Recently diagnosed ~ Questions as heading to Bangkok for initial treatment

[jayfu]

Hello all,

Noticed that admins have requested an introduction from new members, so thought I’d start with that.

I was recently diagnosed as positive and as further tests and treatment are quite expensive here (and I don’t yet have insurance coverage,) plan to head to Bangkok next week. My husband is Taiwanese and we've been together about 12 yeare now.

Was not expecting the positive result and am still a bit shocked, but want to get moving on treatment right away.

The various forum posts have been so helpful and reassuring. Thanks for all the great information and support expressed in the forums.

[jayfu]

I plan to have lab tests done at the Bangkok Red Cross Clinic, then consult with a doctor at another hospital (likely Bumrungrad,) but per posts it appears that they now require prescriptions to be filled at the hospital itself (although also per posts this is contrary to Thai law.) I hope to fill the prescription at the Red Cross Clinic, but also per some posts the prescription will be automatically sent to the hospital pharmacy and thus required. Has anyone found work arounds to this?

Also would anyone recommend having an initial consultation with a doctor before all results are completed or just waiting until the lab results come out?

Many thanks in advance.

[Jim Allen]

Hiya

Sorry to hear about the positive dignosis.
How have you tested so far? Was it an antibodies test only?

Best, Jim

[jayfu]

Thanks very much, Jim.

The first was a lab antibody test and then the follow-up was a lab antibody antigen test, which was also positive. That's it so far, but I plan to have the other tests in Bangkok next week.

Best,
Jeff

[lightalltheway]

Hello,

First, I am sorry about your diagnosis. Yes, its shocking and it will take sometimes to sink in. However, you will soon feel better, just give time some time.

Where is your geographic location if you don't mind me asking? as I may can help you with logistics.

Yes indeed, this forum is a haven for positive individuals as it reflects the lived realities. We are your new family and we warmly welcome you. Please if you have any question or doubt don't hesitate to post.

Always here for you.

Prince

[jayfu]

Very much appreciated, Prince! Thank you for your kind words-was so happy to find these forums.

I see I accidentally left out that I live in Taiwan. Have spent a fair amount of time in Thailand for work over the years and it is a relatively short flight. It’s been a few years since I’ve been back to Bangkok, just wish it was under different circumstances.

Cheers and thanks again,
Jay

[Jim Allen]

Thanks very much, Jim.

The first was a lab antibody test and then the follow-up was a lab antibody antigen test, which was also positive. That's it so far, but I plan to have the other tests in Bangkok next week.

Best,
Jeff

Hi Jeff,

Well sorry to hear about the results so far, I know it can be a lot to digest at first.
Glad to hear you have plans for follow-up labs done and to arrange treatment if confirmed.

Keep us posted on how you get on. I will ask for the time being, that you to post only in this one thread, you can ask whatever questions you have and, members will be able to reply to you here.

Tip;  You can always find this thread by going to your profile and selecting show own post and it will take you here.

Best, Jim

[Expat1]

Hi.  Welcome to Thailand.  Sorry about the circumstances.  How long will you stay?  I live in Pattaya.  I use Pattaya Memorial Hospital, but the tests are much cheaper at Thai Red Cross.  Do you plan on doing the genotype testing?  If so it takes a bit longer to get results for that test.
 
Definitely get Viral Load and CD4 counts.  Also blood panel and urinalysis. 

In Thailand most people are put on generic Atripla, (teevir).  Teevir is cheap here.  About 1100 baht a month.

[jayfu]

Hi Jeff,

Well sorry to hear about the results so far, I know it can be a lot to digest at first.
Glad to hear you have plans for follow-up labs done and to arrange treatment if confirmed.

Keep us posted on how you get on. I will ask for the time being, that you to post only in this one thread, you can ask whatever questions you have and, members will be able to reply to you here.

Tip;  You can always find this thread by going to your profile and selecting show own post and it will take you here.

Best, Jim

Much appreciated, Jim and well noted on the single thread.

[jayfu]

Hi.  Welcome to Thailand.  Sorry about the circumstances.  How long will you stay?  I live in Pattaya.  I use Pattaya Memorial Hospital, but the tests are much cheaper at Thai Red Cross.  Do you plan on doing the genotype testing?  If so it takes a bit longer to get results for that test.
 
Definitely get Viral Load and CD4 counts.  Also blood panel and urinalysis. 

In Thailand most people are put on generic Atripla, (teevir).  Teevir is cheap here.  About 1100 baht a month.

Many thanks! Plan on a week to two weeks and a full battery of tests including drug resistance. Had read in a few posts about teevir and it sounds like a great option. After tests at the Red Cross, plan to consult with one of the doctors at Bumrungrad recommended in these forums, then get the prescription filled at the Red Cross.

It's been a few years since I've been back to Thailand, so am definitely looking forward to that, albeit wish it was under different circumstances.

[jayfu]

Much appreciated, Jim and well noted on the single thread.

Hi Jim,

I do apologise in advance for my ignorance on this, but might I kindly inquire where I will find the option of sending a private message?

Thank you!

[Jim Allen]

Hiya,

Not for the time being. Let's see what your labs bring back.

Best, Jim

[jayfu]

Hiya,

Not for the time being. Let's see what your labs bring back.

Best, Jim

Hi Jim,

Ok, don't quite understand the reasoning, but it's my first membership in forums such as this and perhaps it's just how things work.

I had found some posts asking anyone in need of a doctor recommendation and also how to work around the prescription issue (hospitals requiring prescriptions to be filled there instead of at the Red Cross) to PM them. Nonetheless, I've reached out to the Taiwanese CDC rep who I've been working with/did the follow lab test to see if he knows.

Thanks!

[jayfu]

HI,

not sure what you exactly mean by “verifiable update” but yes, the prescriptions issue is on at Bumrungrad. Anyways, as I said, quite easy to go around it, your Dr. will tell you how. PM me if you need more details.

M.

Hi there! I'm currently not able to send PMs for details, but am I correct in assuming that making an online appointment for consultation with any of the recommended doctors at Bumrungrad will still allow for a work around regarding the prescription issue (that he or she will explain when we meet?)

Many thanks in advance!
Jeff

[Mindless]

Hi there! I'm currently not able to send PMs for details, but am I correct in assuming that making an online appointment for consultation with any of the recommended doctors at Bumrungrad will still allow for a work around regarding the prescription issue (that he or she will explain when we meet?)

Many thanks in advance!
Jeff

Hi,


my dr. at Bumrungrad gives me a prescription on separate paper, so I can take that to Red Cross for refilling. I don’t know about other doctors but on average here in Thailand they are sympathetic to hiv+ people, so I expect most of them do the same thing. You can explain to the dr. when you meet him/her and yes, usually you can book appointments online at least at the major hospitals like Bumrungrad and similar.

Good luck!

[Expat1]

The Thai Red Cross Clinic is the cheapest place for testing and meds. 

That said, in addition to Pattaya Memorial Hospital (where I get treated), I have used this clinic before.  You might want to contact them also.  (I get my Generic descovy here.)  They can also test and prescribe a range of medicine.  It is my understanding that they will also write prescriptions for the Thai Red Cross to fill.   If possible you might want to go here to get the script for Thai Red Cross.  (Currently Genvoya is the rage here.   You might prefer that to Teevir.  but it is a little more expensive.)

https://www.pulse-clinic.com/prep/tafero-em-buy-generic-descovy-in-thailand/

[jayfu]

Hi,


my dr. at Bumrungrad gives me a prescription on separate paper, so I can take that to Red Cross for refilling. I don’t know about other doctors but on average here in Thailand they are sympathetic to hiv+ people, so I expect most of them do the same thing. You can explain to the dr. when you meet him/her and yes, usually you can book appointments online at least at the major hospitals like Bumrungrad and similar.

Good luck!

Thank you so much! I will reach out to a few doctors. Really appreciate the information.

Have a great evening!

[jayfu]

The Thai Red Cross Clinic is the cheapest place for testing and meds. 

That said, in addition to Pattaya Memorial Hospital (where I get treated), I have used this clinic before.  You might want to contact them also.  (I get my Generic descovy here.)  They can also test and prescribe a range of medicine.  It is my understanding that they will also write prescriptions for the Thai Red Cross to fill.   If possible you might want to go here to get the script for Thai Red Cross.  (Currently Genvoya is the rage here.   You might prefer that to Teevir.  but it is a little more expensive.)

https://www.pulse-clinic.com/prep/tafero-em-buy-generic-descovy-in-thailand/

Thanks so much for all of this information. I’ll reach out to Pulse.

I just received the list of meds currently available in Taiwan and their recommendation is to have them prescribe from the list if appropriate and available. I don’t see Genvoya, but it might be a generic with a different name listed. Will research and find out if it is as they have also listed the med type with each medication.

Really appreciate you taking the time to reply and provide this information.

Thanks again,
Jeff

[Mindless]

The Thai Red Cross Clinic is the cheapest place for testing and meds. 

That said, in addition to Pattaya Memorial Hospital (where I get treated), I have used this clinic before.  You might want to contact them also.  (I get my Generic descovy here.)  They can also test and prescribe a range of medicine.  It is my understanding that they will also write prescriptions for the Thai Red Cross to fill.   If possible you might want to go here to get the script for Thai Red Cross.  (Currently Genvoya is the rage here.   You might prefer that to Teevir.  but it is a little more expensive.)

https://www.pulse-clinic.com/prep/tafero-em-buy-generic-descovy-in-thailand/

Hi Expat,

is actually generic Descovy available there? At what price? I’m currently taking Edurant+Generic Truvada but I’m interested in replacing TFD with TAF, so if generic Descovy is available at a reasonable price I may consider the switch. I checked the link but didn’t find a price list.

Thanks

[Expat1]

About $85 for a months supply.  TAFERO-EM.   They want a prescription or complete lab tests so their Doctor can prescribe.

[Expat1]

So I take that with my Edurant.

[Mindless]

So I take that with my Edurant.

Oh good, I was thinking to do exactly the same switch. So, generic Descovy would be around 2500 bath plus the cost of Edurant (which is quite cheap actually), whereas Genvoya at Thai Red Cross is around 2600 bath/bottle, so basically cheaper... I wondering which option is the best... 🤔

[Mindless]

Think I’m going out of topic... TAF vs TDF subject seems to be still quite controversial.

https://www.aidsmap.com/news/nov-2019/96-week-results-discover-prep-trial-presented-european-aids-conference

Studies comparing TAF and TDF as treatment for HIV have found statistically significant differences in kidney function and bone mineral density, though there is some evidence that these may only make a clinical difference in people taking the booster drugs ritonavir or cobicistat, or whose kidney function or bone mineral density has declined with age. In the first PrEP study to prove efficacy, iPrEx, which used TDF/FTC, no decline in kidney function was seen in participants under 40.

https://www.aidsmap.com/news/apr-2018/taf-only-superior-tdf-when-used-boosting-agent

With these findings in mind, can it be justified paying more for TAF?

“The only known economic analyses comparing TAF and TDF used input parameters derived from studies administering boosted TDF, which may not be appropriate,” comment the authors. “Economic analyses should instead consider TAF against unboosted TDF to inform national policies. In the UK, the cheapest TAF regimen (TAF/emtricitabine/rilpivirine) costs $8246 PPPY [per patient per year], while the TDF patent is set to expire from 2018 across Europe. In the generic-inaccessible context, money may be saved by using generic TDF-based regimens costing $107 PPPY.”

They conclude, “the purported safety benefits of TAF over TDF may be overstated.”

[jayfu]

Wanted to post an update, which will also be helpful to anyone in Taiwan.

I received referrals to two nonprofit HIV advocacy groups here in Taiwan. I’ll post links to their websites below.

These groups can help those in Taiwan that don’t yet have National Health Care coverage. You will still need to pay for tests out of pocket and at least a few weeks of meds, depending on the your situation. The doctors they refer you to will then have a few options for med prescriptions~writing a prescription for you to fill online or at the Thai Red Cross, etc. or ordering for you. (They will ensure you have everything you need to get the scripts filled.)

As I mention, these non-profits will provide referrals to two LGBTQI+ friendly, HIV specialists at major hospitals (one in the north and one in the south) that can order your meds. Prices will be just the med cost plus shipping. This takes 2-3 weeks, so you'll still need to get started on meds here. (Out of pocket for the intial meds will be around TWD 15,000 to TWD 20,000 for one month, depending.) Initial tests will run between TWD 12,000 to TWD 15,000. After that, med prices will be more or less comparable to Thai Red Cross prices, plus shipping.

I met with one of these doctors today for consultation and to have all the lab tests done. She was extremely helpful, understanding and friendly. You are also introduced to an LGBTQI+ friendly case manager who will exchange Line contact information with you and be ready to answer any questions you might have along the way as well as provide all types of support.

Also note, that most of the above can be done more or less anonymously if you choose. You will need to tell the nonprofit groups this upfront, however, so they can assist in arranging.

If either legal spouse is HIV positive (and both are on the National Health Care coverage/legal residents) PREP will be provided at no cost to the spouse who is negative. And of course if you are on the National Health Care program or when you become eligible, all HIV treatment costs are completely covered, including further tests.

Note there is a less expensive workaround for the current two year coverage delay requirement for foreigners on work/study residency. Also note this two year coverage delay does not apply to legal spouses (with legal residency) of Taiwan citizens. These non-profits can explain.

Non-profit 1
社團法人中華民國愛滋感染者權益促進會 Persons with HIV/AIDS Rights Advocacy Association
辦公室主任 葉珈語

●電話：+ 886-2-25561383、25561438    傳真：+ 886-2-25504263
●電子郵件：service@praatw.org              官網：http://praatw.org/
●Facebook: https://www.facebook.com/praatw
●地址：103 台北市大同區承德路一段48號2樓

Non-profit 2
http://www.adamslove.org/tw/

I'll post more details regarding my test results and treatment next week.

[Expat1]

 Nice glad  you got that sorted out.   Nice to also have local support.