“It’s your life. Own the journey.” That is the message being delivered by a new HIV prevention campaign launched by the County of San Diego this month. The campaign is designed to encourage individuals at risk of contracting HIV to consider PrEP, or Pre-Exposure Prophylaxis, as a method of HIV prevention. PrEP involves taking a once-daily anti-retroviral pill known as Truvada that is up to 99 percent effective in preventing HIV infection. It’s a once a day decision that allows those most at risk of contracting HIV to take control of their health.
Over the next few months, San Diegans will see billboards, bus shelters and digital ads throughout the region raising awareness for PrEP. The ads encourage those at the greatest risk of contracting HIV to visit PrepSanDiego.com to learn more about the once-daily pill and where to get it in San Diego County.
The PrEP San Diego campaign is a component of San Diego County’s Getting to Zero initiative with a goal of reducing HIV infections to zero within the next 10 years. Currently, one of out every 11 San Diego County residents living with HIV is unaware of their status and every 18 hours a new HIV case is diagnosed in the county.
“It was only last summer that our Board blessed the implementation plan for Getting to Zero, San Diego County’s initiative to end the HIV/AIDS epidemic,” said San Diego County Supervisor Ron Roberts. “Fast forward to today and it is exciting to see the significant strides being taken, including kicking off the PrEP San Diego awareness campaign. We are another step closer to the day when AIDS will be history!”
PrEP is an FDA approved antiretroviral and works to prevent HIV from establishing an infection inside the body if an exposure occurs. Antiretrovirals like PrEP also help treat those infected with HIV by lowering the virus in the bloodstream making them less likely to transmit HIV. PrEP, however, is not a cure for HIV nor is it a vaccine. It also does not protect individuals from other sexually transmitted diseases like syphilis or gonorrhea.
When taken daily, PrEP reaches maximum protection from HIV for receptive anal sex in about seven days. For insertive anal sex, vaginal sex, and injection drug use PrEP reaches its maximum protection in 20 days. PrEP is safe and highly effective. While the pill can cause some initial side effects that include nausea, stomach pain or weight loss, they generally subside over a short time. No significant, long-term health effects have been seen in HIV-negative people who have taken PrEP for up to five years.
According to the Centers for Disease Control and Prevention (CDC), access to PrEP could prevent an estimated 48,000 new infections by 2020. Improving access to PrEP and treatment for people living with HIV could prevent as many as 180,000 new HIV infections. The CDC estimates that one in four gay and bisexual men are at sufficiently high risk that they should consider taking PrEP.
In San Diego County, more than 90 percent of HIV infections occur in men who have sex with men, people who use injection drugs or men who have sex with men and inject drugs. Hispanics experience the highest number of new HIV cases per year and represent approximately 43 percent of all new infections. While African Americans experience the third largest number of new cases per year, they have the highest overall rate of HIV. The annual HIV case rate among African Americans in San Diego County is almost three times that seen in Caucasians. Today, there are approximately 37 million people living with HIV around the world, and 1.2 million of those are living here in the United States. As of December 31, 2014, a total of 13,200 individuals were diagnosed with HIV in San Diego County.
“PrEP is a vital component of the County’s Getting to Zero initiative. When taken as directed, PrEP is up to 99 percent effective in preventing HIV infection. We want to ensure that all individuals at risk for HIV learn about PrEP so they can decide whether it is right for them,” said Patrick Loose, chief, HIV, STD & Hepatitis Branch of Public Health Services.
Because PrEP requires a prescription, talking to a knowledgeable health care provider is an important first step in deciding if PrEP is right for you. Individuals who decide to take PrEP will need to have regular visits with their health care provider and regular testing for HIV and other sexually transmitted infections to monitor their health.
Talking openly about PrEP and HIV helps confront the stigma that is often associated with the disease and those who take PrEP. According to the CDC, talking with friends and partners can reduce the risk of HIV transmission and increase HIV testing.
You may also find additional support online. It is common to see online dating profiles and chat conversations include references to PrEP. Another phrase that appears often is “treatment as prevention” which can refer to PrEP or indicate the individual may be HIV positive but on treatment to reduce their viral load. People who have HIV and are taking anti-HIV medicines whose virus is suppressed are much less likely to transmit HIV than people who have HIV and do not have a low viral load. Either way, people are sharing the HIV prevention message online to stop the spread of HIV. Don’t hesitate to engage online to learn from others.
While PrEP is a drug that can be expensive, it can cost as little as $0 depending on your access to insurance. Many people without insurance are eligible for patient assistance programs and other resources such as studies that can reduce the cost of PrEP.
Most private health insurance plans, as well as MediCal, cover the cost of PrEP. Gilead, the maker of PrEP, provides a co-pay insurance card to help reduce the monthly co-pay cost. Gilead also provides PrEP free to people with limited income and no insurance.
For more information about how to start PrEP, the financial assistance options available and for a list of other local resources, visit PrepSanDiego.com.
PrEP may be right for you if you are HIV negative and at increased risk of contracting HIV because you:
• are sexually active and identify as gay or bisexual or are a man who has sex with other men
• have an HIV positive partner
• have anal sex without using condoms
• have multiple sexual or drug using partners whose HIV status is unknown
• recently had a sexually transmitted disease
• inject drugs and/or share needles with others
• recently attended a drug treatment program
• exchange sex for drugs, money, housing or other needs
To learn more about PrEP and learn about local resources, go to PrepSanDiego.com.
