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News and commentary about the anti-gay lobbyNovember 10th, 2015
In my last update, I reported that Blue Shield HMO had provided me with the name of five doctors who they thought do prep. So I’ve made some phone calls.
First I eliminated the doctor who practices in Santa Paula, 70 miles away in another county. That’s a bit too far to drive every three months during office hours and I certainly wouldn’t want a primary physician that far away.
Then I called the doctor who doesn’t do PrEP at all; he only does HIV testing. Which I do myself using OraQuick, the at-home testing kit.
Next was the doctor who does do PrEP, but not through my insurance. He only accepts patients with my insurance if they are already HIV positive.
Finally, I called the last number (the two remaining doctors practice together). I was transferred to a voice message of someone who I believe said that he is the PrEP coordinator for APLA.
So there is still some hope that this final contact will come through and I will finally have access to the program.
UPDATED
I heard back from the PrEP coordinator and it turns out that the doctor does take my insurance, administers PrEP, and is accepting new patients. He’s 6 miles away and only about a half-hour drive, so I’ve changed my primary care doctor and have an appointment for next week.
This has not been an easy process. But it has proven to be possible, something I was not sure about for a while.
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Markanthony
November 10th, 2015
Congrats Timothy. Thanks for writing so honestly about your experience.
Greg
November 11th, 2015
My spouse originally had his primary care doctor in another city close to ours. He decided he wanted to move his primary care doctor to our city and go on prep.
My doctor, who is the primary HIV+ and Hep C doctor in the city has not taken new patients except for HIV+ and Hep C patients., plus my spouse wanted a doctor close to his office and not clear across the city.
My doctor was one of the five founders of the group that he works with which has now expanded to over 300 doctors. I was one of his original patients 35 years ago.
After trying 3 different doctors from the group close to his office, all of which said they wouldn’t prescribe prep, I sent my doctor an e-mail complaining about the situation and he called me within 15 minutes to say he would take my spouse.
Although he has to drive across town every three months, my spouse only has to see my doctor’s physician assistant and not the primary doctor. My spouse is very happy now.
Unfortunately, sometimes it’s who you know in order to get things done.
BTW, my spouse and I have been together 19 years and I spent a great deal of time trying to get him to change doctors to mine during that time.
enough already
November 11th, 2015
Congratulations on getting basic medical care as a gay man.
It would be great to see an article about your journey – incredible journey – to achieve this goal in the NYT or Slate or WSJ.
Being monogamous and negative, neither my husband nor I need a ‘gay man’s’ doctor. Enjoyed having one in Atlanta for many years, though.
Took three tries to find a decent physician here in the Rocky Mountain Empire…the first two just assumed we were HIV-Positive and disease plagued. Finally found a highly competent woman in her mid-forties. If we were non-exclusive or had need for ongoing treatment for any of the non-Christian-approved issues, wow. Probably couldn’t have settled here.
Eric Payne
November 11th, 2015
When I was born, over a half-century ago, I was over a month premature… bad news in the 1950s. I wasn’t “fully cooked,” most noticeably, physically, manifested in my spine, in which some of the vertebra never fully formed and separated and my heart. I look as if I don’t have a neck (my head sits directly atop my shoulders), the aorta is too thin where it enters the heart (aortic stenosis) and the aortic valve, itself, didn’t operate correctly. My parents were given the diagnosis I was “probably Mongoloid” (this was before medical political correctness, obviously), that I’d be dead before I was 5, and to put me in a home and “try again.” My medical treatment consisted of absolutely nothing.
At 16 I had my first heart attack… though, by today’s standards, that attack would be classified as a “cardiac event.” After that, my medical treatment consisted of exercise (especially walking), annual stress tests and an angiogram.
Sixteen years ago, when I entered heart failure, I was told I “(had) 5 years, tops.” In that first year of failure, I was self-insured, and my treatment consisted of four medications and semi-annual consultations with a cardiologist.
During my second year of failure, I was extended domestic partnership benefits through Bill’s company… and immediately the number of medications I was to take daily doubled. I was scheduled monthly visits with a Kaiser cardiologist and, after an angiogram, scheduled for my first surgery, in which that faulty aortic valve was replaced, and bypasses were routed around the stenosis.
There were complications during and after the surgery; what should have been a three-day in-patient stay turned into the entirety of June, in-and-out of intensive care.
Today, nearly seven years after moving to Georgia, I’m taking 14 different medications, daily, not including insulin. As my blood flow has weakened over the years, other organs have been affected. My pancreas is shot, so I’m an insulin dependent diabetic. My kidneys are failing. I’ve been on Flagyl for years — if I quit taking it, my c-dif infection starts manifesting itself in ugly ways; I apparently picked up that nasty bug while hospitalized to have a pacemaker/defibrilator implanted in my chest. I’ve been ablated, so that the defib unit actually generates my heartbeat. If I should quit taking my medications… I die.
And I, as a gay man, are supposed to be concerned that a drug allowing other gay men the peace of mind to be able to fuck with condoms is so difficult to get?
Puh-leeze.
Those of us who are still alive, and who remember the “everybody fuck everybody” mind-set of the pre-HIV days, I have to ask: Is that really where you want our community to return? Are meat racks and bathhouses really all that important? Do we want a resurgence of the little head not just doing the momentary thinking of the big head… but of doing the only thinking?
I, actually, am amazed that any insurance company is offering access to PrEP. We’re living in an age where conservatives have insurance companies denying straight women access to birth control.
What do you think the conservative response is going to be when the question of access to a drug so gays can fuck, condomless, is going to be?
Lord_Byron
November 11th, 2015
It’s fucking insane that something like PrEP is so hard to get. I know it’s not realistic, nor probably the best idea for both financial and medical reasons, but it’d be nice if the generic form of truvada was available otc when it becomes generic in the next 2 to 6 years. Something that has the potential to end new HIV infections is fantastic. The problem of course is that you have to get tested regularly every 3 months and if you do get HIV they normally move you off truvada for a stronger drug.
Timothy Kincaid
November 11th, 2015
Greg, thank you for sharing your story.
Mattnyc
November 11th, 2015
Eric, I can empathize with your point of view, but have you considered that there are sero-discordant couples who use prep to avoid converting the negative partner?
That takes nothing away from your situation, and I am happy that you are getting the care you need. The real moral of YOUR story is that good health care should not be tied to one’s employment and/or relationship to someone who has good work coverage.
Eric Payne
November 11th, 2015
Mattnyc:
Yes, I’ve considered it… but what is so important about semen that an orgasm be obtained in a seronegative partner than on that negative partner? AFAIC, it’s the sex, itself, that is the intimate act, and not just the orgasm.
Eric Payne
November 11th, 2015
Oh, and my initial posting in this thread reads:
It should have read the following”
I apologize for the confusion.
Priya Lynn
November 11th, 2015
I think if you’re a moderately intelligent gay man taking PREP wouldn’t give you a whole lot of peace of mind that you can have sex without condoms.
Jim Burroway
November 11th, 2015
Eric,
As a partner in a sero-discordant relationship, are you suggesting that the quality of sex that we have should be lesser than the quality of sex that non-discordant couples have? What gives you the prerogative to tell me what kind of sex we have, let alone whether I should be happy to have him come “on” me.
I really don’t give a damn whether you are concerned about a drug that can significantly improve my quality of live. What I do give a damn about however is your judgmental attitude towards those of us whose lives would most certainly be improved through access to this drug. Pulling the “I’m much sicker than you” card really does nothing to advance your argument, nor does it grant you any special authority to cast aspersions on how *others* seek to protect *their* health.
Eric Payne
November 11th, 2015
Jim,
So, exactly how is your “quality of life” improved by going condomless?
Eric Payne
November 11th, 2015
Oh, and Jim,
I was not comparing my health care to anyone else’s — I was attempting to point out that health care in this country is completely dependent upon a person’s immediate ability to pay and the general public “morality” at the time that patient requires treatment.
So, let’s take me, and my health care, out of the picture, and re-describe it in a different way:
For children with leukemia, physicians will, at some point, recommend a bone-marrow transplant, routinely. Yet many, if not most, insurance companies still define such treatment as “experimental,” to disallow payment for those treatments.
MattNYC
November 11th, 2015
Priya, you reminded me of another reason for PrEP. I know at least two people who sero-converted when using condoms.
Condoms break. That’s a reason to not ONLY rely on condoms. I agree with you that other STDs are also a reason to use condoms with strangers.
Eric, Jim answered better–and from a personal perspective–that I can’t really match.
I will say this, though: I believe a monogamous couple should FEEL FREE to have condomless sex. Frankly, I don’t judge those who are not monogamous–it’s none of my business. There are people who are completely reckless who have stayed HIV-free and people who TRY to do everything by the book and contract it.
I participate in an AIDS Ride and donate to many AIDS-related (and plenty of non-AIDS-related) charities and I would never think of demanding to know how any of those they serve contracted HIV/AIDS.
The point has NOTHING to do with morality.
Diseases are **A**moral. They do not discriminate and I believe that anyone who contracts something life-threatening/changing deserves compassion, assistance, and the best healthcare available, regardless of income, employment, sex, sexuality, race, etc. It actually sounds like you agree with this, so I am willing to accept that your last post is how you truly feel. :)
I think we can all agree that in a perfect world, everyone would take at least some measure of responsibility for themselves and make fully open and consensual decisions with those with whom they interact.
But this is what we are stuck with.
And people really need to learn empathy…
MattNYC
November 11th, 2015
And I will say this about condoms and monogamy. My partner and I have been together for 10 years and we actually refrained from anal sex until we cleared the (old three-month) testing window rather than use condoms. Granted we were in our late 30s at the time.
A 20-something MattNYC would certainly have opted for condoms during the testing window rather than abstain :)
MattNYC
November 11th, 2015
OK. I had ONE more thought. Sorry for the sudden verbosity.
The AIDS ride I do benefits Housing Works in NYC. Housing Works is one of the driving forces behind NY State’s goal of ending HIV/AIDS as an “epidemic” by 2020.
PrEP plus Making sure that HIV+ people have access to the drugs to make them undetectable are two of the lynchpins in the strategy–making it so HIV+ people cannot infect others and that HIV- people who are in high-risk categories have access to PrEP. Add in major education efforts and this can be achieved.
Priya Lynn
November 11th, 2015
Matt, I don’t suggest that a person should only use condoms if they are in a high risk category.
Eric in Oakland
November 11th, 2015
Eric Payne, are you aware that semen is not the only bodily fluid capable of transmitting HIV? Blood, for instance, is just as much of a carrier, and can be present after flossing your teeth or due to chapped lips. Should serodiscordant couples also refrain from kissing? After all, it’s not 100% risk free.
Don’t assume that everyone who wants to use PrEP just wants to have sex without condoms. There are many reasons why someone might feel safer with PrEP, including the fact that condoms sometimes break. There are also people who can’t use latex condoms due to allergy and can’t use animal based condoms for moral reasons. Should these couples just abstain from sex?
Besides, if someone DOES want to have bareback sex, why should you care? How does it affect you? What consenting adults do in the privacy of their own bedrooms is nobody else’s business. That is precisely why antisodomy laws were deemed unconstitutional.
Priya Lynn
November 11th, 2015
“Besides, if someone DOES want to have bareback sex, why should you care?”.
Why should I care if someone drives without their seatbelt?
Priya Lynn
November 11th, 2015
Eric, by your logic, why should I care if Uganda puts gays to death? Doesn’t affect me.
Priya Lynn
November 11th, 2015
I don’t buy this whole “Its inappropriate to be concerned with the wellbeing of someone other than yourself.” thing.
enough already
November 12th, 2015
Priya Lynn,
I most certainly am not saying that we shouldn’t take care of each other.
What bothers me about your approach and that of many others is the latent anti-gay-male hostility behind it.
We gay men just don’t fit into the PC driven world of humourless, totally anti-masculine anything policy you so often advocate.
Men are going to come in each other’s asses whenever and wherever they can. It’s nature.
PrEP prevents the transfer thereby of the HI-Virus.
End of discussion.
The whole moralizing and anti-gay male bashing is unnecessary.
I really don’t want to rehash the eternal discussion about whether a man can ‘tell the difference’ or ‘not’.
I can. Most every bottom I know can. I feel pity for those who are either too guilt driven or have such dead assess they can’t.
This nonsense of denying my husband and me (married and monogamous for well over 30 years now) the pleasure of barebacking for some stupid anti-gay-male politically correct game is not going to happen.
MattNYC
November 12th, 2015
Priya, if two CONSENTING adults make that decision, it’s their decision. It’s not something *I* would do. Yes it *might* be self-destructive, but that is their choice. There are risks and consequences, but that is not your business or mine.
Besides saving a life, not wearing a seatbelt means that a driver could more easily lose control of a car and harm others. I suppose in a Libertarian paradise or on private property, that would be part of a mutual agreement and everyone would assume everyone else’s risk. But on the public roads, that’s not something people are willing to deal with.
I just think that we should be able to discuss PrEP without moralizing about sex. I spent the ’00s volunteering at GMHC spreading the harm reduction gospel. Judgement-free education. We have to provide people the tools they need to reduce risks–and if that includes a pill (or seatbelts) and maybe someday a vaccine, then GOOD.
I feel like I am caught in a time warp back to the ’80s. Jesse Helms, Jerry Falwell, and Strom Thurmond are feeding worms.
Eric in Oakland
November 12th, 2015
Priya Lynn, your reasoning is the same that was used to criminalize gay sex and abortion. Both restrictions were imposed with the best of intentions. Acknowledging people’s right to personal autonomy and privacy does not equal unconcern for others’ wellbeing.
Eric Payne
November 12th, 2015
Wow.
Hey, everybody, the point I was trying to make was not meant to be about anal sex, protected or unprotected (and, yes, I am aware the HIV retrovirus can be transmitted via other bodily fluids, though it is most concentrated in saliva).
The point I was attempting to make was to compare PrEP to women’s’ contraception.
If the moralists are going to limit insurance companies in providing contraceptives — remember Rush Limbaugh’s incorrect statement that “more pill means more sex! — then what do you think is going to happen when those same people realize there’s coverage for PrEP? You think they’re not going to blow gaskets at the thought a drug that promotes men fucking mess being readily available?
That was my objective; obviously, I failed to get that across.
enough already
November 12th, 2015
Eric,
I got your point.
I just don’t give a flying f*ck what the hate-driven conservative Christians think.
Here’s one area where I scream into the woods just like you and Priya Lynn do:
Vote!
Gay men fail to vote in enormous numbers.
Now that we’re back at about 10% of the population, the excuse that there are too few of us to matter doesn’t cut it.
Intellectually, I know it’s as much their ‘choice’ as is bug-chasing or not wearing a seatbelt.
Emotionally, though – grrrrr.
Eric Payne
November 12th, 2015
enough already,
I don’t give an airborne fornication about the thought processes of conservative theists, either.
I was just pointing out that, unfortunately, health care issues in this country — especially elective non-life threatening issues — are based on a doctor/treatment facility/pharmacy making a profit, and the general societal morals of the moment.
C’mon, now… what do you think would happen if a Ted Cruz or a Mike Huckabee were to discover a gay man received PrEP therapy through the benefits given him via the Affordable Care Act?
Priya Lynn
November 12th, 2015
Matt said “Priya, if two CONSENTING adults make that decision, it’s their decision. It’s not something *I* would do. Yes it *might* be self-destructive, but that is their choice. There are risks and consequences, but that is not your business or mine…I just think that we should be able to discuss PrEP without moralizing about sex.
Sorry Matt, you’re never going to convince me other people’s wellbeing isn’t my concern. And this has nothing to do with “moralizing” about sex for me, its simply a matter of encouraging people to take the best care for themselves just like I’d encourage them to exercise.
Eric in Oakland said “Priya Lynn, your reasoning is the same that was used to criminalize gay sex and abortion. Both restrictions were imposed with the best of intentions.”.
Nonsense. There’s a world of difference between encouraging people to take care of themselves and criminalizing them for not doing so. And most certainly the restrictions on gay sex were NOT imposed with the best of intentions. Gay sex was criminalized because people thought gay sex was icky, or they were secretly fighting their own same sex attractions by attacking gays. Abortion was criminalized because conservative men can’t stand the thought of women enjoying sex without consequences, it was an attempt to control women and our sexuality.
Priya Lynn
November 12th, 2015
By Eric in Oakland’s logic no one should encourage anyone to exercise because thats a slippery slope to the government imprisoning people for being sedentary.
Timothy Kincaid
November 12th, 2015
To all,
I hereby give you permission not to worry, stress, care or obsess about the details of my sex life. You needn’t concern yourself about the brand, type, or size of condom I may or may not utilize. You are now deemed not to have a social interest in my sexual role, whether I use adequate lube, or the general appropriateness of either my sex partners or sexual practices.
You may now consider yourself liberated from the obligation of lecturing me about things you may imagine about my sex life about which you disapprove. Think of it as a burden lifted.
In return, I will assume that you, too, are an adult who is better equipped to measure your life situations and to determine for yourself what is appropriate and best for you.
What I do invite you to care about, however, is that there is a drug which has the potential to significantly decrease the transmission of HIV and which – if widely used – could end this epidemic. And that this drug has proven, in this experience, to be extremely difficult to get.
That (unlike other people’s sex lives) is something that actually is our business.
Priya Lynn
November 12th, 2015
I’m not in any way opposed to people using this drug Timothy.
Priya Lynn
November 12th, 2015
And if its not my business whether or not users of this drug also use condoms then its not any of my business that it could reduce the transmission of HIV and is extremely difficult to get.
You can’t have it both ways.
Priya Lynn
November 12th, 2015
How hypocritical to invite concern that PREP can reduce STDS and you can’t get it and then to suggest people shouldn’t express concern that condoms can further reduce STDS because some people don’t want to use them.
Priya Lynn
November 12th, 2015
And my previous comment was a paraphrasing if anyone didn’t get that.
Nathaniel
November 13th, 2015
Priya, it would be hypocritical if the situations weren’t very different. “Can’t get” and “don’t want” are two different things. It is not at all self-deluding to be concerned with the problem of access while not worrying about the problem of (dis)use. One we can fight tooth and nail for; the other requires more nuanced work. One involves other individuals making decisions for us; the other involves us providing information then letting individuals make their own decisions. It is not my business if someone smokes, or wears seat belts or condoms. They certainly could not be acting out of ignorance; I can only choose to accept their decisions. Call me when condoms or seat belts are hard to get, then we can be outraged together. Eric Payne is right about one thing: if the LGBT+Ally community can’t agree on ready access of PrEP, regardless of location or doctor, we are in trouble when the hard-core anti-gays start preaching that gay sex is being facilitated with old peoples’ hard-earned tax dollars.
Disclaimer: Priya, I know you aren’t preaching against PrEP, but it really reads like you are.
Priya Lynn
November 13th, 2015
I disagree Nathaniel. Its hypocritical to invite people to be concerned about your wanting Prep to avoid an STD but then to say I don’t want to hear about any other way of avoiding STD’s. In the first case you’re saying, be concerned for me that I can’t get this preventative measure and then in the second case saying don’t be concerned for me that I don’t want to use this other preventative measure.
I didn’t see anyone not agreeing on the desirability of ready access to PREP, certainly not myself. If people read something I didn’t say into what I write and think I’m against PREP, that’s not my problem, its their’s. In no way have I suggested that individuals shouldn’t be able to make their own choices about using condoms so for god’s sake stop suggesting that B.S.
If a person is going to ask people to consider the importance of PREp to their sex lives then they can’t expect not to hear about the importance of condoms to their sex lives. If you want to use PREP and not a condom then the way to handle related talk about condoms is to say “Thanks for your concern, I understand the risk and I chose not to use one” rather than to get indignant (I’m looking at you Enough Already) and falsely claim its inappropriate or Nazi-like to bring up the topic of condoms.
I think by now my point should be clear so I won’t be back to this thread. If Enough or someone else wants to call me a Nazi or dishonestly suggest I’m against PREP or absurdly suggest other people’s well being isn’t any of our business then so be it.
Priya Lynn
November 13th, 2015
Whether one is wanted and the other is not doesn’t keep the discussion from being hypocritical.
To paraphrase:
Be concerned about the risk I have of getting an STD because I can’t get PREP but don’t be concerned about the risk I have of getting an STD because I don’t want condoms = hypocritical.
Lord_Byron
November 14th, 2015
“You needn’t concern yourself about the brand, type, or size of condom I may or may not utilize.”
But they’re magnums, amiright? :P
enough already
November 14th, 2015
Oh, god’s, don’t look at me. I was just out cleaning the dog runs and I’m stinky and covered in poop.
Our disagreement is not about taking sensible precautions against STDs.
Our disagreement is based on the high-handed way you all too frequently treat gay men. Not lesbians, not bisexuals, not our transgender brothers and sisters, not our allies or anyone else in the alphabet soup.
Just us, because gay men aren’t at all the sanitized PC-Police approved ticky-tacky little boxes, cookie-cutter types you demand we be.
We’re the birds of paradise in the GLBT community and you really, really don’t like it.
Timothy Kincaid
November 18th, 2015
Let me take this moment to state the obvious: were access to condoms limited in any way, all of us here at BTB would be up in arms and fighting for access.
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