One Medical faces complaint over PrEP injectable

A bisexual San Francisco man has filed a formal complaint with One Medical about being sent to its Castro office to receive Apretude, after being told it was not available at the company’s other locations. The matter raises concerns about the availability of injectable PrEP even as federal regulators approved another one Wednesday.

Robert Long, 59, told the Bay Area Reporter he filed his June 4 complaint after a May 30 meeting with his then-primary care physician at One Medical, Dr. William Sellman. (One Medical was acquired by Amazon in 2023.)

Long said he wanted to take Apretude injections as PrEP, and that he was “trying to find places as early as at least March” to provide it, starting with his primary care physician. 

“My primary wouldn’t even help me find a place,” he said. “I had to go out and call these places myself till I found a place.”

PrEP, or pre-exposure prophylaxis, refers to the use of antiviral drugs to prevent people exposed to HIV from becoming infected. The pill Truvada was first approved for PrEP use in 2012 by the federal Food and Drug Administration; since then, the FDA has also approved the pill Descovy for some groups, and the drug Apretude as an injectable treatment. Apretude is injected every two months after the initial doses. The FDA is expected to consider the twice-yearly lenacapavir injectable at its June 19 meeting.

Long found Apretude at One Medical’s Castro location at 2355 Market Street.

“They had given me a sample, and they wanted to schedule [future injections] closer,” to where he lives, he said. 

After it turned out the One Medical office at 535 Mission Street near the Salesforce Transit Center couldn’t offer Apretude (Long lives downtown), Long had the May 30 meeting with Sellman, he said.

“I got his diatribe before I started with my question,” Long recalled. “That’s when I got told to go back to Castro. That was B.S. Even Castro had offered him that medication. There was no reason he couldn’t do it.”

Long claims Sellman told him One Medical had not rolled out Apretude.

“Dr. Sellman falsely claimed that One Medical had not rolled out Apretude treatment – a statement proven to be categorically false by a provider at One Medical’s Castro location, who confirmed their regular administration of the medication,” Long wrote in his June 4 complaint. “Dr. Sellman’s statement was not only factually inaccurate but appears intentionally misleading, serving as a pretext to deny care.”

Long said that he “felt abandoned” and reached out to Magnet, the sexual health clinic at Strut, the San Francisco AIDS Foundation’s health center in the LGBTQ Castro neighborhood, only to be told it was full and not accepting new patients.

Asked if Magnet was at capacity, Stephanie Rivera, the associate vice president of clinic administration at the AIDS foundation, told the B.A.R. this week that is no longer the case and the clinic can now see new patients.

“We previously had to put a limit on the number of clients served with injectable PrEP due to the administrative burden on our benefits navigation team,” Rivera stated June 17. “We have recently been able to increase our capacity and lift this enrollment cap by increasing our clinical staffing, streamlining administrative workloads, and with added capacity from our pharmacist. 

“We do have capacity to enroll clients onto injectable PrEP, and this capacity will only increase when SFAF’s pharmacy opens later this summer,” Rivera added. 

The pharmacy is set to open at Strut, which is located at 470 Castro Street.

“Clients interested in using injectable PrEP may discuss this option with clinical providers at SFAF’s Magnet clinic,” Rivera stated.

Asked if the Magnet clinic’s HIV prevention services, and not just its capacity to provide injectable PrEP, were at capacity, AIDS foundation spokesperson Emily Landon on Tuesday stated, “We are currently at full staffing capacity so are fully open to new and existing clients. And we can see clients on a same-day basis.”

Long did end up going back to One Medical in the Castro to get Apretude but claimed in his complaint that the limited number of locations where it is available “raises serious questions about institutional discrimination and whether your policies and practices comply with city, state, and federal anti-discrimination laws.” 

Long said Sellman called to apologize. 

“His apology was not sincere, but I was willing to drop it,” Long said, referring to the phone call. He did not drop his complaint.

The B.A.R. reached out to One Medical for a statement from Sellman and from the company. A spokesperson stated that the federal Health Insurance Portability and Accountability Act, or HIPAA, prohibits them from discussing patient information, and so they could not comment on Long’s specific case.

The spokesperson continued that Apretude injections can be prescribed and stored at several One Medical offices in the Bay Area including its Castro, Noe Valley, Hayes Valley, Transbay, Spear Street, Two Embarcadero and Four Embarcadero offices in San Francisco, as well as at Evergreen Park of Palo Alto, Menlo Park, and North First Street and The Alameda in San Jose.

The spokesperson continued that all One Medical primary care providers have been educated on the clinical requirements and guidelines for prescribing Apretude, and that it’s not widely available in most primary care settings because it needs to be directly ordered for the specific patient in question. The offices with the highest demand, the spokesperson stated, have been equipped with the proper storage and procedural knowledge. 

For a patient to be a candidate for Apretude with One Medical, six to seven visits a year are required for injectables and HIV tests, the spokesperson continued.

“One Medical is proud to be a leading provider of PrEP in the Bay Area and nationally,” the spokesperson stated. “Our primary care providers are educated on safely providing HIV prevention medications based on each patient’s unique needs. We offer oral PrEP in all of our Bay Area offices, and patients can receive rapid HIV testing and Apretude injections, as clinically appropriate, at over 10 One Medical offices across the Bay Area. We understand that the complexities involved with accessing injectable PrEP can be frustrating, and are continually striving to increase convenient and safe access to more people.” 

The spokesperson added that One Medical is looking forward to the FDA approval of lenacapavir. 

SFAF partnership
Relatedly, Dr. Nasser Mohamed, a gay man, is working with the AIDS foundation to increase access to HIV preventative care in the LGBTQ community. His clinic, Osra Medical, has already started providing free telehealth visits for commercially insured patients with PPO plans seeking to take PrEP orally. 

“We’re trying to expand access to more people that need access to HIV preventative services,” Mohamed told the B.A.R. 

Osra’s partnership with the nonprofit service provider allows it to take on more PrEP cases, both for the oral and injectable forms of the medication.

“The oral PrEP set up can be done with no cost sharing to the patient now, but we do need to bill for injection visits for long-acting injectables now to cover admin fees (that patients with PPO plans can get reimbursed for by their plans),” Mohamed stated. “This is new territory so we are navigating if we can make the math work eventually to have it done at no cost sharing.”

Mohamed stressed the logistical difficulties companies face in providing injectable PrEP. 

“A lot of insurance plans pick one specific pharmacy they want to work with,” he said, because “ordering, storing, and dealing with the medication” is more difficult than for oral PrEP. Further, a navigator to remind people to return for HIV tests and appointments for injections is something companies would have to pay for themselves, he said. 

Tyler TerMeer, Ph.D., a gay Black man living with HIV who is the CEO of the AIDS foundation, said he is proud to be working with Mohamed on HIV prevention access.

“We are delighted to be able to partner with Dr. Nasser Mohamed to increase the availability of PrEP and other sexual health services in the Bay Area,” TerMeer stated. “As a gay man of color, Dr. Mohamed is very knowledgeable about the priorities and needs of SFAF’s communities and the clients we serve – he delivers individualized care with compassion and without judgment. People interested in PrEP who may not be able to visit our in-person clinic at Magnet can now access PrEP with video visits made possible by Osra Medical and Dr. Mohamed.” 

For more information, go to osramedical.com/sfaf .

Updated, 6/18/25: This article has been updated to indicate the FDA approved lenacapavir on Wednesday.