Leana Ramirez, PharmD, AAHIVP, CSP
Chief Clinical Officer
(She/Her/Hers)
Last month, The Arlene Cooper Community Health Center provided PrEP, Pre-Exposure Prophylaxis, for eighty patients. That was a record month for the clinic. Last year, PrEP services averaged about forty patients a month. This is great news for our clinic, but in the grand scheme of HIV prevention, these numbers are still not enough.
There are currently three medication options for people who may want to start on PrEP: Descovy, Truvada (available as a generic pill) and Apretude. Each of these treatment options has their own unique profile. For example, Descovy is not indicated for use in people who were assigned female at birth. Truvada has some lipid lowering effects, however, it is available in a generic form which can be more cost effective for some patients. Apretude is an injection every other month and is the newest medication added to the PrEP market.
Despite having these three options, the use of PrEP medications is still widely underutilized. CDC data estimates that there are 1.2 million people who should be on PrEP. Of that number, only about 25% of people are prescribed medication... not necessarily taking the medication, but simply prescribed the medication. Some other barriers to note include insurance hurdles (copays, prior authorizations, deductibles to name a few), laboratory requirements (every three months), and even simply finding a provider who is knowledgeable about PrEP. No wonder it isn’t as utilized as we want or need it to be.
Nevada recently passed legislation authorizing Pharmacists to prescribe PrEP outside of a clinic setting. Although this is intended to improve ease of access, it has not been as easy as hoped to implement this in the real world. The Pharmacy profession must continue to try to navigate the payor, training, and malpractice requirements. Still, this is a step in the right direction, and we at least have a state that recognizes not only the need for this program, but the value of utilizing Pharmacists in preventative care.
Here in Nevada, in 2020, 392 people were newly diagnosed with HIV. In 2021, there were 5,001 people utilizing PrEP, with 86.6% of them being men. The number of PrEP users almost doubled between 2020 and 2021 which is great momentum for our state. Education and the ability to have conversations about sexual health are at the pivot of this epidemic.
Yes, HIV is still an epidemic.
Yes, HIV still can progress to AIDS and cause death if left untreated.
Yes, PrEP can be a significant help in preventing HIV transmission – per the CDC it is 99% effective in preventing sexual transmission.
This is great news. Let us educate and communicate to the public, our community, our friends, that this is out there and available to all people.
