Opinion
3 min

Taking a gamble with generic PrEP

Navigating my health . . . on the internet

As my stash of Truvada dwindled, I had to rely on the internet (and my gut) and take my health into my own hands.  Credit: Marc Bruxelle/iStock/Thinkstock

I had 12 pills of Truvada left, and I felt my only option to continue using was to order generics online. I knew it was risky though. It even sounds sketchy when I say it aloud. When I mention this to my friends they laugh and call me crazy. My doctor’s warning about how you never really know what you’re going to get when ordering online kept playing around in my head. He did also say that some generic brands work though — that was something. I’ve been using Truvada as PrEP for over a year and it made me feel protected, so much so that I was debating ordering online despite the risks and warnings. 

I went back to the PrEP Facts Facebook group and explained about how I was currently low on Truvada and was considering ordering generics. I also mentioned the warning that my doctor had given me. I asked whether anybody had ordered from alldaychemist.com, and if so, what their experience had been. About 20 people commented on my post, and all of them had positive things to say about the site.

Greg Owen, a co-founder of iwantprepnow.co.uk, pointed me to his site. It raises awareness of PrEP and how to access it, taking more of a grassroots approach. In the UK, one cannot get a prescription for PrEP from their GP unless they pay them for a private appointment. They can’t get it from their local sexual health clinic either.

As well as providing practical information about the drug, the site also informs how to take it and where you can purchase it from online. Alldaychemist.com was listed as one of the verified sources, so I ordered it immediately.

A three-month supply came out to $190.33 USD, which was significantly cheaper than the Truvada I was getting, even with my drug plan. It’s incredible to think how much Gilead Sciences is charging for the drug, considering the sort of profits it is making. Its total revenues in 2015 was $8.2 billion, with a net income of $4.5 billion. This is up $1.7 billion from 2014. Gilead does have various programs to make their products more accessible in the United States, but now that the drug has been approved by Health Canada, can we expect a program for Canadians?   

The Tenvir-EM I ordered was going to take anywhere from 5-15 days to deliver, which was a problem. I only had 12 pills, and was leaving New York in 13 days, so if it took 15 to arrive then I wouldn’t get the shipment and would run out. And were the 15 days business days or regular days? I was never good at math, so the whole thing gave me a headache.  

On I Want PrEP Now, there was an interesting section about ways in which you can take the drug. They of course recommend daily use to ensure 99 percent protection, but if you take it every other day or four times a week, the site claims that it can be 95 percent effective, which is still pretty high, especially if it’s your only option. It also mentions something called “event based” dosing, where you can take two tablets the day before a sexual encounter (2–24 hours before), take one just after the sex and take one the following day. The site warns that there’s a lot of conflicting data on the “event based” dosing, and that there’s no evidence to prove its protection levels, but my doctor had once told me about this method. Still, it was too risky for me, but if I wanted to conserve my stash in order to tide me over, I needed to take less than seven per week. I decided on five.

In the meantime, I was tracking my order, which had come from Singapore. I only had a week left in New York but it just shipped and I knew that at that rate, there was no way I was going to get the generics in time. A couple of my friends were nice enough to give me me some of their pills to tide me over. One gave me seven Truvadas and another gave me seven Tenvir-EM, but still, if the pills arrived after I left New York, I wasn’t sure how I would get them.

My lover back in Toronto was planning a visit to Scotland for a few days to see family before coming to visit me in Germany. It was legal to send the drug to the UK, so he suggested that I get them shipped to Glasgow and then he could bring them over the border, which was legal too. And so that’s exactly what we did.   

The more I think about the process that I’d gone through to get the generics, the more I’m incensed by the whole thing. I wanted to protect myself but had to go to such ridiculous lengths to do so. I was basically left to navigate my health on my own without the help of my doctor or any sort of official. I’ve had some friends say that I was silly for what did, dangerous even, but if I didn’t fight to protect myself then nobody else would. I understand that now.   

 

 

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PrEP School runs every other Monday on Daily Xtra. Columnist Mike Miksche explores and navigates the world of sex and PrEP.

Editor’s note: The subheadline on this column has been changed. An earlier version read “The internet told me it was fine.”

This column is the second part of an earlier piece; a brief summary of the previous column has been added as the first paragraph of this story.

This story is filed under Opinion, News & Ideas, Sex, Blogs & Columns, PrEP School, Canada