Health insurance: How to protect medicines from HIV

The health insurance companies have been reimbursing the costs of medicines that protect against HIV infection since the beginning of September. Who should take her? And which risks do they harbor? The most important questions and answers at a glance.

How does so-called pre-exposure prophylaxis (prep) work?

When treated, HIV-negative people ingest drugs that prevent the HI virus from multiplying. If a person then comes in contact with the pathogen, the agent protects against infection. As a rule, it is recommended to take the medication daily. But it is also possible to swallow them in consultation with the doctor specifically for a certain period - about a holiday.

How well do the remedies protect against infection?

HIV prophylaxis with medications has been approved and well studied in the EU since 2016. Consistently taken the drugs of the German Aidshilfe protect as well as from a contagion like a condom. In contrast to rubber, however, the tablets have one major disadvantage: they do not protect their users from other sexually transmitted diseases.

Who will be reimbursed for the cost of the medication?

The drugs make sense only for people who have a particularly high risk of infection. It is they who are reimbursed by the statutory health insurance companies. To do this, a doctor must prescribe the drug, which is familiar with the treatment of HIV patients and pre-exposure prophylaxis.

In a consultation, he determines what his patient's risk of HIV infection is. According to the German-Austrian guidelines, drug-based HIV prophylaxis makes sense for:

• Homosexual men or transgender people who have had anal sex without a condom within the past few months and / or are likely to have anal sex without a condom over the next few months.
• Homosexual men or transgender people who have been infected with a sexually transmitted disease in the past year.
• People whose partners are HIV-positive and who have not been able to drastically reduce the amount of viruses in their blood for months. In a successful HIV therapy, the viruses are no longer detectable, the affected are no longer contagious.
• People who have sex without a condom with a partner who is likely to have undiagnosed HIV infection.
• People who inject drugs and do not use sterile syringes.

If the physician prescribes the funds, patients only have to pay the usual prescription fee.

Does that also apply to insured persons in private health insurance companies?

No, that only applies to statutory health insurance. The private insurance companies have their own regulations. It is advisable to inquire there.

Can you get the funds yourself?

Yes. If the doctor can not prescribe the funds at the expense of the health insurance, he can also issue a private prescription. The costs are around 1.60 euros per tablet, so per day. "In any case, it is important to have good medical advice, preparation and supervision of the prep", writes the German Aidshilfe. Self-attempts, for example with funds from abroad, are urgently to be discouraged.

For example, it is important to rule out prior to therapy that the person is infected with HIV. In an infection, the amount of active ingredients is not enough to completely suppress the viruses. Then there is a risk that the remaining pathogens develop resistance to the drugs. It is also important to rule out that a hepatitis B infection is present. This can worsen when the medication is discontinued.

What side effects can the therapy have?

The drugs are considered to be well-tolerated, but some may experience fatigue, nausea, diarrhea, headache, abdominal pain, or joint pain. In addition, the agent can easily lower bone density and reduce kidney performance. For this reason, the kidney values ​​should be examined before taking.

What controls are planned during therapy?

If you get a prep prescribed, you have to check every three months to get a new prescription. At the same time, HIV and other venereal diseases are being tested, as well as kidney function.