Pre-exposure prophylaxis (PrEP) has the opportunity to be a game changer in the fight against HIV/AIDS. It has been included in President Obama’s National HIV/AIDS Strategy, as well as endorsed by Center For Disease Control (CDC) and The World Health Organization (WHO) for men and women at risk of acquiring HIV. It is one of the essential “pillars” in New York Governor Cuomo’s plan to “End The AIDS Epidemic” by 2020. Yet startling data released on June 20th shows PrEP is not effectively being accessed by populations in most need.
According to the CDC, African-American gay and bisexual men in the United States are at significantly high risk for acquiring HIV in their lifetime than their Caucasian counterparts. At current rates, 1 in 6 men who have sex with men (MSM) will be diagnosed with HIV in their lifetime, including 1 in 2 black MSM, 1 in 4 Latino MSM, and 1 in 11 white MSM.
Truvada is an FDA approved medication that is covered by all insurances, including Medicaid, can be paid for by the manufacturer if someone has no insurance, and has 99% efficacy when used on a daily basis. It is so far the only FDA approved HIV strategy. (Condoms have never been FDA approved for HIV prevention.)
Data from Gilead Sciences, the manufacturer of Truvada, shows that despite these HIV risk disparities, PrEP is not being utilized in correlation with risk.
- Whites make up 27% of new U.S. HIV cases but 75% of current PrEP consumers.
- African-Americans make of 44/% of new U.S. HIV cases but only 10% of current PrEP consumers.
- Hispanics make up of 23% new U.S. HIV cases but only 12% of PrEP consumers.
- Women make up 19% of new U.S. HIV cases but only 11.4% of current PrEP consumers.
Numbers regarding risk and PrEP utilization among transgender populations were not included in the report.
So what happened on the way to the finish line? How can we have such a powerful method for ending HIV, yet so little uptake?