In a world where information is literally at our fingertips, there are those of us who still remain in a bubble of unawareness. What’s disturbing, however, is that many of those people are the very doctors charged with protecting our health.
According to the Centers for Disease Control and Prevention, one in three primary care physicians and nurses have never heard of PrEP, the medicinal strategy proven to prevent HIV-negative people from contracting the virus when taken correctly. Could this be why nearly 60 percent of gay/bisexual men are also unaware of PrEP, as the Advocate has reported?
Less than 10 percent of all gay and bisexual men in the state of California have used PrEP, Plus reported, and Black and Latinos by far were the least likely to know about the HIV-preventative drug Truvada (the only drug currently approved to use as PrEP).
As many as 30,000 people in the U.S. may be using PrEP today, according to AIDSMap — a small number in comparison to the millions of Americans at risk of contracting HIV. So the question remains: why don’t doctors know about PrEP, and why aren’t those who do telling their patients about it?
Dr. Ken Mayer, principal investigator of the ADAPT study, has said that 14.5 percent of his patients who’d started PrEP have already stopped, which is unfortunate due to his estimation that there are 415,000 people in the U.S. (of all orientations) who have the highest risks of contracting HIV, yet are not currently using any kind of protection against the virus.
At the International Association of Providers of AIDS Care's Controlling the HIV Epidemic with Antiretrovirals summit in Paris last year, Dr. Mayer said that PrEP is hard to get for those who can’t afford it. At the time 80 percent of those on PrEP paid for the medication through private insurance, and 80 percent of those recipients were white gay men.
A survey of healthcare practitioners found that the third most common reason practitioners don’t present PrEP as an option to their patients was that these medical professionals felt they lackted the training to appropriately prescribe the prevention treatment. Other reasons included a “lack of demand” and “lack of insurance converage.”
Prescriptions for Truvada more than doubled between 2014 to 2015, and an estimated 8,000 people in 2015 were accessing PrEP via clinical trials, Medicaid, or Gilead's patient assistance program, AIDSMaps reported.
Some states are stepping into the information vaccum in an effort to increase PrEP knowledge; California recently passed a law requiring that PrEP education be provided to all of those who receive negative results from an HIV test.
Here's the bottom line: even if doctors aren't equipping themselves with PrEP knowledge, what matters is that you do. The next time you get tested, do it proudly. If you're negative, make a plan to stay that way. And never be afraid to ask your doctor about Truvada (or other PrEP options as they become available) and how it can benefit your health — and life. Don't be disuaded if they seem reluctant, by pushing for your right to HIV prevention, you'll encourage your medical provider to become better educated themselves. It's not your doctor's health, its yours. Be your own advocate, if you need to be. Fortunately, today, knowledge is just a few clicks away: which means it's always in your control.