Philicia

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Re: PEP, or Where's the ARV fairy when you need him?
« Reply #12 on: August 28, 2013, 12:32:04 PM »
Surprise!

https://fight.org/fight-programs/the-jonathan-lax-center/special-programs/prep-program/

Damn that smelly Lax Center!

Also U-Penn

http://phillyvax.org/prep/

and Project PrEPare

http://www.projectprepare.net/philadelphia.html

Of course, it is likely these slots are full as they're just study groups or not ongoing now, etc. but worth a look.
« Last Edit: August 28, 2013, 12:35:54 PM by Miss Philicia »
"Iíve slept with enough men to know that Iím not gay"

Offline jkinatl2

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Re: PEP, or Where's the ARV fairy when you need him?
« Reply #13 on: August 28, 2013, 12:50:40 PM »
Sorry I gave a wrong guess about PEP/PrEP. I still think CALLING an ASO would not be a bad idea so at least they could repeat what the members here already know.

PrEP is expensive, and if your friend is unable to get insurance to pay for it it seems pretty unobtainable.  I have shipped out every single extra Truvada I own, sadly. And though i empathize, I do not think I would give it away for PreP. Might not even for PEP, as there are too many positive people doing without.

Hopefully your friend's partner is on successful med therapy and his viral load is undetectable. If that risk reduction plus condoms isn't enough, then perhaps a rethinking of the relationship is in order.

"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

-Kimberly Page-Shafer, PhD, MPH

Welcome Thread

Offline BT65

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Re: PEP, or Where's the ARV fairy when you need him?
« Reply #14 on: August 28, 2013, 01:06:05 PM »
Sorry I gave a wrong guess about PEP/PrEP. I still think CALLING an ASO would not be a bad idea so at least they could repeat what the members here already know.

No, not really a wrong guess.  It would make sense to call an ASO to find out. 

Truth be told, we have a whole drawer full of Truvada donated by a client who was switched to Stribild.  But we do not provide it to people who are not clients.  And in order to become a client, their positive status has to be documented by either a Western Blot or physician certification. 
I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

Offline darryaz

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Re: PEP, or Where's the ARV fairy when you need him?
« Reply #15 on: August 28, 2013, 01:31:33 PM »
And, by the way, it's surprising what some people *don't* know about how not to get HIV. I figured that message had trickled through to everyone by now. Nope.

Not so surprising if you've read the "Am I Infected" forum at all.

Offline oksikoko

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Re: PEP, or Where's the ARV fairy when you need him?
« Reply #16 on: August 28, 2013, 08:14:29 PM »
Is that a typo again? PrEP (PRE-exposure prophylaxis) is taking Truvada daily, without missing doses, for however long you're in a position where you may be at risk for infection. It needs to be taken for around a week before it's considered effective. I believe some insurance companies are paying for PrEP. Otherwise, I would imagine you'd have to pay out-of-pocket.

PEP (POST-exposure prophylaxis) is what you'd need in an emergency/accident. It should be started within 72 hours, ideally within 36, and it is taken for 28 days following a risk, such as unprotected anal or vaginal intercourse - particularly when the person proposing to take PEP is the receptive partner.

Yes, it's pre-exposure I'm talking about. So he would be protected in general - and in the event that an accident might happen.
Code: [Select]
2014-11-14: CD4 Wars Episode II: Return of the Stribild (released in Europe as Stribild II: Werewolf Bitch)
2014-11-06:                ☣ VL (→) 12,627      ☣ CD4 (→) 639
2014-??-??: off treatment  ☣ VL (?)              ☣ CD4 (?)
2013-10-03:                ☣ VL (=) undetectable ☣ CD4 (+) 1105
2013-05-23:                ☣ VL (=) undetectable ☣ CD4 (-) 945
2013-02-25:                ☣ VL (-) undetectable ☣ CD4 (+) 1123
2012-12-16: Enter Stribild
2012-11-20: HIV+           ☣ VL (→) 132,683      ☣ CD4 (→) 920
2012-04-01: HIV-
Dates in this signature file conform to ISO 8601. ;-)

If no one complains, nothing will ever change.

Offline oksikoko

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Re: PEP, or Where's the ARV fairy when you need him?
« Reply #17 on: September 05, 2013, 08:01:01 PM »
Hey, everyone. Just to close out the thread:

I did talk to him the other day about PREP/PEP, but maybe it's moot, because (I found out today) they're not seeing each other anymore. Kids these days.

But he had never heard of PREP/PEP and didn't know it was possible, so I guess there was an general educational component, if nothing else.

Thanks for your info on Philly. For unknown reasons, I seem to meet people from there all the time, and I'm sure it will come in handy again.
Code: [Select]
2014-11-14: CD4 Wars Episode II: Return of the Stribild (released in Europe as Stribild II: Werewolf Bitch)
2014-11-06:                ☣ VL (→) 12,627      ☣ CD4 (→) 639
2014-??-??: off treatment  ☣ VL (?)              ☣ CD4 (?)
2013-10-03:                ☣ VL (=) undetectable ☣ CD4 (+) 1105
2013-05-23:                ☣ VL (=) undetectable ☣ CD4 (-) 945
2013-02-25:                ☣ VL (-) undetectable ☣ CD4 (+) 1123
2012-12-16: Enter Stribild
2012-11-20: HIV+           ☣ VL (→) 132,683      ☣ CD4 (→) 920
2012-04-01: HIV-
Dates in this signature file conform to ISO 8601. ;-)

If no one complains, nothing will ever change.

Offline oksikoko

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Re: PEP, or Where's the ARV fairy when you need him?
« Reply #18 on: November 12, 2013, 09:24:56 PM »
Since you good people took the time to answer, I figured an update was due.

So, they never really broke up. Or rather they've broken up and gotten back together multiple times since I posted, and he lives here now. There was an accident on purpose with the sexing, and he's started Post-Exposure Prophylaxis today - zidovudine, lamivudine and tenofovir. I have no experience with zidovudine or lamivudine, so I wasn't much help there, though what I've heard of zidovudine ain't great. I didn't tell him that because why scare the kid?

I think, and he thinks, he should be on PrEP, but that doesn't seem to be readily available still. We're going to look into his eligibility for a study that starts up soon, so maybe science will prevail.
Code: [Select]
2014-11-14: CD4 Wars Episode II: Return of the Stribild (released in Europe as Stribild II: Werewolf Bitch)
2014-11-06:                ☣ VL (→) 12,627      ☣ CD4 (→) 639
2014-??-??: off treatment  ☣ VL (?)              ☣ CD4 (?)
2013-10-03:                ☣ VL (=) undetectable ☣ CD4 (+) 1105
2013-05-23:                ☣ VL (=) undetectable ☣ CD4 (-) 945
2013-02-25:                ☣ VL (-) undetectable ☣ CD4 (+) 1123
2012-12-16: Enter Stribild
2012-11-20: HIV+           ☣ VL (→) 132,683      ☣ CD4 (→) 920
2012-04-01: HIV-
Dates in this signature file conform to ISO 8601. ;-)

If no one complains, nothing will ever change.

Offline CallMeSid

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Re: PEP, or Where's the ARV fairy when you need him?
« Reply #19 on: November 15, 2013, 05:27:47 PM »
Hmmm...

Best of luck to your friend. 

I wonder why he has been choosing to pine for the mythical "ARV fairy" when there's a real-life "condom fairy" available on every block...?
07/2006 HIV-negative
06/2007 HIV-positive
07/2007 CD4: 795 (40%), VL: <50
09/2007 CD4: 629 (43%), VL: 895  (~2 weeks after measles/mumps/rubella booster)
12/2007 CD4: 854 (45%), VL: <50
03/2008 CD4: 880 (45%), VL: 151
12/2008 CD4: 943 (46%), VL: 116
05/2009 CD4: 865 (44%)  VL: 107

Offline oksikoko

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Re: PEP, or Where's the ARV fairy when you need him?
« Reply #20 on: November 15, 2013, 06:17:41 PM »
He's in love or something.

Given the same opportunity, I'd likely do the same, though I've never been charged with having good decision-making skills.
Code: [Select]
2014-11-14: CD4 Wars Episode II: Return of the Stribild (released in Europe as Stribild II: Werewolf Bitch)
2014-11-06:                ☣ VL (→) 12,627      ☣ CD4 (→) 639
2014-??-??: off treatment  ☣ VL (?)              ☣ CD4 (?)
2013-10-03:                ☣ VL (=) undetectable ☣ CD4 (+) 1105
2013-05-23:                ☣ VL (=) undetectable ☣ CD4 (-) 945
2013-02-25:                ☣ VL (-) undetectable ☣ CD4 (+) 1123
2012-12-16: Enter Stribild
2012-11-20: HIV+           ☣ VL (→) 132,683      ☣ CD4 (→) 920
2012-04-01: HIV-
Dates in this signature file conform to ISO 8601. ;-)

If no one complains, nothing will ever change.

 


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