Wednesday, June 10, 2015

The PrEP Files: Part 3 It is always darkest before dawn

I had originally planned a number of separate posts detailing talking to my doctor and getting the prescription filled.  Having gone through the whole process however I think I need to provide a more current update as I would have done things differently had I known then what I do now.

Here are some things point form that I discovered while trying to get my prescription filled:

  • No one will know what to do with you.  The systems in Alberta are not designed to deal with this usage yet so every step will be a process of education and clearing out miss-information. 
  • Getting the prescription filled is not as easy as going to your local pharmacy only two pharmacies provide truvada in the Edmonton area (the Rexall at the Royal Alex and University of Alberta Hospitals) and they are not super easy to get to.  Accessibility is something I took for granted and those who are dealing with the healthcare system in Alberta with HIV have a number of barriers accessing services and medication.  
  • Only an infectious disease doctor can prescribe truvada and get it covered by Alberta Health.  This is a huge deal and something I will go into more detail on later in the post.
  • People will treat you differently.  My local pharmacist looked like I had handed her a bomb when I tried to get my prescription filled.  That look was echoed by every health care person I have had to deal with in getting the pills.
  • Be sensitive to your privileged status as a negative person trying to access medications used as a critical life saving tool for many people. 
  • Also note that groups and organizations that you may have relied on for help in the past may not support the use of PrEP.  This kind of political bullshit really pissed me off as I was reaching out for informational resources from local queer groups that should have been able to provide at least some help and all I received was silence.  
  • PrEP is very expensive and establishing how you are getting it covered should be the first thing you do.  It was the last step we took and so far has been the most difficult and very expensive.  
  • There are great resources out there if you know where to look.  This facebook group has been by far the most helpful.  I learned more on that page than I did from any other official resources.
Step 1:  Talk to your Doctor and provide them with education materials.  Be open and honest with them about your sex life.  If you can't do this you should try and find a doc you can trust.  We found ours through our local pride centre.

Step 2: Establish that you can get coverage.  As of today I can confirm that Manulife Group Benefits will never cover the medication in Alberta until the CMA recognizes it as a legitimate use and treatment.  Talk to your benefits provider.   This is a lengthy process for most benefit companies because they don't have answers ready and often there is paperwork that you and your physician may have to fill out for pre-approval.   There are no programs currently in Alberta that help people find coverage for PrEP.

Only after doing both of these should you even consider getting PrEP.

I was asked this past pride weekend if all the work and expense was worth it?  My answer is not a simple yes or no.

For a short while I was able to experience sex the way it should be without fear or concern of the big bad wolf that I was raised to be terrified of.  It is a freeing experience and I am glad I had it. Traveling this path has been difficult and it has opened my eyes to a great many things that I had been ignorant to. There is little doubt in my mind that this treatment should be in the hands of every single person who needs it.

Accessibility is the problem and until that issue is solved PrEP in Alberta will never be ready for the average person who needs it most.  Until then the small handful of people fighting, educating and pushing the medical corporate establishment and the queer community will continue to do so but it takes a chorus of voices to enact change.

So please go out and educate yourself educate others and ask those power brokers why this isn't being provided to a community seeing a rapid increase in infections.  Together and only together can we solve the problem of accessibility.