MISTR

No waiting room. No pharmacy line. No conversation with a doctor who does not quite get it. MISTR moved sexual health online, where it should have been all along: a licensed physician by video, labs you can do at your kitchen table, and medication that turns up at your door in a plain box nobody can read anything into. More than 800,000 adults have already switched, across all 50 states, Washington, D.C. and Puerto Rico.

PrEP is the heart of it. One pill a day cuts the risk of HIV by up to 99%, and MISTR makes every step of getting there free. The consultation is free. The labs are free. The STI testing is free. The medication is free whether or not you have insurance, and when a plan will not cover it the team goes and fights the patient assistance paperwork so you never see a bill. Want more cover than that? Add DoxyPEP, a single dose of doxycycline after sex that knocks down the risk of chlamydia, gonorrhea and syphilis. Would rather not think about it daily at all? Long-acting injectable PrEP is one shot every six months, and MISTR is enrolling for it now.

Three steps, and the first one takes about three minutes. Answer some questions and meet a licensed physician by video. Do the labs, at home with a collection kit or in person at any of 2,200 locations. Then watch the mail. Refills arrive with reminders and renewals take almost nothing, because the hardest part of staying protected should never be the logistics.

The rest of the menu is just as unbothered. Long-term HIV care for staying undetectable, with bloodwork every six months and medication at the door. Hepatitis C testing and treatment. Something for erectile dysfunction, bundled with PrEP or ordered entirely on its own. All of it by video, all of it private, none of it requiring anyone to sit in a waiting room holding a clipboard on a string.

MISTR calls itself stigma-free and sex-positive and then goes ahead and behaves like it, which is rarer than it ought to be. Its companion platform, SISTR, brings the same free PrEP to women, and between them they invented National PrEP Day to drag HIV prevention out into the open where it is actually useful. Care comes in English and Spanish, in the app and on the phone. MISTR was founded by Tristan Schukraft, a technology entrepreneur whose first company helped the airline industry move to electronic ticketing, and who built this one on a blunt observation: the science, the medication and the technology to end HIV already exist, and the thing still missing is access.