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How to Get PrEP Online

How to Get PrEP Online

Thinking PrEP might be for you? Read on and find out how you can get a PrEP prescription online!

Pre-exposure prophylaxis (PrEP) is available online through PlushCare. PrEP must be prescribed by a healthcare professional, but PlushCare is making it easy to see a doctor online and get your PrEP prescription without a visit to the doctor’s office (and yes, an online doctor can write a prescription!)

Getting PrEP online is a simple three step process:

  1. Our patients have an online appointment with the physician of their choosing, during which they discuss PrEP and whether they are a good candidate for the prescription, Truvada.
  2. Following the online appointment, patients get the necessary blood work done at a lab in their area to make sure they are HIV negative to start. The PlushCare doctor will direct patients to the nearest lab.
  3. Once your lab results come in the doctor will send in your PrEP prescription. This process will be repeated every three months so we can make sure PrEP is working for you and monitor your health.

Take a look below to see if our online PrEP program might be for you!

Background on PrEP for HIV

HIV, or human immunodeficiency virus, still remains a worldwide health problem. HIV, is a virus that attacks the white blood cells in the body. Because white blood cells normally fight off infection, HIV leads to a weakened immune system and can greatly affect the health of those who are infected, making them susceptible to all kinds of infection.

The disease became an epidemic in the 1980s and 1990s and continues in epidemic proportions. In the United States alone, an estimated 1.2 million people have HIV, many of whom are unaware they are infected.

HIV continues to be a persistent problem in the United States and worldwide. In the United States, just under 40,000 new cases were diagnosed in 2016, according to the CDC. As of 2015, an estimated 1.1 million people in the United States were living with HIV – and about 15% of them (165,000 people) don’t even know that they have it.

On average, there are about 50,000 new HIV infections in the United States every year.

While medicine and preventative measures, particularly the use of condoms, have increased to ensure that HIV can be managed and controlled, there still remains no actual cure for the disease.

That said, a cure may be closer than ever before. Doctor's have recently reported the second ever case of sustained HIV remission using a stem cell transplant on a patient in London. You can read more about it here.

While a potential cure to HIV is beyond amazing news, the treatment is still in early developmental stages and there is a long way to go before it will be accepted within the medical community and available to HIV patients.

So for those with increased exposure to HIV, PrEP remains your best way to stay healthy.

PrEP is one of the most recent advancements in anti-HIV medication. The preventive medication is allowing people all over the world to sleep soundly knowing that they are safe from contracting HIV.

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What is PrEP?

PrEP is an anti-HIV medication that prevents HIV infection in HIV-negative individuals. PrEP is intended for those who do not have HIV but may be at a high risk of becoming infected. PrEP is approved by the FDA and has been around since 2012.

The medication combines two HIV medicines, emtricitabine and tenofivir, into one pill that is sold under the brand name Truvada. PrEP works by interfering with the virus’s ability to create copies of itself in your body, thereby preventing HIV from replicating and spreading.

PrEP is a daily pill and must be taken at the same time every day to be effective. When administered properly, PrEP has been shown to reduce the risk of contracting HIV through sex by up to 90 percent. It can reduce the risk of contracting HIV from using injected drugs by over 70 percent. PrEP can also be combined with other medications and protective strategies for further risk reduction, such as wearing condoms.

Many people mistake PrEP as a type of vaccine, but it works differently. Vaccines use weakened or killed forms of certain microorganisms to teach white blood cells how to fight off the actual, full-powered microbes.

PrEP requires daily administration of a single pill. This places the medicine in your bloodstream to actively stop the HIV from spreading in your body. If you stop taking PrEP every day, you will not have enough medicine in your blood to actually block the HIV virus and will be at risk.

How Long Does PrEP Take to Work?

After seven days of daily use, PrEP will reach its maximum protection level from HIV for recipients who have receptive anal sex. After 20 days of daily use, PrEP will reach its maximum effectiveness against HIV for recipients who have receptive vaginal sex or use injection drugs.

Who Should Take PrEP?

Studies have shown that PrEP helps reduce the risk of HIV infection among transgender women and bisexual and gay men. Other studies have demonstrated that PrEP can be effective as an HIV preventative for heterosexual men, women, and people who inject drugs.

PrEP should be taken by anyone who is HIV-negative, but at high risk for being exposed to HIV. This includes:

  • Anyone in a sexual relationship with someone who has tested HIV-positive
  • Gay or bisexual men who engage in anal sex without the use of a condom
  • Gay or bisexual men who have been diagnosed with an STD in the past 6 months
  • Straight men and women who do not use condoms when engaging in sex with partners who are at a high risk of HIV infection
  • Straight men and women who do not regularly use condoms while having sex with partners of unknown HIV status
  • People who have used injected drugs in the last 6 months and shared needles
  • Anyone who has been in a drug treatment program in the past 6 months

Click here for more info on whether PrEP is right for you.

And learn the top 3 reasons to get on PrEP here.

Who Should Not Take PrEP?

Those who are HIV positive or may have already been exposed to HIV should not take PrEP. People who know or suspect they may have been exposed to HIV in the previous 72 hours should contact a doctor to discuss taking post-exposure prophylaxis (PEP).

PEP is an antiretroviral medication that prevents HIV from spreading if used within 72 hours of exposure. Contact a doctor at PlushCare right away if you may have been exposed to HIV through sexual contact or injected drugs as they can also help you to get PEP.

PrEP requires you to take a pill every day to maintain protection and effectiveness, which means forgetting to take the pill is out of the question, and it may not be a realistic option for those who are not good at consistently taking medication. PrEP also requires regular visits to your doctor, which may be difficult if you already have a hectic schedule.

Fortunately, PlushCare and other virtual doctor providers make seeing a doctor easy. PlushCare allows patients to meet face-to-face with a doctor from a phone or computer. You will still need to go to a lab to have blood work done but you can skip the doctor's office beforehand by having online appointments. This makes the PrEP program convenient and more accessible to patients at risk of HIV who don't want to spend time in doctor's offices.

How Much Does PrEP Cost?

Out-of-pocket, PrEP would cost about $20,000 per year! Luckily, most insurances will cover the cost of PrEP, so that most people pay little to nothing for their prescription. Those who don’t have insurance shouldn’t worry either. The company that makes PrEP, Gilead, has a Medication Assistance Program that can help those without insurance pay for the medication. They also have a Copay Assistance Program for those who have insurance, but receive a bill as a result of being on a plan with a high deductible.

When you get PrEP through PlushCare, you will also get assistance from a PrEP Coordinator who can guide you through the payment process and check to see if you are eligible for one of these assistance programs. If you are eligible for copay assistance we will make sure that you are able to obtain it. Most of our patients pay next to nothing out-of-pocket for PrEP when they use insurance. Insurance plans should cover the cost of the medication via your plans' Pharmacy Benefits.

If you're uninsured, the best route to getting PrEP is to visit Gilead's Advancing Access website and fill out a quick form to better understand your options.

Access and payment assistance to PrEP vaires state-by-state so be sure to check if your state has any programs you can take advantage of. For example, the California Department of Public Health (CDPH) has partnered with PlushCare to provide free access to PrEP statewide. Read more about it here.

Below is information from our PrEP FAQ page about PrEP costs and insurance coverage.

  • I have private health insurance. Will my health insurance plan cover PrEP?
    If you have health insurance, they will almost certainly cover PrEP. They may require some paperwork before you can get the medicine, but that is something we take care of for you. You will pay your normal drug co-pay for PrEP. Email us at [email protected] if you have any questions about insurance coverage. Visit our blog for more information about insurance coverage and copay assistance.

  • I have government-funded insurance (e.g. Medicaid, Medicare). Will my health insurance plan cover PrEP?
    Yes, these plans cover PrEP! All plans should cover the medication cost, but some may not cover the initial doctor's visit. Please contact us at [email protected] to inquire about your plan and how it works with PlushCare.

    Additionally, copay or deductible assistance is available through private non- profit organizations for individuals with government-funded insurance. Read more on our blog about paying for PrEP with or without insurance.

  • I have a high deductible plan or my co-pay is too high, what can I do?
    The drug maker of Truvada, Gilead, has set up a co-pay assistance program to help cover the cost. You can find out more info here. Email us at [email protected] if you have any questions about insurance coverage.

  • I don’t have private health insurance and PrEP is too expensive. Can I get Truvada for PrEP for free or discounted?
    The drug maker of Truvada, Gilead, has set up an assistance program for the uninsured to help cover the cost if you meet the income criteria. You can find out more info here. There are many places to get low cost PrEP and many government and nonprofit organizations provide assistance. However, this greatly varies by the city and state you reside in. You can find more information on how to find organizations here. If you live in San Francisco, Healthy San Francisco covers PrEP costs if you meet the coverage criteria. Learn more here

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Is PrEP Safe?
Yes, generally, the Truvada PrEP medication is very safe and well tolerated. Most people report no side effects at all. Those that do experience side effects tyipically see them disapear in a matter of days or weeks as the body adjusts.

PrEP Side Effects
Those that do experience side effects may experience any of the following:

  • Nausea– About 9% of PrEP recipients reported nausea in the first month that went away over time.
  • Headaches – About 4.5% of recipients reported headaches.
  • Weight Loss – About 2.2% of recipients reported unintentional weight loss.
  • Slight increase in serum creatinine – Serum creatinine is a naturally occurring molecule that is filtered by the kidneys. A small percentage of recipients (0.3%) reported a slight increase in their serum creatinine that went away on its own after the first few weeks of taking Truvada or when they stopped taking the medication.
  • Diarrhea
  • Tiredness
  • Dizziness
  • Depression
  • Problems sleeping
  • Abnormal dreams
  • Rash

Rare and serious side effects include:

  • Kidney problems, including kidney failure. Your healthcare provider may do blood tests to check your kidneys before and during treatment with Truvada.
  • Too much lactic acid in your blood (lactic acidosis), which is a serious but rare medical emergency that can lead to death.
  • Severe liver problems, which in rare cases can lead to death.
  • Bone problems, including bone pain, softening, or thinning, which may lead to fractures. Your healthcare provider may do tests to check your bones.
  • Changes in your immune system. If you have HIV-1 infection and start taking HIV-1 medicines, your immune system may get stronger and begin to fight infections. This may cause minor symptoms such as fever, but can also lead to serious problems.

When you book an appointment with one of our online physicians the doctor will discuss all of these possible side effects. They will also ask about your medical history to make sure that you are a good candidate for PrEP. We at PlushCare want to make sure that our PrEP patients receive quality care, so if you ever have questions or concerns about the way PrEP might be affecting your body you can book a follow-up appointment with your PrEP doctor.

Where is PrEP Available Online?
PrEP with PlushCare is available online in every state! We are proud to serve your state with online PrEP assistance. No matter where in the country you are book an appointment and if PrEP is right for you a Truvada prescription can be electronically sent to your local pharmacy.

How to Get PrEP Medication Online With PlushCare
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PrEP is available online through PlushCare’s PrEP Program. PlushCare’s program allows you to speak with a physician online; the necessary bloodwork will be ordered; and, you will receive your PrEP prescription in a matter of days.

Be sure to ask your doctor about any concerns you may have and stay open and honest to ensure that you are getting the best quality care. PlushCare is the perfect answer for anyone who would rather not go through their primary healthcare provider to get PrEP or anyone who simply wants to get top notch medical care from the comfort of their home or on the go.

Here's how to get PrEP online step-by-step:

  1. To get PrEP, click here and book an appointment with a physician. At your doctor’s appointment your doctor will answer any questions or concerns you may have about taking PrEP. You will discuss any potential side effects and the cost of the medication.

  2. If you decide that you want to start PrEP, your doctor will order lab tests for you to have completed at a lab in your area. We work with national lab companies to ensure that everyone has access to a lab near them. The lab tests will confirm that you are HIV negative and thus a good candidate for the Truvada medication. The tests take only 30 minutes to complete and you will receive your results within 3 business days.
    What Lab Tests are Needed to be on PrEP?
    In order to get and stay on PrEP, lab tests are needed very 90 days to ensure patients are HIV-negative, STD-free, and maintain normal metabolic panel results. The following labs are needed:

    • HIV 1 (RNA test)
    • HSV 1 / 2
    • Chlamydia & Gonorrhea
    • Syphilis
    • Hep B (immunity & vaccine)
    • Hep C (RNA test)
    • Basic Metabolic Panel
  3. Assuming your labs come back clear, the doctor will send a 90-day prescription for PrEP to the pharmacy of your choosing.

  4. Every three months, you will repeat this process. This repetition is to ensure that you are staying healthy and that the medication is working. As you approach the end of your 90-day prescription, we'll order new lab tests and book a quick check-in with your doctor to make sure that the treatment plan is working for you and to refill your prescription.

If you have any questions in the meantime, you can always give PlushCare a call at 1-800-221-5140, where our Care Coordinators are ready and willing to assist you.

PlushCare’s PrEP program is easy, convenient, and discreet. You can make an appointment to speak with a physician online, get your lab work ordered online, and then receive your prescription after your test results come back.

Think PrEP might be right for you? Book an appointment with a PlushCare physician and start our PrEP program today.

Read more about how to get PrEP online:

Read more about getting PrEP in SF & LA:

Read more of our online doctor series:

Article Sources

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Dr. Umer Khan

Dr. Umer Khan

Medically reviewed by Dr Umer Khan, MD who is a Board Certified physician practicing in Pennsylvania. His special interests include wellness, longevity and medical IT.

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