A man who has undergone PrEP treatment at his own cost for 18 months says it was a huge relief for him to stop having to worry about getting infected by HIV. He is one of many men considered at high risk for HIV because of his lifestyle.
A milestone was reached in June when the Icelandic Medicine Pricing and Reimbursement Committee agreed that PrEP treatment should be free in Iceland. PrEP stands for Pre-Exposure Prophylaxis, an anti-viral drug used to prevent HIV infection in individuals at high risk. GayIceland interviewed Iceland’s Chief Epidemiologist last year after he recommended PrEP treatments to be made free of cost to Icelanders.
However, a few individuals in Iceland have actually been undergoing PrEP treatments for the past couple of years, at their own cost but with the assistance of health authorities in Iceland, infectious disease specialist Bryndis Sigurdardottir revealed in an interview on Monday.
“The reason why I wanted to start using PrEP was to protect myself from HIV infection and to be in control over my own health.”
Being at high risk of sexually acquired HIV infection simply means that an individual is having sex without using condoms, is having sex with HIV infected individuals, is having unprotected anal sex, has a certain number of sexual partners over a period of time or is in a steady relationship with a HIV infected individual so people in that group can be of all genders. However, the most worrying rate of HIV infections in Iceland occurs in the MSM group, or amongst men who have sex with other men.
GayIceland has spoken to one of those individuals, a man who belongs to a high risk group of men who have sex with other men and was assessed at high enough risk to be eligible for PrEP treatment.
“This medicine was really liberating for me and even more liberating was to have access to the infectious disease ward at Landspitalinn where the nurses welcome me without any prejudice,” he starts by saying, but because he doesn’t want to be judged for his lifestyle choices, he prefers to be unnamed in the interview.
“The reason why I wanted to start using PrEP was to protect myself from HIV infection and to be in control over my own health. I was basically just tired of worrying all the time about getting infected by HIV and perhaps inadvertently infect others as well. Those who are undergoing treatment for HIV are usually not infecting others at the same time so, the biggest threat is those who are infected but don’t know about it.”
As Bryndis pointed out, a condom is the go-to prevention from HIV infections but the reality of it is that certain groups of people simply don´t use it and keep on practicing high risk sex. So, rather than trying to change people´s behaviour to no or little avail, it´s considered a better option in the long haul to help these individuals to prevent getting infected by medicating. Our interviewee agrees and explains the risk. “I know I should use condoms but sometimes that fails to happen, sometimes it’s because of me, sometimes it’s my sexual partners who fail to use them or they use them incorrectly.”
Truvata is the initial PrEP drug prescribed by Icelandic health authorities but there are some generic drugs available at a lower cost. Up until now, Truvata has been available to Icelanders as a PrEP treatment but only for the full price of 66,000 ISK for 30 tablets. But it wasn’t until 2016 that individuals in Iceland began seeking a PrEP treatment.
Our interviewee read up on PrEP on the internet and followed what was happening in the US and finally in Europe as well, in 2016, and saw a chance there. “I found a legal way to buy a generic PrEP drug, called Tenvir-EM from Cipla which I order from Dynamix International and get delivered from the UK. A three months’ supply costs about 107 USD with posting plus a 24% VAT added in Icelandic customs. So, end of year 2016 I went to the the Infectious Diseases Ward and was tested for HIV to be sure that I could start using PrEP. I received a confirmation in writing that I had been tested and would be monitored by health staff so I was able to order the medicine online and started taking it regularly. Every three months, I go there for consultation, to get tested for STDs and for a renewed confirmation for the customs,” he says.
“I was basically just tired of worrying all the time about getting infected by HIV and perhaps inadvertently infect others as well.”
His yearly cost of PrEP has so far been about 45.000 ISK, which is still cheaper than a one month´s dosage cost in Iceland before the drug was subsidised. Now of course, he can start getting a prescription for PrEP and have it subsidised by health authorities, which he hopes will be encouraging for others to start using it too. “It was a huge relief for me to start using PrEP. Sure, there are other sexually transmitted disease I have to be wary of but majority of them are curable. Not everybody is eligible for PrEP treatment but I am and it suits me very well and I’m really happy with the service and consultation I have received at the hospital.”
As was stated in Monday’s interview, all studies show a remarkable success of PrEP treatments. It is believed that out of over 300,000 people using PrEP, only three individuals have been infected by HIV. Daily usage of PrEP, in a controlled environment, reduced the risk of HIV infection by 92-99% or more. Bryndis Sigurdardottir, specialist at Landspitalinn, gave a presentation on the subject on the International HIV Day in Iceland last year, which can be watched here (only in Icelandic, courtesy of samkynhneigd.is):