PrEP should be available over the counter

Yes, but I think Gilead is holding out for the most profits first

Republicans are getting ready to ban it, so.

Condoms are available over the counter.

Because Truvada has potentially serious side effects, I can't ever see this going OTC.

Most rich countries pay far less for branded prep. Then supply it free or low cost to the population. It is over the counter in a few countries. Than your Congress and Presidents for the deplorable rip off in the USofA.

And viagra.

And whatever will keep you alive when you use viagra and poppers at the same time.

Everything should just be sold over the counter.

[quote] Because Truvada has potentially serious side effects, I can't ever see this going OTC.

You would be shocked to read the side effects of advil and aspirin

This would really help men who are on the down low. Many minority men remain the closet because of religious and social reasons. It's hard for many to go to a doctor and ask for daily PrEP. Instead, over the counter PrEP for 2-1-1 would be much more helpful.

It is possible (depending on your location) to order generic prep direct from the manufacturer.

See below

Accessing Prep is a bitch here in Ireland. You need a doctor's prescription, which many sexual health clinics offer only once a week, at inconvenient times. Plus, importing medication from abroad is banned! I lost an entire batch to Irish customs once and had to route the next lot via Northern Ireland (and I believe the protocol has closed off that route too).

Sexual Health services targeted at gay men have actually decreased availability since the pandemic.

I don't understand. You need a new prescription every month in Ireland?

??? No, I need a new prescription whenever I run out.

R11, why do you have to import it? Why can't you just get it there?

Because he is married, his wife has access to his medical history, and so he needs to buy it anonymously online.

R11. No, because the clinic I go to has really inconvenient hours and I can't always make it and sexual health services are really not sufficiently funded in Ireland.

First, if you live in Ireland, you are not really European. That is just pretension. You’re West England and you know it.

Second, stop being such a slut.

R17 People have been kneecapped for less.

And no. Why? Jealous?

R17 that's incredibly ignorant or just a foolish troll. FUCK OFF

Same thing with contraception (the pill) for women. I don't understand why you have to go to a GP for it. I think this is because of homophobia (for PrEP) and sexism (the pill). Straight men get to get Viagra over the counter.

[quote] Because he is married, his wife has access to his medical history, and so he needs to buy it anonymously online.

This is a more common scenario than is acknowledged. This is the population over the counter PrEP would reach

We're going to refuse to sell it to you! We're using our religious freedom to punish you!

[quote] Same thing with contraception (the pill) for women. I don't understand why you have to go to a GP for it. I think this is because of homophobia (for PrEP) and sexism (the pill). Straight men get to get Viagra over the counter.

There's been a strong push to make the pill OTC but it never goes anywhere. I suspect that if states try to ban it, it will go OTC, maing it easier to be sent there.

Viagra isn't OTC--it still requires an Rx

R20 why are you comparing a disease preventing drug and birth control to Viagra? The first 2 ain't have a shit to do with Viagra. Stop looking for imaginary enemies.

I was unaware that no gay man ever uses Viagra.

R23 Should have made it clear that I'm not in the U.S. but in Europe.

R24 Sorry but how does it make any sense that PrEP and the pill aren't available over the counter? If anything, something that prevents disease and unwanted pregnancy should be more likely to be available freely.

R25 But straight men use it. It's something that facilitates sex.

[quote] Sorry but how does it make any sense that PrEP and the pill aren't available over the counter?

Profits.

Now that the original form of PrEP has gone off patent, Gilead will consider pushing for it to become OTC

R27 Yes and? It's being available over the counter benefits gay men just as much as it does straight men.

R29 PrEP is something that mainly benefits gay men. Viagra is something that mainly or equally benefits straight men. That's the difference.

I'm not seeing how viagra 'mainly' benefits straight men. Unless you think it's because there are more straight men than gay men.

One of the reasons that many drugs require a prepscription is that it forces patients (and doctors) to interact.

Many doctors will require at least a consultation or office visit once a year to continue to prescribe medications - that is a good thing. It allows for tests to be run and general health to be assessed.

If you think about it for a moment, there is likely a very high correlation between people who want or need to be on Prep and people who are at higher risk for a lot of other health-related problems. Requiring engaging with a doctor to continue to receive prescriptions is probably a good thing.

R31 Yeah, because there are a lot more of them. What's your problem? Why don't you seem to think that PrEP should have the same treatment?

[quote] Many doctors will require at least a consultation or office visit once a year to continue to prescribe medications - that is a good thing. It allows for tests to be run and general health to be assessed.

This is mainly just an American model.

Europe doesn't require prescriptions. You just go to a pharmacy, describe your symptoms, and you get a medicine.

R33 No, that's dumb. Viagra benefits gay and straight men equally (those who need it). Like someone else said, don't be so desperate to be a victim.

Upthread I posted on how to order generics from abroad so no, I don't think that PreP shouldn't be available over the counter

[quote] Upthread I posted on how to order generics from abroad so no, I don't think that PreP shouldn't be available over the counter

Does it make sense to make someone jump through so many hoops to get a potentially life saving drug?

PrEP is basically free in the US--Insurance has to offer it without co-pay, and the uninsured can get approval through a specific government website.

BUT, you still need a doctor's RX to get it.

R36 No.

[quote]PrEP is basically free in the US--Insurance has to offer it without co-pay, and the uninsured can get approval through a specific government website.

Not for much longer based on various rethug proposed legislation attempts.

[quote]You would be shocked to read the side effects of advil and aspirin

That's so cute. Are they monitoring your kidneys and bones regularly when you take Advil or aspirin?

Access to preventative health care, for everybody, including PrEP, should be available to everybody, But it isn’t…

[quote]One of the reasons that many drugs require a prepscription is that it forces patients (and doctors) to interact.

All fine and good, R32. Obviously there are solid reasons that a patient should see a doctor at least once a year. But a prescription for PrEP is not a cure for a condition that is going to dry up within 12 months; taking the medicine doesn't serious risks that require intensive monitoring, As with drugs for asthma, allergies, birth control, cholesterol, vitamin deficiencies, etc., the greater good is in making these medications readily available through standing prescriptions to those who need or want them.

How often one should consult a doctor for a general health review and how often the renewal of long-term terms needs to be checked by mandatory visits to a doctor are separate issues and shouldn't be complicated to fill quotas of visits where half a day is lost to 2-minutes with a doctor who says, like last time and the last six times beforfe that, 'well it looks like everything is good, let's stick with this plan and we'll see you next October,' or a complicated log-in to get an encrypted message saying 'all your levels look good still, let's see you this time next year.' The truth is too many doctors bristle at being viewed as prescription writers but their inducement for regular check-ups is nothing more than a glance up from a sheet of blood test results to say 'looks good.' Of course there are drugs that do require careful monitoring, but appointments for nothing more than to renew expiring prescriptions for Cialis, PrEP, and Flonase seems like it sbould be a low priority for a stressed system.

[Quote] Not for much longer based on various rethug proposed legislation attempts.

A Texas judge did say that the parts of the ACA that required free prevention meds was discriminatory for religious organizations. This is being challenged or course but the right is coming after everything that would help gays

[Quote] That's so cute. Are they monitoring your kidneys and bones regularly when you take Advil or aspirin?

Over the counter PrEP would be used mainly for 2-1-1. Not sure how much damage that would do to kidneys and bones

When I receive prep my doctor has to make an std penis exam first. I secretly love it thats why I think it shouldn't be available over the counter.

[quote]Obviously there are solid reasons that a patient should see a doctor at least once a year. But a prescription for PrEP is not a cure for a condition that is going to dry up within 12 months

PrEP users tend to have high rates of STIs and regular doctor visits screens and treats for them, which helps stem community spread of them.

Tip…Los Algodones, Mexico. Easy in, easy out for all your Rx needs….close to Palm Springs, stay for a lovely margarita.

R47, do you need an Rx?

Whores, the lot of you.

Perfect timing. I had a physical this week. Just moved, smaller town, new doctor. When I brought up getting on PreP, he couldn’t get out of there fast enough. Had NO idea how to deal with it at all and was so uncomfortable could not verbally react logically - and wasn’t about to just prescribe it. Yes, I can drive to a city and try to find a clinic to prescribe it. BUT it proves that NO you can’t just “go to the doctor and get it”. Primary Care is a useless, unnecessary mediator between insurance companies, the government, society and the person who just wants to take care of their own health. Maddening.

Yes I could ah e persisted with the doctor - but it was such an a awkward, judgement filled interaction, I just wanted to end it (similar to the Puritan trolls here on DL)

R50 sorry to hear about your small town doctor experience. It makes me really angry that he ignored your request for preventative medicine, when he should have commended you for trying to take care of your health. I live in a backwards county and there was not any monkey pox vaccinations at all available, until a person tested positive locally. Then they to order some, should’ve had some on hand. Stupid.. I really hate when medical personnel are derelict in their duties.

Ahem

what is 2-1-1?

R53, 2-1-1 is a PrEP dosage regime found to be equally effective as taking PrEP daily, particularly if you can schedule sex, like over weekends.

It requires two pills at least one hour before sex, one pill 24 hours later, and another pill 24 hours after that. If you continue to have sex, you have to take keep taking one pill daily until one pill 24 hours after the last sexual encounter.

Small town doctors often may not be up to date on medical practices found commonly in urban areas.

In my experience, doctors get scared and may come across as judgmental--they seem to react best when you don't react and educate them about PrEP in pretty mundane terms--"I took this regularly where I lived before. It's one pill a day to prevent HIV transmission. I would see the doctor every 3-4 months for the STI check. If you don't feel comfortable prescribing this, could you refer me to someone who would be?"

Thanks R55 - that’s helpful. I guess part of the problem was I was nervous bringing it up so didn’t manage the interaction well. It’s easy to forget doctors are just people - and often sheltered, work focused family men/women who spent so much time in medical school they never acquired good social skills and in smaller towns are as clueless as most people. It’s a reason to live in a major city - but like many during the pandemic I bought into the country life fantasy.

R56, you sounds so cute and level headed. Can I date you?

[Quote] That's so cute. Are they monitoring your kidneys and bones regularly when you take Advil or aspirin?

One of the major causes of liver failure is Tylenol overuse

Has someone on her experienced side effects from prep? I am worried about my kidneys.

R59, I do know someone who could not take Truvada because it hurt his kidneys. This was picked up on the regular testing done by his doctor.

His doctor is recommending that he try Descovy, which apparently has fewer issues but my friend is hesitant. The whole thing freaked him out so he went from slut to celibate over night.

He may try Descovy for 2-1-1 just to minimize its use. He’s getting pretty horny

Isn't the reason as simple as the company that makes it still holds the patent and makes a lot more money selling it as prescription, which in turn allows them to justify funding the research?

R61, but that’s a big old lie, of course.

40 of the top 45 drugs were developed with NIH funding (in academic labs) and the patents handed over to private Pharma that spends more to publicize them than on new research.

In this case, the Truvada’s 20 year patent has run out. The company made a molecular changes and suddenly it’s Descovy and another 20 years of exclusive rights! It holds off in revealing the new drug (that has fewer side effects) until the former Druid’s patent is expired.

Generics of Truvada can now be made (in the past before lawmakers caught on, companies would pay generic drug companies not to make generics of their blockbuster drugs so they could keep making great profits). Even Gilead itself likely has a generic packaging to sell in that market

In time, Gilead will see that Truvada is not make it enough money so may push the FDA to making it over the counter. This was it can try to convince people the brand name is better than the generic

A drug that has a specific and easily understood application, a drug the use of which may help curb rates of infectious disease, that has no obvious attraction for misuse, that has clear benefits, that does not require careful monitoring, and that doesn't pose a significant risk for grievous side-effects...FFS, make it an OTC drug.

With PrEP, there exists some question with the last 2 points, but surely it is better to issue it as an open-ended prescription. Yes, testing for syphilis and HPV and skin cancer for that matter should be be more frequent for most of us, but it's a separate issue: the renewability for a drug against HIV infection shouldn't turn on whether a small mole on my chest has not changed over the last X months.

Uninterrupted access to life saving medicine shouldn't be complicated by a quid pro quo, no "I'll renew you PrEP Rx only if I can take your height and weight and look for signs of a Parkinson's gait every 12 months." Both things are important, but there should be a much more compelling reason ro cut off a patient's Rx for against a life threatening infectious disease...or birth control, or asthma medicine...

bump for my trunk

I thought that some states allow pharmacists to prescribe PrEP.

I don't know any state allowing pharmacists to prescribe anything except vaccines.

See the next-to-last paragraph in this article.

[quote] PrEP is basically free in the US--Insurance has to offer it without co-pay, and the uninsured can get approval through a specific government website.

If that's the case, then if PrEP went OTC, a lot of people might end up spending more money for it out-of-pocket, since there are hardly any OTC drugs that are covered by insurance.

R68, yes, but it would be available as needed. You wouldn't have to first go to the doc to get an Rx.

I figure they could sell it over the counter in groups of 4 pills for 2-1-1 but keep 30 pills at one time by prescription only

Just get a vasectomy. Problem solved.

R70, Um...no

Vasectomies don't stop HIV transmission.

OTC would help all those those on the DL and those who can't get to a doctor.

HIV transmission is still a big thing in the Southern US among the black population. They dont have great access to healthcare and they are the least likely to ask their docs for PrEP. Also, docs outside the major cities resist prescribing it.

If it's OTC, it could make a real dent in the transmission rates there.

Good Christian men don't have to worry about such things. God protects them.

[quote] I figure they could sell it over the counter in groups of 4 pills for 2-1-1

Just 4 pills? I thought you had to take it every single day.

I'm going to ban Prep after I ban porn!

R75, 2-1-1 is a way of taking the pills with nearly as much effectiveness as daily.

If you know when you expect to have sex, you take 2 pills an hour before, one pill 24 hours later and another pill 24 hours after that.

Those who have sex alot at random times benefit most from daily use. If you know you're not having sex until the weekend, for example, this method is a great substitute

The big obstacle with OTC for 2-1-1 is that method is not officially approved by the FDA while daily use is.

I just get mine from a dispenser in my bedroom!

I thought we was talking about Pez. What's PrEP?

How could you plan sex down to the hour? What happens if I take it an hour before but sex happens sooner or doesn’t happen til hours later?

Doesn't one need to get an HIV test before starting PrEP? That would mean going to a clinic/prescriber anyway.

How about you DON’T take raw loads up the ass and use condoms like the rest of us did for twenty five years?

It’s crazy how entitled people feel to raw dogging and how it becomes a centerpiece of the cultural conversation. A little personal responsibility would be nice. So many of the world’s issues would be solved if more adults familiarized themselves with calendars and condoms.

[quote] How about you DON’T take raw loads up the ass and use condoms like the rest of us did for twenty five years?

The rest of you didn’t that’s the whole point lol.

[quote] How could you plan sex down to the hour? What happens if I take it an hour before but sex happens sooner or doesn’t happen til hours later?

AT LEAST 2 hours before.

So you're going out to a bar, assuming you'll meet someone. Take two pills before you go out.

PrEP should be in the drinking water.

Sex should be available on the counter.