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Less than three hours after walking into Legacy, Michelle received a prescription for PEP and had it filled at a CVS pharmacy nearby. She began the regimen just before the 72-hour deadline.
When told about Michelle's experience at a local hospital, Roland said: "That makes me really angry. Women have a hard enough time going to ER after an assault. She did what she was supposed to do, and they didn't treat her right."
He then groaned after learning that Michelle went to Memorial Hermann, since Legacy refers all sexual assault victims there.
According to Roland, PEP is not at all well known in the Houston area. He says he has even known healthcare workers exposed to HIV through needles on the job who did not report the incidents because they had never heard about PEP and worried about getting into trouble with their employers.
But even Legacy and other local clinics offering HIV services do little to inform clients about PEP and its potential benefits. Legacy offers no written materials such as brochures or posters regarding PEP. Doctors there may prescribe the medication as rarely as once a month, Roland says.
And the regimen isn't cheap, costing about $800. Many insurance plans do not cover it, and Legacy has no pool of money to draw from to help the indigent with an entire month's supply, Roland says.
Kelly McCann, CEO of AIDS Foundation Houston, says there needs to be a citywide public awareness campaign: "I thought it was common practice to prescribe PEP."
Last week, Michelle's blood tests came back negative for HIV and other sexually transmitted diseases. Since the virus often appears in the bloodstream within the first month after exposure, she was elated.
But she remains angry about the obstacles she faced in getting treatment, and concerned about others in similar situations.
"All these health care professionals were telling me it doesn't exist," she says. "You trust these people.
"Who knows what role the PEP played? But at least I know I did everything I could to stay healthy."