The PrEP quest continues

Timothy Kincaid

November 7th, 2015

truvadaOn Thursday I shared with you the surprising difficulty of finding a doctor within my health network that will prescribe pre-exposure prophylaxis (PrEP), a proactive approach to avoiding HIV infection.

Since then I’ve received help and suggestion from several sources, including in the comments here at BTB. Thank you.

I dropped by the new West Hollywood outpost of the Los Angeles LGBT Center and, though it was after hours, the young man at the desk sought to be helpful. I’m not sure that I was able to adequately explain that I needed to know whether they would honor my insurance or that I needed to find a primary care physician, but he did provide me with the main number of the Center.

I also had a response from a pharmacist who was able to recommend two sources: the LGBT Center, which he warns has a two month waiting list, and an HIV treatment center 25 miles away. Neither of these options seem ideal.

But yesterday I did hear back from Blue Shield. And they were able to provide me with a comprehensive list of all of the doctors in the network who offer PrEP service in the Los Angeles area. There are a grand total of five.

Now I need to see if any of them are willing to add a new patient.


November 7th, 2015

And as reimbursement for doctors gets more and more complicated on the side of insurance companies, the less of them that will offer their services.


November 7th, 2015

Wow, wtf. I realize that it is for your insurance only, but how can only 5 doctors in LA provide PrEP services? That is just crazy.


November 8th, 2015

Timothy, if that doesn’t work, call the UCLA CARE Center (310) 557-9680. They coordinate PrEP implementation across Los Angeles.

Also, come join the PrEP Facts Group on Facebook. 11,000+ members. Any further issues or problems, we can help. :-)

Timothy Kincaid

November 8th, 2015

Thanks Jody. Unfortunately, the only group I found was “USA PreP Facts” which appears to be a community for those preparing to immigrate to the US.

Tom in Lazybrook

November 8th, 2015


For the benefit of all the others that might follow you, it might be instructive to file a complaint with the state insurance commission. And with the public health commission of your city, county, and state.

We have the same problem in Texas (its actually a lot worse – as you can’t get real insurance at any price). At least in other states, there are probably laws that prohibit discrimination in health provision based upon sexual orientation. Since the CDC recommends that all Gay men discuss PrEP with their doctors, then an argument can be made that any insurance plan that doesn’t have any doctors available to new patients that actually are willing to prescribe said pill amounts to discrimination in health services on the basis of sexual orientation.

Either way, filing a complaint will get the attention of the insurance company. Simply filing the complaint will result in lots of expense on the part of the insurance company (responding to the complaint and subsequent investigation by the insurance commissioner and the public health folks).

Joe Beckmann

November 8th, 2015

Once you win the PrEP case, you should start a PEP case as well, since post-exposure is as tested as pre- and takes a lot less medication (5-7 days and only after a risky exposure). I’m surprised, actually, that you’d begin with Pre-exposure since it takes a lot more pills and is only slightly more secure.

You know, I hope and I gather, that sex with people in treatment is virtually as safe as PrEP or PEP. In Boston and New York, it seems, the real barriers are caused by AIDS Service Organizations, who make their most (financially) successful treatments in lieu of medications. There have been some attempts to import Truvada (and its generic equivalent abroad) via Dallas Buyers Club like networks. Perhaps that makes the most sense, since Truvada in places like Cairo costs $1 a pill.


November 9th, 2015

Ha, Joe, the CDC would beg to differ on the idea that PEP can be a routine drug after possible HIV exposure.


November 9th, 2015

The above will give you the most current list of every PrEP provider in California. You can also hit up for a fully comprehensive site of everything PrEP.

I also have tons of information on my site around PrEP, but PrEPWatch is a more strictly informational resource. Mine is more of a news roundup and sharing my experiences while being on it since the first human trials, and staying on it ever since.


November 9th, 2015

Ps. Gillead has just changed their copay program and made it a lot more liberal, so depending on what/if your insurance does come through with picking up a portion, their program will pick up the balance of the cost. I’ve never paid a cent for my prescription since being on it.

Timothy Kincaid

November 9th, 2015

Thank you Daniel for the resources.


November 10th, 2015

@Joe Beckmann – PEP is a 4 week (28 day) course of a full HAART treatment. It includes efavirenz in addition to tenofavir and emtricitabine (Truvada).

IIRC, PEP hasn’t been shown to be more effective then PreP in the ‘real world’ since most of the studies have been in work-place exposures.


November 10th, 2015

@Timothy – I wish you luck. I know several people that have had trouble getting PreP due to doctor issues. I got lucky with mine, the doctor even assisted me with getting on the copay program, which covers the $80/month my insurance does not.

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