The Centers for Disease Control and Prevention announced that PrEP among at-risk men increased 500 percent between 2014 to 2017. And those numbers are expected to rise following Gilead Sciences' new commitment to donate up to 2.4 million bottles of Truvada to the CDC by 2030 (which amounts to 200,000 per year).
The study is one part of the government's “Ending the HIV Epidemic" initiative, seeking a 90 percent reduction of new diagnoses by 2030. But while the numbers for PrEP use and awareness are encouraging, there are still growing concerns.
Black men in particular practice PrEP in fewer numbers than at-risk white and Hispanic men. Furthermore, only one in three people at risk of contracting HIV practice PrEP, a prevention strategy that when taken accordingly can make it virtually impossible to contract the virus. Truvada is the only FDA-approved drug to be prescribed as PrEP. People who are prescribed Truvada must see a physician every three months for testing and follow-ups.
The CDC study specifically studied 18,610 gay, bisexual, and other men who have sex with men in 20 urban areas. Researchers found that 7,873 of the men had a negative HIV test and, within the last twelve months, also been sexually active with at least one person living with HIV, had two or more sexual partners, had practiced condomless anal sex, or reported a bacterial STI such as syphilis, gonorrhea, or chlamydia.
Overall, there were substantial increases of PrEP awareness and PrEP use across the board, but there remains large differences between ethnic and socio-economic groups. For example, among white and Hispanic men who have sex with men, the study found PrEP use at 42 percent and 30 percent, respectively. But that percentage drops to 26 percent among Black MSM.
The difference between white and Hispanic men becomes negligible when weighted for income, access to health insurance, and region. However, the rate among Black men remains disproportionately low when weighted for these factors.
Education and income were also key escalators for PrEP use and awareness, with a 39 percent usage rate among MSM who had seen a provider within the last twelve months.
Phase 1 of the CDC's initiative to reduce HIV by 90 percent by 2030 is focusing on Washington, DC; San Juan, Puerto Rico; 48 U.S. counties where the majority of new cases of HIV occurred; and seven states with disproportionate occurrence rates in rural areas. Broader efforts to reach at-risk groups is further complicated by barriers such as poverty and lack of access to health care. Gilead Sciences hopes that by partnering with the CDC, they can deliver treatment free of charge to those most at-risk.
“We are proud to partner with CDC to dramatically expand access to medication that can help prevent new HIV infections,” said Gregg Alton, Chief Patient Officer, Gilead Sciences, in a May press release. “We believe today’s donation, combined with efforts to address the root causes of the epidemic, such as racism, violence against women, stigma, homophobia and transphobia, can play an important role in ending the HIV epidemic in the United States, particularly in parts of the country with the highest burden of disease.”
The efforts and results are encouraging, but there clearly remains much to be done. Increased awareness and use are key among at-risk groups.