3 min

Is generic PrEP right for me?

Mulling over the options as my Truvada stash dwindles

Without the benefits work offered me, I had to figure out new ways to protect myself. Credit: Facebook/Andrew Jacome

I had 20 pills of Truvada left.

Since I had decided to leave my job and travel the world as a freelance writer, I’d given up my extended health coverage, and by extension my access to PrEP. My first stop was a few weeks in New York City, then on to Berlin for a few months after that.

While in New York, I was trying to accept that I would no longer be protected the way I had been for the last year or so since I started taking PrEP. The pharmaceutical industry is a business, but if the drug is approved elsewhere and it’s effective in preventing HIV by 99 percent, why is accessibility for Canadians so limited?

A friend reminded me that it’s possible to order a generic brand of PrEP from Asia for a fraction of the cost. The idea of stopping PrEP was bothering me so much that I was actually considering this. It felt like a way to take my health into my own hands.

The Facebook group PrEP Facts: Rethinking HIV Prevention and Sex has been much more helpful to me than any doctor or website has been since I started taking Truvada. The group members offer reliable information about PrEP, both official and unofficial, including some stuff that doctors might be too afraid to say.

It was from that group where I saw a thread about accessing a generic version of PrEP, Tenvir-EM. The Canadian man who started the thread said he drove from Vancouver to Blaine, Washington, to pick up his order. Cipla, the pharmaceutical company that produces the drug, is recognized by the FDA in the United States.

I was already in New York with a valid US address, so I wouldn’t need to cross a border or anything if I wanted to try the same thing. It’d be relatively straightforward for someone like me to get generics — right?

The next day I called my doctor’s office in Toronto. He’d prescribed a three-month supply of Truvada for me a couple of months ago, knowing that I was losing my benefits, and so he knew that I would be running low by now. When I explained that I was considering ordering generic PrEP, he warned me that it’s impossible to trust a website to be giving you what you think you’re ordering. He told me a story about a patient who’d ordered HIV antiretrovirals that ended up not working. I mentioned the site alldaychemist.com, the one the Facebook group mentioned, and said that it was highly recommended, but he repeated that you never know what you’re going to get online.

I’ve always listened to my doctor when it came to PrEP and usage, so based on his advice I finally told him that I wouldn’t order the generics — they seemed too unreliable. He then repeated, yet again, that you don’t know what you’re going to get when you order online, but added that there are a lot of generic brands out there that do work. I paused for a moment, trying to figure out exactly what he was trying to tell me. Listening, I tried to interpret what he was saying, and what he couldn’t say: he didn’t think it was a bad idea to order them, but he couldn’t help me because of liability. He’s been a great doctor, and has helped a lot of people gain access to Truvada, but this was the best he could offer me right now.

I put off the ordering of the generics for a week; I still wasn’t sure if it was worth taking a chance. As I continued to deliberate, I noticed that my stockpile was still shrinking. I was leaving the US in 13 days, so if I was going to order these pills I would need to do it right now.

Only 12 Truvada pills left . . .