PREP WITHOUT PRESCRIPTION
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STATE SENATOR SCOTT WIENER OF SAN FRANCISCO
came out of the“PrEP Closet”five years ago, publishing a column disclosing his daily Truvada regimen in hopes it would raise awareness about the then-relatively new drug. “It makes no sense to me that we haven’t done everything in our power to make sure everyone knows about these medications and can easily access them,” Wiener told Metrosource recently.“PrEP access has been a passion for me for years, and I have an obligation to do everything in my power to end new HIV infections.” This year, Wiener has been ramping up his efforts to improve access to PrEP (pre-exposure prophylaxis) via a legislative measure that, if enacted, would allow anyone in California to access PrEP without a physician prescription. Wiener and San Diego Assemblymember Todd Gloria’s legislation to dismantle barriers to access such preventative medications has overcome some, but all hurdles, passing the State Senate and two Assembly Committees to date (and at press time was awaiting a vote by the Assembly Committee on Appropriations). The bill authorizes pharmacists to furnish PrEP and PEP (postexposure prophylaxis) to patients similar to how they can already distribute emergency contraceptives and the birth control pills without prescriptions, and bars insurance companies from requiring patients to obtain prior authorization before using insurance benefits to obtain either medication. “We know we can end the HIV epidemic thanks to these drugs like PrEP and PEP,”said Josh Stickney, Communications Manager at Equality California, a co-sponsor of the measure.“Right now, the issue is access. Access for millions of Californians who should be on this drug who are at risk of exposure, and we are proud to partner with these openly gay champions in our legislature.” Legislators stress that the measure would broaden the number of places where people can access PrEP and PEP, particularly in communities that lack access to primary care physicians, and motivate people FEBRUARY/MARCH 2020
METROSOURCE.COM
who aren’t comfortable seeing a physician. Wiener notes that it also will benefit those who may have been exposed to HIV, allowing them to quickly access PEP at a pharmacy, instead of having to visit a physician or emergency room. To be effective, a person must start PEP within 72 hours. “I’ve seen too many people get sick and die and have seen the impact of the disease on my community,” Wiener says. “The fact that a single pill a day can almost entirely eliminate the risk of HIV and the fact that a 28-day course can stop HIV from taking hold in someone’s body, that is just incredible.” The California measure is the first of its kind in that nation. New York adopted a pilot program allowing pharmacists to dispense a 7-day supply of PEP (though, not PrEP). But the proposed legislation goes further, allowing pharmacists to provide the full 28-day course of PEP without a prescription and the first 60 days of Scott Wiener PrEP without a prescription. Initially, physician organizations—particularly the California Medical Association—contested the measure, but Wiener praised the organization for recently withdrawing its opposition. Supporters stress that the more people who can access PrEP and PEP, the fewer new infections. Data suggests that only about 9,000 people in California were taking PrEP in 2016, even though between 220,000 and 240,000 residents could have been, according to the California Department of Public Health’s Office of AIDS. Additionally, a recent report found that while new HIV infections have decreased, the state is still experiencing a significant disparity between black and Latino gay men and their white counterparts. Latino men were nearly twice as likely to contract HIV as white men, and black men were more than three times as likely. “California is leading the way on a lot of things when it comes to LGBTQ equality,” Stickney says. “If California can continue to lead the way in getting to zero new HIV transmissions and deaths, and zero stigma, we are hopeful the rest of the country will follow suit.” ■
THIS PAGE: SAN FRANCISCO STATE SENATOR SCOTT WIENER, COURTESY PHOTO • TRUVADA IMAGE, COURTESY OF GILEAD
BODY
METROHIV
BY JEFF SIMMONS