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PrEP Clinic Berlin

PrEP is you you
Check your Risk:

Play Safe – and book your PrEP appointment today – be protected

meet our doctors and get your PrEP prescription. 

PrEP will be available from 01.09.2019

FAQ

Before you make an appointment in our practice to learn more about PrEP, please read the most frequently asked questions and their answers below.

Make an appointment with our doctors and you will receive a PrEP prescription directly.

From 01.09.2019 onwards, you will receive the medicine as prescribed by the health insurance company.

Not all private health insurance companies reimburse for PrEP. Please keep the receipt for the PrEP from the pharmacy, as we assume that other health insurance companies will also reimburse the PrEP.

Other ways of obtaining Truvada or generic drugs (e.g. abroad or on the black market) may be risky and are NOT recommended by us.

The PrEP is still available through a normal private prescription from 40 Euros per 28 tablets. PrEP can only be prescribed by HIV specialists.

PrEP is the abbreviation for pre-exposure prophylaxis and is a protection against infection through medication before having sex with HIV. PrEP consists of the two drugs Tenofovir (TDF) and Emtricitabine (FTC). This drug is the only proven effective drug for PrEP. It is available in Germany as an original but also as a generic drug.

The PrEP drug contains two active ingredients that prevent the cells from multiplying in the body. If the virus gets into the cells of mucous membranes or the immune system during sex without a condom, it cannot multiply there. In this way, an infection can be prevented, and you remain negative – even though individual body cells have already been infected.

Its effectiveness has been proven in trials with gay men who are at particularly high risk of HIV. These are men who have sex frequently and who find it difficult to use condoms. PrEP could also work for heterosexual men or women. However, the studies so far do not provide such convincing success data. Protection often failed because the participants did not take PrEP regularly.

In 2015, the “Ipergay” and “PROUD” studies showed an 86 percent reduction in the risk of transmission among gay men. Overall, the protection is over 90%. In other words: in the group of men who took the PrEP, there were only a good tenth of the infections that would otherwise exist without PrEP. PrEP thus has a similarly high protective effect against HIV as condoms. Regular use is crucial to its effectiveness. PrEP is not a suitable method for people who have difficulty taking tablets in a disciplined way.

PrEP is approved in Germany for permanent PrEP, i.e. you take one tablet a day.

Most people tolerate PrEP well and feel little or no side effects. Some users complain of nausea, diarrhoea, headaches, stomach and joint pain, as well as tiredness or sleep disturbances. Taking PrEP over a long period of time can reduce kidney function in the very unlikely event. Normally, this reduced function will disappear after stopping PrEP. This is not a relevant problem for healthy people, but who knows how well their kidneys are performing? That is why you need to check your kidney function before starting PrEP and then every 3 months. People who suffer from kidney disease should not take PrEP.

You will immediately receive PrEP from us, even if you have had condomless sex (fucking, fisting) or other risky situations (e.g. chemsex) in the last 4 weeks. To make sure you are as safe as possible, we repeat the HIV test 4 weeks later to rule out an HIV infection that was not detectable at the beginning of the PrEP (the diagnostic window only starts after 4 weeks).

No. PrEP does not provide protection against syphilis, gonorrhoea, chlamydia and hepatitis C. You may experience increased STIs and the risk of contracting hepatitis C increases.

If the PrEP is not taken properly, HIV infection can occur. If the infection is then not detected quickly, HIV can become resistant (insensitive) to PrEP. The medicine can then no longer be used to treat the HIV infection. It is therefore important to have an HIV test immediately before starting PrEP and at least every 3 months thereafter.

As of 01.05.2019, AOK insured persons can prescribe the medication from a health insurance prescription retroactively.

All others with statutory health insurance still receive a private prescription. Please keep the receipt for the PrEP in your pharmacy, as we assume that other health insurance companies will also reimburse the PrEP retroactively.

From 01.09.2019 onwards, you will receive the medicine prescribed on a prescription from the health insurance company.

Not all private health insurance companies will reimburse the PrEP. Please keep the receipt for the PrEP from the pharmacy, as we assume that other health insurance companies will also reimburse the PrEP.

Other ways of obtaining Truvada or generic drugs (e.g. abroad or on the black market) may be risky and are NOT recommended by us.

The PrEP is still available through a normal private prescription from 40 Euros per 28 tablets. PrEP can only be prescribed by HIV specialists.

My special HIV programme

In the context of HIV therapy, I offer the usual things here in my programme according to the guidelines: that we take care of the immune system, determine the corresponding values, the viral load – these are always key words. But we also look at whether patients have problems taking their pills, whether they have side effects from the therapy. It should be a long therapy, if possible without complications.

One to one HIV Therapy

“One to one care” is very important to me in HIV therapy, because you build up a very personal connection to your doctor, or the doctor to his patient. Due to constant changes of doctors, where you have to tell your story over and over again, the patient at some point no longer trusts the doctor. Therefore it is absolutely essential for me to see every patient “one to one”. If it’s a small thing, the patient can of course also go to a colleague. But basically, I do everything.

HIV Patients in my practice

HIV patients come to my practice because they appreciate the personal care. They always meet me here, they can turn to me with any problem, no matter what it is.

HIV therapy & sexual behaviour

HIV and sexual intercourse is an important issue for HIV patients because they have mostly become infected through unprotected sexual intercourse and are likely to continue to practice it.

This raises questions:

In this context, the HIV patient simply has other sexually transmitted diseases more often. It is important to talk about it, you have to know about it, you also have to pass on information. The patient must always have the feeling, no matter what symptom he comes to me with, we talk about it openly and treat it.

So my message for the people remains:
“Come with all you have.”

Gaps in HIV therapy

What I have often missed in other programmes is that HIV patients are only looked at their values. I missed the whole package.

Hepatitis B and C

Dr. Ochlast is a member of the  Deutschen Leberstiftung e.V. and the Europäischen Vereinigung zur Studie der Leber (EASL).
In the care of our patients, we place special emphasis on individual psychosocial support. Before, during and after the therapy you will be accompanied by our social worker/social pedagogue Michael Pesendorfer. 
We carefully plan each individual therapy in cooperation with the head physician Chefarzt Prof. Dr. med. Ulrich Böcker, M.A., FEBG,

Clinic for Gastroenterology and Diabetology, Vivantes Klinikum Neuköln. HIV infection is not a factor here. 

Since the beginning of 2015, we have had several new drugs available in the field of hepatitis C to cure patients interferon-free of the infection. The chances of cure are in the 90-100% range.

For all patients without pre-treatment with the more modern drugs and without cirrhosis, the therapy can be limited to 8 weeks. An HIV infection is not important here.  

The modern DAA therapy (direct antiviral agent)

DAA therapy is an interferon-free therapy consisting of a combination of the preparations listed below. The combination with ribavirin is still partly necessary. A major advantage of these therapy combinations is the significantly lower side effect profile and the possibility of using these therapies even if there are contraindications for interferon. The combination of 2 or 3 of different classes of active substances even makes it possible to do without ribavirin, as this drug is responsible for poor physical condition and anaemia.

DAA therapies – their individual drug classes

I. Protease inhibitors (word ending on “-previr”)

These drugs have been available to us for several years with the 1st generation (Boceprivir and Telaprivir). The 1st generation drugs are no longer recommended as 1st line therapy by the medical associations. 2nd generation “-“previrs”, i.e. a further development of the drugs already available to us, they are characterised by a significantly better efficacy profile (cure rates between 90 and 100%). No significant side effects have been reported.

At present, the following drugs are officially available in Germany: Glecaprevir (Maviret® in combination with Pribrentasvir), Voxilaprevir (Vosevi® in combination with Ledipasvir / Velpatasvir), Simeprivir (Olyseo®), Pariatrivir (Viekirax® – in combination with Ombitasvir/r) and Grazeprevir (Zepatier® – in combination with Elbasvir).

Other very promising compounds such as voxilaprevir are in clinical trials, which even offer healing options to patients who have failed on previous interferon-free therapy.

II. polymerase inhibitors (word ending on “-buvir”)

These drugs block the RNA polymerase of the hepatitis C virus, thereby preventing the hepatitis C RNA from “copying”. The “-buvirs” are a good combination partner in interferon-free therapy. They act on all hepatitis C genotypes.

At present, we officially have Sofosbuvir (Sovaldi®, in Harvoni®, in Epclusa®) and Dasabuvir (Exviera®) available in Germany.

III. NS5a inhibitors (word ending on “-asvir”)

These drugs also intervene in the “copying” of hepatitis C RNA. They are highly effective and have few side effects. The “-asvirs” are good combination partners in interferon-free therapy.

At present, we officially have pibrentasvir (Maviret®- in combination with glecaprevir), daclatasvir (Daklinza®), ledipasvir (Harvoni®- in combination with sofosbuvir) in Germany, Ombitasvir (Viekirax® – in combination with Pariatrevir/r), Velpatasvir (Epclusa®- in combination with Sofosbuvir, Vosevi®, in combination with Sofosbuvir /Voxilaprevir) and Elbasvir (Zepatier® – in combination with Grazoprevir)

Sexually transmitted diseases

Our practice offers the examination of sexually transmitted infections (STI check).

Patients with private health insurance are kindly requested to clarify with their health insurance company in advance which costs will be covered or whether you have booked the right insurance tariff for you (e.g. high deductible). As a practice, we will charge you for the medical services and basic laboratory services according to the scale of fees for doctors (GOÄ). In addition, you will receive a GOÄ invoice directly from our laboratory via the special laboratory, the contact person for this is the laboratory. Anonymous tests (e.g. before taking out insurance etc.) are also possible as a self-payer.

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