Anyone using 2-1-1 PEP?

[johnnyboyz]

I was at the dr getting regular tested and they recommended using 2-1-1 PEP with truvada since i see sp only occasionally (I'm definitely not one of those weekly guys. Not enough money ) . Granted, i always use condoms, of course. The dr. felt this was good insurance against broken condoms when having sex with sex workers. Any opinions? Anyone actually doing this? I didn't fill the prescription, but cost seems pretty low.

Thanks for your insights/opinions.

 

[AnthonyAnderson]

It's not indicated for people who use condoms consistently. Did you ask about the side effects? Your best insurance against condoms breaking is using enough lube and storing your condoms properly. In 10 years I've only had one break and I noticed it before putting it on. I've also never had an STI (regular tests). In case of breakage, the same drugs (or close analogs) that you refer to can be given after the fact, within 72 hours, to prevent HIV acquisition.

 

[2fast2slow]

out of my many many encounters the condom only broke once or twice, and it was clearly due to misuse on our part. To take an oral medication against something that has such low odds just seems wrong.

This doctor probably qualifies seeing sex workers as "risky behaviour", a common prejudice in the medical community

 

[Giselle Montreal]

I will say the same as @AnthonyAnderson and @2fast2slow. I am a sex worker and I am not taking it, as I use a condom 100% of the time for penetration. Never a condom broke, but it had slipped once or twice, at most. I would rather take the medication post-exposure since it's considered effective. Unless you never use a condom, or rarely, I don't see the necessity.

 

[Fonseca]

if you are not a bbfs regualr you dont need to be doing this.

 

[Hmmm…]

Highest risk is male with male community esp those who do bb anal and drug users. Bbbj and daty have very low but a nonzero chance of transmission. Risk goes from 5/1000 encounters to 0.05/1000 for insertive oral and 0.1 for receiving oral. So the math means 50x lower chance for bbbj compared to the highest risk method but not zero. Technically it takes only one virion for infection.

Here is where the Canadian healthcare system meets its limits. I started trying Yeztugo (lenacapavir) as a 6 month injection and it was entirely covered by insurance , but it’s not available in Canada because it’s like $30,000 per year. Canada is not great for the most expensive and the latest treatments.

 

[supersoaker]

Here is where the Canadian healthcare system meets its limits. I started trying Yeztugo (lenacapavir) as a 6 month injection and it was entirely covered by insurance , but it’s not available in Canada because it’s like $30,000 per year. Canada is not great for the most expensive and the latest treatments.

No disrespect, but I would argue that not covering this treatment through insurance in Canada is not necessarily a limitation. I’m not sure where you’re at to have this covered by insurance but I imagine perhaps it’s the States? I have numerous American friends that can’t afford insurance because the premiums are so crazy expensive. I wouldn’t say having a $30,000 annual prophylaxis for a recreational activity where a similar level of protection can be achieved through a $2 condom as a way that I would want my insurance premium spent, especially if it means that families who need insurance for critical medical expenses for their children can’t afford insurance because premiums are so high paying for someone’s discretionary super-drug.

Perhaps you have your reasons for taking it, and all the power to you that it’s covered by your insurance, but the reality is that the cost of it gets spread over everyone’s premiums and the more people taking these exotic medications, the more of the common whole suffers …

 

[Hmmm…]

No disrespect, but I would argue that not covering this treatment through insurance in Canada is not necessarily a limitation. I’m not sure where you’re at to have this covered by insurance but I imagine perhaps it’s the States? I have numerous American friends that can’t afford insurance because the premiums are so crazy expensive. I wouldn’t say having a $30,000 annual prophylaxis for a recreational activity where a similar level of protection can be achieved through a $2 condom as a way that I would want my insurance premium spent, especially if it means that families who need insurance for critical medical expenses for their children can’t afford insurance because premiums are so high paying for someone’s discretionary super-drug.

Perhaps you have your reasons for taking it, and all the power to you that it’s covered by your insurance, but the reality is that the cost of it gets spread over everyone’s premiums and the more people taking these exotic medications, the more of the common whole suffers …

I was offered it before any doing any recreational activities or telling my provider I have tried, and it was offered by the clinic due as public health concern and my clinic is also very progressive treating many in the lgbt community. From what I've seen, prophylaxis has no downsides health wise and likely should be given in the city water system to prevent transmission of all new cases. I think you have the Canadian mindset of payments based on the public payer system, but for those on private insurance, it's the judgement and often financial judgement of one private company for another private company (big Pharma Gilead). From what I've seen, the clinic wants as many people on it as possible as they get compensation from it too and for implanting it and doing the monitoring. They in turn would get more funding for treating others in the community.

I've heard from big pharma execs and they complain that drug discovery costs $2 billion US -$3 billion US if successful and 10-15 years, and it's only the US market that has the ability to allow them to make back investment with profit if the drug is successful, which few are. If they had to rely on the prices of Europe, Canada or Asia, they would not be able to make such investments or take the risks for R&D that they do. This is where the argument that the US is subsidizing global pharma innovation comes from. Whether you believe that or not is up to you, but if you look at the money available and the number of drugs developed and approved in the US vs Europe vs Japan.