[mathewsanders]

> They can take pre-exposure prophylaxis (prep), a kind of drug that reduces their chance of contracting it by 99% or so. This comes as a daily pill, and is popular among gay men in rich countries.

The article takes a global focus (which makes sense since most new HIV diagnoses happen outside of the United States), but even the United States has over 30,000 new HIV infections per year.

In 2021 feds mandated that insurance companies must include PrEP as free preventative care, but that doesn't help the most at risk who are young and may not be insured (30-day supply of generic PrEP costs ~$2,500, and every 3 months people must have doctor visit and bloodwork to check HIV and STIs, and for potential liver and kidney damage).

In 2022 a federal judge ruled that they can not require Christian companies to cover PrEP as this violates their religious rights under federal law[1]. This will likely make it's way up to the Supreme Court, and there's a high risk that as a result people in the United States will then need to pay out of pocket for PrEP.

[1] https://www.axios.com/2022/09/07/court-hiv-prep-requirement-...

[chimeracoder]

> 30-day supply of generic PrEP costs ~$2,500

Er, no, generic Truvada costs $30-$60/month, although it was not available as a generic in 2019, which is when the mandate for free PrEP without cost-sharing was first issued. (The mandate was issued in 2019, but it did not fully go into effect until 2021).

That said, the drug costs aren't the only (or even biggest) costs associated with PrEP - the doctors' vists and labwork are much more. Under the ACA, those were required to be covered for free on all insurance plans, but a judge in Amarillo, TX blocked that as part of a ruling on a lawsuit against abortion care.

> and for potential liver and kidney damage

They aren't checking for liver damage. They do check for indications that the drug isn't being absorbed correctly, which is done via a test for kidney functioning, but kidney issues for both Truvada and Descovy as PrEP are extremely rare. And there are no liver concerns associated with either one.

[mathewsanders]

I guess I don't fully understand U.S. healthcare system (I'm an immigrant from a country with universal healthcare, and this is the first time in my life that I've had a medication prescribed other than short-term antibiotics).

I pay a $10 co-pay for generic with my insurance, but when I pick up from pharmacy the receipt says "you insurance saved you $1888" (you're right it's not ~$2500/month - I just checked and that's a different prescription I have that I get filled at the same time).

[yieldcrv]

For a rich person by global standards, HIV is a solved problem in the US right?

PreP for people trying to inhibit both progression and transmission of HIV and PeP for those that don't have it

The article talked about a new 3 month lasting version of PeP as well

when we’re not talking about uninsured and poor people, this is done now, right?

cishet men dont have anything near the vulnerability surface as other populations, if I’m understanding correctly. just test and move on or react accordingly. anybody that was subject to the traumatic sex-scare education of the 80s to early 2000s should just get updated education.

[diogenes4]

It doesn't help that heterosexual use of prep is virtually unheard of.

[hellojesus]

I hear of it, but typically it's only taken by those who engage in high risk activities. There are potential issues with the liver and kidney that make it not worthwhile if one isn't at moderate to high risk.

[cltby]

Rather depressing that we're subsidizing wanton sexual indulgence to the tune of $30k/year/person.

[elil17]

Just to dispel some myths here:

1. Many people who use PrEP have only one partner. They're using PrEP because their partner has HIV.

2. The alternative is letting people get AIDs. This is more expensive than PrEP.

3. Insurance doesn't pay the full list price of drugs, they pay a lower, negotiated rate. CostPlus Drug Company charges about $20/month for PrEP. This is probably closer to what insurance companies actually pay.

[535188B17C93743]

So queer people should remain celibate?

Other methods of protection fail. People lie about the status. People don't know their status.

Know what's ridiculous is that these drugs cost so much money and companies like Gilead can engage in "revenue maximization" schemes at the cost of the health of US citizens... and then apparently win lawsuits with their Big Pharma war chests.

[Clamchop]

What motivated you to share this?

[mock-possum]

Dude.

Have a heart.