What to Do If Your Provider Says 'No' to PrEP
PrEP stands for Pre-Exposure Prophylaxis. It is a once-daily pill regimen that can help you stay HIV-negative. When taken as prescribed by a knowledgeable healthcare provider, PrEP has been shown to be more than 90 percent effective against contracting HIV.
But one in three healthcare providers has not even heard about PrEP, which means you could encounter some resistance if your clinician doesn't have all of the facts. Here are some common misconceptions you might hear from a PrEP-skeptical provider and ways to address them using information from the Centers for Disease Control and Prevention (CDC)'s 2014 Clinical Practice Guidelines (you may even want to print out the guidelines and bring them with you to your PrEP consultation/appointment):
PROVIDER SAYS: "I'm not an HIV specialist. You need to see an infectious disease doctor."
YOU COULD SAY: "Actually, the CDC says primary care providers like you are fully equipped to prescribe PrEP. If you need more information, I know the Clinician Consultation Center offers clinically supported advice about PrEP to those who may need it. You can call them at 1-855-HIV-PREP. Can we re-visit this conversation after you've spoken to them?"
PROVIDER SAYS: "PrEP is only for [this type of person], and you're not one of them."
YOU COULD SAY: "While that may have been the conventional wisdom at one point in time, the CDC says anyone at substantial risk for contracting HIV may be a good candidate for PrEP. Can I walk you through some of the reasons I think PrEP might be right for me?"
PROVIDER SAYS: "We don't know enough about the long-term effects of PrEP."
YOU COULD SAY: "Multiple studies have shown PrEP to be safe and highly effective against contracting HIV. I appreciate your concern and certainly understand the need for regular check-ups. But for me, the benefits of PrEP far outweigh the risks."
PROVIDER SAYS: "You don't need PrEP. Condoms works just fine."
YOU COULD SAY: "Nothing I've read suggests PrEP use and condom use are mutually exclusive. I plan to use PrEP in addition to the other safer sex strategies I'm currently using."
YOU COULD ALSO SAY: "Condoms don't work for me and my partner, hence my interest in PrEP. I'd also be interested in learning about other ways to prevent sexually transmitted infections, since I know PrEP only protects against HIV."
PROVIDER SAYS: "There has not been a lot of research done on transgender people and PrEP, so I'm uncomfortable prescribing it to you."
YOU COULD SAY: "Can you walk me through your specific concerns? Perhaps we could address them together. I know other doctors have successfully prescribed PrEP to transgender individuals, and that a growing number of experts support making PrEP available to transgender people at substantial risk of contracting HIV."
PROVIDER SAYS: "PrEP is prohibitively expensive."
YOU COULD SAY: "Fortunately, my insurance plan covers the use of PrEP, so that won't be a major factor in my decision-making."
YOU COULD ALSO SAY: "I know there are several payment assistance programs out there to help offset the costs of the drug. Would you, or someone else in the office, be willing to help me navigate any necessary paperwork?"
Seeking advice from a knowledgeable healthcare provider is crucial as PrEP may not be right for everyone. Entering the conversation with an open mind and the proper information will go a long way toward getting the care that you need. Be sure to check out our other resources on talking to your provider about PrEP, while keeping in mind that if your provider doesn't meet your needs, you're always free to find one who will. You can also contact Lambda Legal's Help Line if you continue having difficulty accessing PrEP.
This article is not a substitute for sound medical advice. Visit www.hrc.org/HIV for additional resources -- including HRC's What Do I Do? A Handbook to Understanding? Health & HIV.