Category Archives: PrEP

New study finds 4% of HIV-negative gay/bi men using PrEP

From OUT Magazine online…

A mere 4% of gay and bisexual men reported using Truvada as PrEP in a new study, recently published in PLOS ONE.

Led by Psychology Professor Phillip Hammack of the University of California Santa Cruz, the study examined HIV testing and use, familiarity, and attitudes toward pre-exposure prophylaxis (PrEP) among HIV-negative gay and bisexual men in the United States.

Truvada is a daily pill that reduces the likelihood of acquiring HIV by almost 100%. Currently, it is the only FDA-approved form of pre-exposure prophylaxis, or PrEP, which is recommended by the Centers for Disease Control and Prevention (CDC) for those at high risk of HIV/AIDS.

“The extremely low rate of PrEP use, while not surprising given barriers to access in various parts of the country, is disappointing,” said Hammack.

The study used a national probability sample of 470 men ages 18-59. Participants completed the survey between March, 2016 and March, 2017.

Other key results of the study included:

— The majority of gay/bi men between the ages of 18-25 are not tested for HIV annually, as recommended by the CDC.

— 25% of young men in the same age group have never been tested for HIV.

— Approximately 8% of men over 25 had never been tested for HIV.

— Visiting an LGBT health clinic and searching online for LGBT resources were associated with greater likelihood of PrEP use.

— Bisexual and non-urban men were less familiar with PrEP compared to gay-identified and urban men.

— Attitudes were positive among most men (68.4%) who were familiar with PrEP, despite low usage of the drug.

“I worry especially about younger men who didn’t grow up with the concerns of HIV that men of older generations did,” said Hammack. “The low rate of HIV testing probably reflects a degree of complacency and cultural amnesia about AIDS.”

Principal investigator Ilan H. Meyer said of the study, “Our findings suggest that health education efforts are not adequately reaching sizable groups of men at risk for HIV infection. It is alarming that high-risk populations of men who are sexually active with same-sex partners are not being tested or taking advantage of treatment advances to prevent the spread of HIV.”

Why don’t more Americans use PrEP?

From the New York Times

Truvada was approved by the Food and Drug Administration in 2012. But over six years later, the United States is failing miserably in expanding its use. Less than 10 percent of the 1.2 million Americans who might benefit from PrEP are actually getting it. The major reason is quite clear: pricing. With a list price over $20,000 a year, Truvada, the only PrEP drug available in the United States, is simply too expensive to become the public health tool it should be.

[…] The disparities in PrEP access are astounding: Its use in black and Hispanic populations is a small fraction of that among whites. In the South, where a majority of H.I.V. infections occur, use is half what it is in the Northeast. Women use PrEP at drastically lower rates than men, and while there’s no national data on PrEP and transgender Americans, it’s almost certainly underused. The issue of PrEP access has become an issue of privilege.

The ability of PrEP to greatly reduce new H.I.V. infections is no longer in question. In New South Wales, Australia, a program providing free access to PrEP led to a drop in H.I.V. diagnoses in the most vulnerable communities by a third in just six months, one of the fastest declines recorded since the global AIDS crisis began.

Read the full article on New York Times online.

State-level PrEP utilization data now available from AIDSVu

From HIV.gov

Since PrEP is one of the newer HIV prevention tools, understanding more about who is using it is important to better tailoring HIV prevention efforts at the national, state, and community levels. PrEP, or pre-exposure prophylaxis, is when people at high risk for HIV take HIV medicine daily to lower their chances of getting infected with HIV. AIDSVu has released the first-ever publicly available data and interactive maps of PrEP use by state from 2012 through 2016, stratified by sex and age.

 

The new maps from AIDSVu show more than 77,000 people were prescribed PrEP in 2016, with an average 73 percent increase year over year in persons using PrEP across the U.S. from 2012 – when the drug TDF/FTC was approved by the FDA for use as PrEP – to 2016. However, approximately 1.1 million people in the U.S. are at substantial risk for HIV exposure and could benefit from PrEP, according to analysis presented by the Centers for Disease Control and Prevention (CDC) at CROI 2018 earlier this year.

The data presented on AIDSVu reveal that the growth and distribution of PrEP use has been inconsistent across different sexes, age groups, and geographic regions. For example, the Southern U.S. accounted for more than half (52 percent) of all new HIV diagnoses in 2016 but represented only 30 percent of all PrEP users in 2016. That same year, women comprised 19 percent of all new HIV diagnoses but made up only seven percent of all PrEP users.

Read the full article.

Many at-risk men still don’t take HIV prevention pill

From The Associated Press…

From gritty neighborhoods in New York and Los Angeles to clinics in Kenya and Brazil, health workers are trying to popularize a pill that has proven highly effective in preventing HIV but which — in their view — remains woefully underused.

Marketed in the United States as Truvada, and sometimes available abroad in generic versions, the pill has been shown to reduce the risk of getting HIV from sex by more than 90 percent if taken daily. Yet worldwide, only about a dozen countries have aggressive, government-backed programs to promote the pill. In the U.S., there are problems related to Truvada’s high cost, lingering skepticism among some doctors and low usage rates among black gays and bisexuals who have the highest rates of HIV infection.

“Truvada works,” said James Krellenstein, a New York-based activist. “We have to start thinking of it not as a luxury but as an essential public health component of this nation’s response to HIV.”

A few large U.S. cities are promoting Truvada, often with sexually charged ads. In New York, “Bare It All” was among the slogans urging gay men to consult their doctors. The Los Angeles LGBT Center — using what it called “raw, real language” — launched a campaign to increase use among young Latino and black gay men and transgender women.

“We’ve got the tools to not only end the fear of HIV, but to end it as an epidemic,” said the center’s chief of staff, Darrel Cummings. “Those at risk have to know about the tools, though, and they need honest information about them.”

In New York, roughly 30 percent of gay and bisexual men are using Truvada now, up dramatically from a few years ago, according to Dr. Demetre Daskalakis, a deputy commissioner of the city’s health department.

However, Daskalakis said use among young black and Hispanic men — who account for a majority of new HIV diagnoses — lags behind. To address that, the city is making Truvada readily available in some clinics in or near heavily black and Hispanic neighborhoods.

Read the full article on Newsday.com.

Health insurance agency apologizes, reverses Truvada policy after HIV activists push back

From NBC News

Following outrage by HIV advocates after UnitedHealthcare sent a rejection letter to a patient seeking Truvada — denying him due to his “high risk homosexual behavior” — the insurer announced Friday it is changing its policy for the daily HIV prevention pill “effective immediately.”

“We apologize for the insensitive language appearing in the letter and regret any difficulty it caused. We have corrected our letters, removed the prior authorization requirement for Truvada and members can fill their prescription at the network pharmacy of their choice,” a spokesperson for the company wrote in an email to NBC News Friday night.

Image: Daily Antiretroviral Pill Found To Protect Healthy From AIDS TransmissionBottles of Truvada are displayed at Jack’s Pharmacy on November 23, 2010 in San Anselmo, California. Justin Sullivan / Getty Images

The monthlong controversy started with a pre-authorization denial letter sent to Thomas Ciganko, a New York man whose physician prescribed Truvada for Pre-Exposure Prophylaxis (PrEP). While the rejection came as a surprise, the stated reason was the real shock.

“The information sent in shows you are using this medicine for high risk homosexual behavior,” the letter, dated July 11, 2017, read. In the same paragraph, however, the letter listed an approved reason for taking the medication “to reduce the risk of sexually acquired HIV-1 infection in adults at high risk.”

Read the full article on NBC News online.

Regional resource for men who havd sex with men

m4mHealthySex.org is a joint effort between the HIV Prevention and Care Project and the Pitt Men’s Study at the Graduate School of Public Health, University of Pittsburgh. Our goal is to provide up-to-date sexual health information for men who have sex with men. You can use the site to find free STD testing in your area (including free HIV testing). You can also locate PrEP providers based on a zip code search. Other site features include an up-to-date blog of news and information related to sexual health and listings of regional health services (including HIV treatment specialists).