Updated: Post-Exposure Prophylaxis, coming to a bath house near you! #HIV #AIDS
(Update: This was an unexpected surprise. After running my article below, which in summary says “great idea, but it’s got some holes it in that worry me”, the program director Dr. Demetre Daskalakis had their website information updated after reading my piece. I never contacted him on the side; this was all his own initiative, and he tweeted me to advise of the update.
Was I a bit brutal in my commentary? To a point, yes. You can attribute that to me having a migraine, being a sarcastic toad, or whatever you like. Or maybe, you’ll chalk it up to alot of years in advocacy and seeing too many programs come and go despite their best intentions.
That says a lot to me about his concern for the community as well as his group’s intention to do things the right way.
Do I feel better about this program? Absolutely. Do I still have some lingering “issues” on this? I do, but not nearly as many as I did 24 hours ago.
As long as I’ve been a writer/journalist and advocate I’m ALL for any program that’s going to decrease infections. But it’s also the journalist’s curse that I’m thinking four steps ahead and wondering what happens to the person after they get their PEP meds and roll out of the testing site.
I’ll be very curious to see what the community response is to the testing dates and sites and see what the general feedback is from participants…dm)
This just doesn’t sit well with me:
M*SHP Project 36:00 provides free, convenient 24 hour access to HIV medications that may prevent infection after a high risk exposure. You have 36:00 hours after the exposure to take action and start these medications (called PEP) to prevent infection.
High risk exposures include:
- Unprotected anal sex
- Unprotected vaginal sex
- Oral sex with exchange of body fluid
Please dial (646) 501-5200 to see if you should start PEP.
M*SHP Project 36:00 will provide the first four days of medications and will set up an urgent appointment at our clinic for testing and continuation of these preventive medications for the full 28 days required to prevent infection.
THERE IS NO EMERGENCY ROOM VISIT NEEDED TO START PEP.
The clock is ticking. You have 36:00 hours to prevent HIV.
I’ve been a BIG supporter of Truvada and PrEP, and I give this one about 24 hours before AIDS Health Foundation comes out with a press release denouncing it. If they do, I’m almost inclined to agree with them. Why?
- Despite information being sloppily shared that the meds are free, they’re not. Four days worth are free, in a recommended 28 days of treatment. There’s no mention of anything regarding how you’re going to spring for the remaining 24 days of treatment, presumably given to you at the ER. I’ve been on it (due to my blood-to-blood accidental exposure) and not only is it not cheap, it’s not like you’re popping a vitamin. Symptoms can range from being woozy and tired, to all out hell on earth going thru your body.
- Their testing setup’s are in bathhouses. Enough said there.
- Their Facebook page says they’ll be happy to set you up with free, or affordable continued treatment, but no mention on whether or not you’re going to be accepted. Check a single health provider service out there. Just because you walk in the door doesn’t mean that you’re automatically enrolled.
- I’ve read thru their website(s), and I’m not seeing a single mention of counseling anywhere, or follow up on their part. To me, it’s translating into “Yep, your 20 minute rapid test says you’re positive, here’s your four days of meds (and by the way you need to figure out your own way for the remainder you must have), here’s a list of places you can go for help, next please.”
I admire this project for putting a plan out there, but there’s just too many holes in this one for me to get behind it. Not like this. PEP has to be administered under a fairly strict set of guidelines or it’s essentially worthless.
Tag-lining this project as “You can prevent HIV infection” is reckless and a half truth. Even fully administered, your odds of acquiring HIV are greatly reduced, and in one study – six years old - there wasn’t a single case of transmission.
Marketing this in a bath house, essentially as a “morning after pill” is exactly was PEP is not supposed to be. This program, to me, either has some serious marketing issues that have to be addressed in their literature and sites, or they truly have some real concerns in it’s effectiveness
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