How MISTR Makes PrEP Access Easy and Affordable

Now more than ever, it's crucial for the LGBTQ community to stay resilient and focused when it comes to sexual health. Sexual activity will inevitably increase as stay-at-home orders and social distancing decrease. With months of only ourselves for pleasure, some might be tempted to leap into action. Telemedicine platform MISTR offers discrete and convenient online access to PrEP, the once-daily pill regimen that helps prevents HIV – one less thing to worry about during these stressful times.

Despite the FDA's approval in 2012, it's been a long road to get PrEP into the hands of those who need it most. The U.S. Centers for Disease Control (CDC) determined that upwards of 1.1 million people would benefit from PrEP, yet by October of last year, only 135,000 PrEP prescriptions had been filled in the U.S.

A combination of determining factors have made access unaffordable and inaccessible. The cost of a doctor's visit and required lab work can cost upwards of $400, not to mention the time and hassle for an in-person appointment and follow-up visits. Some people may not feel comfortable discussing PrEP as an option with their doctor or disclosing their sexual activity. And then there are the forms and approvals. Enrollment in patient assistant programs can be daunting, along with insurance pre-authorizations and appeals, which deter many from following through on prescriptions.

As an active member and business leader in the LGBTQ community, MISTR Founder Tristan Schukraft understood the barriers facing many from the inside, and the importance of increasing access to PrEP.

Organizations approached him to start a program, and after meeting with the Los Angeles County Commission on HIV, he was "appalled" at the meager numbers. The paradigm needed to shift but there wasn't an infrastructure to make it happen, so Schukraft set about helping friends and others through the process. Dozens turned into hundreds, and when those numbers soared higher, he knew it was time to formalize his process and go national.

The MISTR Model

MISTR focuses on gay and bisexual men, which accounted for 69 percent of all new HIV diagnoses in 2018. The service is completely free in nine states (Alabama, California, Florida, Georgia, Indiana, North Carolina, Oregon, South Carolina and Texas). In other states, it's $99 per quarter and no insurance is required.

MISTR manages all external communications so it's a one-stop shop, including the convenience and privacy of online lab testing. There's nothing to download: all of the information is accessible via securely encrypted mobile phone, tablet and desktop platforms.

The initial questionnaire takes less than 10 minutes to complete, and depending on how quickly you return required at-home lab tests (HIV, Hepatitis B, kidney function), you can receive your prescription in five to seven business days. Some states require a video chat with a doctor, which is also easily managed through the portal. Here's a summary of the six-step process:

1. Health Review
Answer some basic health questions and create a profile. Confidential and judgement-free.

2. Labs
Simple at-home testing. No needles, no doctor's office.

3. Doctor Consult
Licensed physicians will review your results and prescribe PrEP if appropriate for you.

4. Free Delivery
MISTR's pharmacy network will ship medication in discreet packaging and refill automatically each month free of charge.

5. No Paperwork
MISTR works with your insurance company and the various patient assistance programs to ensure you have no out-out pocket costs.

6. Follow Up
Prescription renewals every quarter are hassle-free.

Schukraft sees telemedicine as rapidly growing and vital part of personal health. "I think people were skeptical of telemedicine initially, but now it's more common," says Schukraft. "At the moment, demand is really surging, as many community organizations and doctors are not offering non-urgent medical appointments, and people want to avoid the doctor's office."

Sistr, a female-focused site, as well as Spanish language and transgender services are on the horizon for Schukraft, while MISTR's goal remains to empower all men to take control of their sexual well-being.

For more information, visit heymistr.com.

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