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Generic PrEP available from December 4th

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  • 01-12-2017 1:56pm
    #1
    Ten of Swords
    Moderators, Category Moderators, Social & Fun Moderators, Society & Culture Moderators Posts: 22,497 CMod ✭✭✭✭


    Teva Pharmaceuticals have said their generic version of PrEP will be available in Ireland from Monday December 4th. The cost is not subsidized by the HSE and a monthly prescription will cost €90~€100 which is about a 70% cost reduction. Historically Truvada cost approximately €400 for a 30 day course.

    Considering HIV infection rates are at an all time high, particularly among gay and bisexual men, this will hopefully be a step in the right direction to reducing the number of cases.

    Hopefully in the future some kind of scheme or cost subsidy can target some high risk categories but I think that's a good result today.

    Irish Times

    The Journal

    Moderator: Lesbian, Gay, Bisexual & Transgender, Vegan & Vegetarian

    Category Moderator: Social & Fun



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    #2
    Annasopra
    Registered Users Posts: 40,982 ✭✭✭✭Annasopra


    Great news for those who can afford it. We still need it even cheaper again though.

    It was so much easier to blame it on Them. It was bleakly depressing to think that They were Us. If it was Them, then nothing was anyone's fault. If it was us, what did that make Me? After all, I'm one of Us. I must be. I've certainly never thought of myself as one of Them. No one ever thinks of themselves as one of Them. We're always one of Us. It's Them that do the bad things.

    Terry Pratchet



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    #3
    Tenigate
    Closed Accounts Posts: 849 ✭✭✭Tenigate


    The cost seems more than reasonable, particularly given that it's tax deductible.

    My fear of people taking prep is it may result in the rise in other stis like Chlamydia, gonorrhea, genital warts, herpes, Syphilis due to unsafe sex while on prep... Some viruses aren't curable, and bacterial infections are becoming antibiotic resistant.

    The other risk is a carefree attitude towards hiv just because we're told so many people do prep and use condoms... but many people don't and i believe infection numbers are rising or at least aren't falling. It's fine saying "hiv isnt a big deal, it's only a pill like a vitamin pill and the inconvenience of a blood test".

    Finally there are short and perhaps long term side effects of using prep. I can only compare it to using an antimalarial prophylactic. For a short term need it's fine. Long-term and you're better off avoiding mosquitos.


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    #4
    JackTaylorFan
    Closed Accounts Posts: 1,452 ✭✭✭JackTaylorFan


    Tenigate wrote: »

    The other risk is a carefree attitude towards hiv just because we're told so many people do prep and use condoms... but many people don't and i believe infection numbers are rising or at least aren't falling. It's fine saying "hiv isnt a big deal, it's only a pill like a vitamin pill and the inconvenience of a blood test".

    Kinda have to agree with the above https://www.irishtimes.com/news/ireland/irish-news/record-numbers-of-people-diagnosed-with-hiv-1.3079987

    http://www.pinknews.co.uk/2017/12/01/hiv-cases-in-northern-ireland-have-reached-an-all-time-high/

    The drive to remove the stigma attached to HIV while well intended, seems like it's leading to a more laissez-faire attitude in young people today. Yes, it's not a death sentence anymore, in the first world, thanks to today's medications - but it is still a devastating diagnosis, and a life altering condition.


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    #5
    Annasopra
    Registered Users Posts: 40,982 ✭✭✭✭Annasopra


    Tenigate wrote: »
    The cost seems more than reasonable, particularly given that it's tax deductible.
    .

    It's reasonable if you are able to afford it. So its not reasonable for people living in poverty or on low wages.

    It was so much easier to blame it on Them. It was bleakly depressing to think that They were Us. If it was Them, then nothing was anyone's fault. If it was us, what did that make Me? After all, I'm one of Us. I must be. I've certainly never thought of myself as one of Them. No one ever thinks of themselves as one of Them. We're always one of Us. It's Them that do the bad things.

    Terry Pratchet



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    #6
    Goodshape
    Registered Users Posts: 8,488 ✭✭✭Goodshape


    Could anyone do a short "dummy's guide" to PrEP?

    Some questions I have anyway –

    Can it be taken 'as needed' or is it something you're either taking all the time or not at all?

    Possible negative short and long term effects?



    Whatever about having a care-free attitude towards sex, it would be nice not to be overly paranoid about HIV _all the time_.


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    #7
    Annasopra
    Registered Users Posts: 40,982 ✭✭✭✭Annasopra


    Some good info in all these links (although a little outdated now)

    http://actupdublin.com/prep/

    http://www.hivireland.ie/hiv/prevention/prep/

    http://www.thejournal.ie/anti-hiv-medication-in-ireland-prep-3446022-Jun2017/

    http://www.tht.org.uk/sexual-health/About-HIV/Pre-exposure-Prophylaxis

    It was so much easier to blame it on Them. It was bleakly depressing to think that They were Us. If it was Them, then nothing was anyone's fault. If it was us, what did that make Me? After all, I'm one of Us. I must be. I've certainly never thought of myself as one of Them. No one ever thinks of themselves as one of Them. We're always one of Us. It's Them that do the bad things.

    Terry Pratchet



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    #8
    Ten of Swords
    Moderators, Category Moderators, Social & Fun Moderators, Society & Culture Moderators Posts: 22,497 CMod ✭✭✭✭Ten of Swords


    This American site (a collaboration of several charities and public health bodies in San Francisco) seems to have the most comprehensive guide online, several other guides seem to cite this one.

    http://men.prepfacts.org/the-questions/

    Moderator: Lesbian, Gay, Bisexual & Transgender, Vegan & Vegetarian

    Category Moderator: Social & Fun



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    #9
    Goodshape
    Registered Users Posts: 8,488 ✭✭✭Goodshape


    To summarise then :)


    Can it be taken 'as needed' or is it something you're either taking all the time or not at all?

    It can be taken as a tablet once a day for full cover.

    It can also be taken 'on demand', which is two tablets two to 24 hours before sex, one tablet 24 hours after sex and a further tablet 48 hours after sex.

    http://www.tht.org.uk/sexual-health/About-HIV/Pre-exposure-Prophylaxis#dose


    Possible negative short and long term effects?

    "About one in 10 people experience mild side effects like upset stomach, headaches or tiredness when they start PrEP. These effects usually last only a few days or weeks. A very small number of people experience kidney problems, which clear up when they stop using PrEP."

    http://actupdublin.com/prep/


    And all those sites suggest it is very effective against HIV when taken as directed.


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    #10
    Annasopra
    Registered Users Posts: 40,982 ✭✭✭✭Annasopra


    Tenigate wrote: »
    The cost seems more than reasonable, particularly given that it's tax deductible.

    My fear of people taking prep is it may result in the rise in other stis like Chlamydia, gonorrhea, genital warts, herpes, Syphilis due to unsafe sex while on prep... Some viruses aren't curable, and bacterial infections are becoming antibiotic resistant.

    The other risk is a carefree attitude towards hiv just because we're told so many people do prep and use condoms... but many people don't and i believe infection numbers are rising or at least aren't falling. It's fine saying "hiv isnt a big deal, it's only a pill like a vitamin pill and the inconvenience of a blood test".

    Finally there are short and perhaps long term side effects of using prep. I can only compare it to using an antimalarial prophylactic. For a short term need it's fine. Long-term and you're better off avoiding mosquitos.

    Some interesting observations and opinions. I wonder how you arrived at them? Is there a particular notable rise in other states of other STIs? Where are you getting information on the side effects?

    It was so much easier to blame it on Them. It was bleakly depressing to think that They were Us. If it was Them, then nothing was anyone's fault. If it was us, what did that make Me? After all, I'm one of Us. I must be. I've certainly never thought of myself as one of Them. No one ever thinks of themselves as one of Them. We're always one of Us. It's Them that do the bad things.

    Terry Pratchet



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    #11
    Tenigate
    Closed Accounts Posts: 849 ✭✭✭Tenigate


    Joeytheparrot wrote: »
    Some interesting observations and opinions. I wonder how you arrived at them? Is there a particular notable rise in other states of other STIs? Where are you getting information on the side effects?

    Sorry just opinions i formed through discussion and reading. I didn't note the sources of the info, other than to know I'm not interested in it.
    Sti's in general are reaching epidemic levels. I know a pill isn't going to fix that.


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    #12
    JackTaylorFan
    Closed Accounts Posts: 1,452 ✭✭✭JackTaylorFan


    Joeytheparrot wrote: »
    Some interesting observations and opinions. I wonder how you arrived at them? Is there a particular notable rise in other states of other STIs? Where are you getting information on the side effects?

    The rising number of cases of STIs is a genuine concern across the board - gay , straight or other.

    PrEP protects specifically against HIV, which seems to be the only concern for some men engaging in otherwise unsafe sex, it does not protect against any other STIs - a lot of which are quite worryingly becoming entirely resistant to antibiotics. Last time I read untreatable "super gonorrhea" has now been reported in over 50 countries worldwide.


    https://www.theguardian.com/society/2017/jul/07/untreatable-gonorrhoea-superbug-spreading-around-world-who-warns


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    #13
    Annasopra
    Registered Users Posts: 40,982 ✭✭✭✭Annasopra


    JackTaylorFan wrote: »
    The rising number of cases of STIs is a genuine concern across the board - gay , straight or other.

    Of course. I wondered aloud if there was data suggesting that using prep directly leads to higher STI rates of other STIs

    It was so much easier to blame it on Them. It was bleakly depressing to think that They were Us. If it was Them, then nothing was anyone's fault. If it was us, what did that make Me? After all, I'm one of Us. I must be. I've certainly never thought of myself as one of Them. No one ever thinks of themselves as one of Them. We're always one of Us. It's Them that do the bad things.

    Terry Pratchet



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    #14
    JackTaylorFan
    Closed Accounts Posts: 1,452 ✭✭✭JackTaylorFan


    Joeytheparrot wrote: »
    Of course. I wondered aloud if there was data suggesting that using prep directly leads to higher STI rates of other STIs

    I think it's dangerous to deny that there is a link between otherwise unprotected sex and PrEP use - at best it's a naive viewpoint.

    Even this article from Poz.com references these concerns https://www.poz.com/article/prep-fails-third-man-time-hiv-drug-resistance-blame
    So we’ll have to acknowledge that. It also doesn’t protect against STDs. So we think it’s clever to combine different prevention methods—PrEP being one of them, condoms and other risk-reducing behaviors being other ones.”


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    #15
    Annasopra
    Registered Users Posts: 40,982 ✭✭✭✭Annasopra


    JackTaylorFan wrote: »
    I think it's dangerous to deny that there is a link between otherwise unprotected sex and PrEP use - at best it's a naive viewpoint.

    Even this article from Poz.com references these concerns https://www.poz.com/article/prep-fails-third-man-time-hiv-drug-resistance-blame

    Where did I deny anything?

    It was so much easier to blame it on Them. It was bleakly depressing to think that They were Us. If it was Them, then nothing was anyone's fault. If it was us, what did that make Me? After all, I'm one of Us. I must be. I've certainly never thought of myself as one of Them. No one ever thinks of themselves as one of Them. We're always one of Us. It's Them that do the bad things.

    Terry Pratchet



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    #16
    JackTaylorFan
    Closed Accounts Posts: 1,452 ✭✭✭JackTaylorFan


    Joeytheparrot wrote: »
    Where did I deny anything?

    Perhaps you weren't. Your previous comments read like you were dismissing the concerns though.


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    #17
    Annasopra
    Registered Users Posts: 40,982 ✭✭✭✭Annasopra


    JackTaylorFan wrote: »
    Perhaps you weren't. Your previous comments read like you were dismissing the concerns though.

    I wasnt dismissing anything either. I was asking for more information and elaboration of opinion.

    I am puzzled though at this perception that asking a question or two is denial and/or dismissal. It's not like I said - "No you're wrong because you have nothing to back your point up".

    It was so much easier to blame it on Them. It was bleakly depressing to think that They were Us. If it was Them, then nothing was anyone's fault. If it was us, what did that make Me? After all, I'm one of Us. I must be. I've certainly never thought of myself as one of Them. No one ever thinks of themselves as one of Them. We're always one of Us. It's Them that do the bad things.

    Terry Pratchet



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    #18
    JackTaylorFan
    Closed Accounts Posts: 1,452 ✭✭✭JackTaylorFan


    Joeytheparrot wrote: »
    I wasnt dismissing anything either. I was asking for more information and elaboration of opinion.

    I am puzzled though at this perception that asking a question or two is denial and/or dismissal. It's not like I said - "No you're wrong because you have nothing to back your point up".

    Fair enough.


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    #19
    JupiterKid
    Moderators, Social & Fun Moderators Posts: 12,631 Mod ✭✭✭✭JupiterKid


    It’s great that this is finally available in Ireland now, although the price does seem a bit steep.

    But my concern would be that it may give some gay guys license to have regular bareback, unprotected sex. And although HIV is (thankfully) no longer a death sentence, it is still not something good to have and there is still a major stigma against poz men.


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    #20
    thereality
    Registered Users Posts: 74 ✭✭thereality


    I don't know what the obsession with PrEP and barebacking is about. If you don't agree with people barebacking, use a condom. Others should be so concerned about what others are doing in the bedroom. If someone wants to bareback, they are likely to do it with or without PrEP. At least with PrEP, they won't contracting HIV. If they do bareback on PrEP, they will have to go to their local GUM for a full regular screening to get another prescription. We should be delighted with the fact people, that are potentially exposing themselves to HIV are getting effective protection against. I seriously doubt everyone here disagreeing with PrEP is strolling up to the GMHS every 3 months

    I know it is lovely to tell gay men to just use condoms and not introduce PrEP. But lets get real. Pushing condoms as the only effective way to reduce HIV is failing and will continue to fail. HIV among Irish born MSM has flat lined since 2003. Despite all the headlines of record numbers contracting HIV in Ireland, that is mainly just Latin Americans contracting it. Actually a fair of that is them registering for HIV services in Ireland.

    PrEP has been one of the main factors in reducing HIV rates by 40% in London in recent years. We can keep pretending condoms will eliminate HIV, despite decades of this policy failing. Or we can get real and see PrEP as a step in the right direction.

    FYI I have feeling most of the people disagreeing with PrEP over bareback concerns would not tell their female friends to just use condoms and not the pill...


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    #21
    Annasopra
    Registered Users Posts: 40,982 ✭✭✭✭Annasopra


    The HSE has produced an information booklet


    http://www.hpsc.ie/publications/informationleafletsforthegeneralpublic/HIV%20PrEP%20in%20Ireland_English.pdf
    http://www.hpsc.ie/publications/informationleafletsforthegeneralpublic/

    It was so much easier to blame it on Them. It was bleakly depressing to think that They were Us. If it was Them, then nothing was anyone's fault. If it was us, what did that make Me? After all, I'm one of Us. I must be. I've certainly never thought of myself as one of Them. No one ever thinks of themselves as one of Them. We're always one of Us. It's Them that do the bad things.

    Terry Pratchet



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    #22
    Annasopra
    Registered Users Posts: 40,982 ✭✭✭✭Annasopra


    thereality wrote: »
    I don't know what the obsession with PrEP and barebacking is about. If you don't agree with people barebacking, use a condom. Others should be so concerned about what others are doing in the bedroom. If someone wants to bareback, they are likely to do it with or without PrEP. At least with PrEP, they won't contracting HIV. If they do bareback on PrEP, they will have to go to their local GUM for a full regular screening to get another prescription. We should be delighted with the fact people, that are potentially exposing themselves to HIV are getting effective protection against. I seriously doubt everyone here disagreeing with PrEP is strolling up to the GMHS every 3 months

    I know it is lovely to tell gay men to just use condoms and not introduce PrEP. But lets get real. Pushing condoms as the only effective way to reduce HIV is failing and will continue to fail. HIV among Irish born MSM has flat lined since 2003. Despite all the headlines of record numbers contracting HIV in Ireland, that is mainly just Latin Americans contracting it. Actually a fair of that is them registering for HIV services in Ireland.

    PrEP has been one of the main factors in reducing HIV rates by 40% in London in recent years. We can keep pretending condoms will eliminate HIV, despite decades of this policy failing. Or we can get real and see PrEP as a step in the right direction.

    FYI I have feeling most of the people disagreeing with PrEP over bareback concerns would not tell their female friends to just use condoms and not the pill...

    Have you got some proof of your assertion that HIV among Irish born people has been flatlining since 2003 and that the increases in HIV amongst MSM is mainly due to Latin American Men?

    It was so much easier to blame it on Them. It was bleakly depressing to think that They were Us. If it was Them, then nothing was anyone's fault. If it was us, what did that make Me? After all, I'm one of Us. I must be. I've certainly never thought of myself as one of Them. No one ever thinks of themselves as one of Them. We're always one of Us. It's Them that do the bad things.

    Terry Pratchet



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    #23
    thereality
    Registered Users Posts: 74 ✭✭thereality


    Joeytheparrot wrote: »
    Have you got some proof of your assertion that HIV among Irish born people has been flatlining since 2003 and that the increases in HIV amongst MSM is mainly due to Latin American Men?

    The HSPC monitors infectious diseases in Ireland. They keep track of everything from TB, the flu and STIs. It is not my assertion that HIV has been stable, it is the view of an independent body that collects data on HIV. According to their 2016 HIV report :
    The rate of diagnosis among those born in Ireland has remained stable since 2003, ranging
    from 3.4 to 4.2 per 100,000 population (see Figure 5).
    Of the 508 new diagnoses, just over half (51%) were among men who have sex with men
    (MSM). This was the largest number of diagnoses ever reported in MSM, who remain the
    subgroup most affected by HIV in Ireland. Similar to what was seen overall, the proportion of
    MSM previously diagnosed HIV positive before arrival in Ireland has been increasing and was
    42% in 2016 compared to 16% in 2012. The majority of these men (87%) were born abroad,
    with the highest number from Latin America. Similarly the numbers of new diagnoses in MSM
    not previously diagnosed abroad dropped by 14% in 2016 compared to 2015.

    www. hpsc. ie/a-z/hivstis/hivandaids/hivdataandreports/HIVIreland_2016.pdf (remove the spaces between the www. and hspc. ie to use the link correctly)

    As much as people like to think HIV is soaring in Ireland due to younger people not using condoms and not remembering the AIDS crisis and thinking it is just a pill a day etc etc. HIV among Irish men has not really changed much in just over a decade.


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    #24
    Tenigate
    Closed Accounts Posts: 849 ✭✭✭Tenigate


    A bit more empirical evidence but i was chatting to someone who only found out he had hiv because he applied for a job in healthcare in Ireland and tests like hiv and tb were mandatory.

    Personally I'd like to see mandatory screening for illnesses like hiv from countries like Brazil. Many people would say that's discrimination or stigmatisation but if it stops the disease from spreading in Ireland i wouldn't particularly care too much.


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    #25
    Ten of Swords
    Moderators, Category Moderators, Social & Fun Moderators, Society & Culture Moderators Posts: 22,497 CMod ✭✭✭✭Ten of Swords


    A new online resource giving information about PrEP in Ireland has gone online recently, it is run by a group of Dublin based volunteers

    https://www.getprep.online/

    Good job guys!

    Moderator: Lesbian, Gay, Bisexual & Transgender, Vegan & Vegetarian

    Category Moderator: Social & Fun



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    #26
    Goodshape
    Registered Users Posts: 8,488 ✭✭✭Goodshape


    A lot of good and useful info there! Fair play.


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    #27
    what the hell!
    Registered Users Posts: 823 ✭✭✭what the hell!


    Can I ask a stupid question- I asked my GP to enquire about it and he came back from the Pharmacist to me and said it was costing €600 a month. Am I missing something?


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    #28
    haro124
    Closed Accounts Posts: 684 ✭✭✭haro124


    what the hell! wrote: »
    Can I ask a stupid question- I asked my GP to enquire about it and he came back from the Pharmacist to me and said it was costing €600 a month. Am I missing something?

    Maybe the pharmacy only has the branded version?


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    #29
    Tenigate
    Closed Accounts Posts: 849 ✭✭✭Tenigate


    what the hell! wrote: »
    Can I ask a stupid question- I asked my GP to enquire about it and he came back from the Pharmacist to me and said it was costing €600 a month. Am I missing something?

    Shop around.


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    #30
    Annasopra
    Registered Users Posts: 40,982 ✭✭✭✭Annasopra


    what the hell! wrote: »
    Can I ask a stupid question- I asked my GP to enquire about it and he came back from the Pharmacist to me and said it was costing €600 a month. Am I missing something?

    It should be around €100 per month.

    https://gcn.ie/affordable-prep-made-available-irish-pharmacies/

    It was so much easier to blame it on Them. It was bleakly depressing to think that They were Us. If it was Them, then nothing was anyone's fault. If it was us, what did that make Me? After all, I'm one of Us. I must be. I've certainly never thought of myself as one of Them. No one ever thinks of themselves as one of Them. We're always one of Us. It's Them that do the bad things.

    Terry Pratchet



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    #31
    thereality
    Registered Users Posts: 74 ✭✭thereality


    what the hell! wrote: »
    Can I ask a stupid question- I asked my GP to enquire about it and he came back from the Pharmacist to me and said it was costing €600 a month. Am I missing something?

    I imagine that is the branded version from Gilead Sciences called Truvada. Meaghers pharmacy on Baggot St beside the GMHS is apparently charging €85 per month.

    You are better off going to a local STI clinic in a hospital. With PrEP you will need a kidney function test and HIV test before you start. Then another HIV test after month one to ensure you are negative. You will need quarterly HIV / kidney function tests to ensure you are negative and your kidneys are ok. If you don't have a medical card, it will have cost you about €300 in GP fees in year 1.

    Whereas the likes of the GMHS is free and can actually advise you where is selling generic truvada. I know a few people who went to their GP for advice on PrEP and they were useless.


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