An HIV prevention drug is available in Orange County. Why don't people know about it?

Since 2012, the FDA has approved the use of a drug that reduces the risk of HIV infection by 92 percent — but despite it being widely available in Orange County, not many are taking advantage of it. 

Pre-exposure prophylaxis, also known as PrEP,  is  taken daily as a pill. While it is currently not well known, PrEP is on the path to save thousands of lives. 

PrEP, which is produced by Gilead Sciences under the brand name Truvada for PrEP, is intended for people at high risk for HIV through sex or drug use. When taken consistently, PrEP has an over 90 percent prevention rate for those at risk through sex and a 70 percent prevention rate for those at risk through injecting drugs. 

The pill is taken daily and loses efficacy when taken incorrectly. According to the CDC, no serious side effects from PrEP have been reported.

UNC School of Medicine professor David Wohl said there are large geographic and ethnic disparities in PrEP usage.

“It’s just a shame that despite PrEP being totally available, being covered by insurance or by manufacturer support programs, (being) available at UNC Campus Health, that still a lot of people just don’t know about it,” Wohl said. 

Andrea Mulholland, a family nurse practitioner at the Orange County Health Department, said the primary people who visit the health department with questions about PrEP are 25-44 year-old gay men. She also said they mostly see people who are uninsured or underinsured.

“Unfortunately, the South is the region where we have the highest rate of HIV infections, and the highest rate of STIs, but we do have less people using PrEP,” Mulholland said.

Wohl said in the South, providers might not want to prescribe PrEP because they think it will promote promiscuity. 

Mulholland said education is key to solving this problem.

“We just need more education in the community among patients, and particularly among people who are at high risk for acquiring HIV,” she said.

The biggest success stories for PrEP are in big cities like New York or San Francisco, where there has been some kind of government intervention.

“Government involvement requires an investment of time, energy, enthusiasm, money,” Wohl said. “And we’ve seen that these partnerships have really led to campaigns that have resulted in people being supported to get their PrEP.”

Wohl said in order for PrEP to be effective in the ways it can be, it needs to be normalized.

“We’ve learned the hard way that condoms aren’t going to solve the HIV epidemic,” he said.

Mulholland said she believes the future is bright for PrEP and that it’s picking up pace in the industry. Eventually there could be an injectable version of PrEP or an implant. 

Wohl said Gilead is starting a campaign for the drug and that PrEP will have a big impact as long as it gets out there.

“It could really help save some lives,” Wohl said.

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