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Looking to increase PrEP uptake

 

Key clinical point: To know if patients need PrEP, you first have to ask about at-risk behaviors.

Major finding: About 500,340 blacks have indications for preexposure prophylaxis (PrEP), but only about 7,000 filled a prescription from Sept. 2015-August 2016.

Study details: The findings are based on pharmacy data and estimates of risky behavior.

Disclosures: CDC funded the work. The lead investigator didn’t have any disclosures.

Source: Smith DK et al. 2018 CROI, Abstract 86.


 

REPORTING FROM CROI

– More than 1.1 million Americans are at substantial risk for HIV and would benefit from preexposure prophylaxis (PrEP), but only 90,000 prescriptions were filled by retail or mail-order pharmacies in the United States from Sept. 2015 to August 2016, according to the Centers for Disease Control and Prevention.

The CDC estimated that 500,340 blacks in the United States have indications for preexposure prophylaxis, but only about 7,000 (less than 1%) filled a prescription during that time. Among an estimated 282,260 Hispanics who might benefit, just about 7,600 (3%) filled prescriptions. Uptake was a bit higher among whites: about 42,000 prescriptions among 303,230 at-risk people (14%).

Dr. Dawn Smith, a CDC medical epidemiologist

Dr. Dawn Smith

“These data paint a full-enough picture to say that without a doubt, nearly 6 years after [Food and Drug Administration] approval, we are nowhere near tapping the full potential of PrEP as a hugely powerful HIV prevention tool. Our study makes it clear that there is an urgent need to increase awareness of and access to PrEP, particularly among black and Hispanic populations,” said lead investigator Dawn Smith, MD, a CDC medical epidemiologist.

PrEP uptake might be particularly low among black and Hispanic people because, in addition to the well-known disparities in health care access and other issues: “There’s a stigma with being gay: ‘If I’m taking this drug, does that mean I’m gay?’ ” Dr. Smith said.

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