“This addresses a whole segment of society that has been marginalized and feels like they are not included,” said Rick Dean, executive director of the Santa Rosa nonprofit HIV test center, Face to Face, whose clients include gay and transgender people. “It addresses it squarely and says, ‘We get it. Not a big deal.’?”
PrEP stands for Pre-exposure Prophylaxis, protection before exposure to HIV. It’s a once a day pill called Truvada for people who are HIV negative to protect them from getting HIV. PrEP was approved by the FDA in 2012, and by the U.S. Centers for Disease Control for use in HIV prevention.
I recently attended the National PrEP Summit with other HIV prevention professionals from around the country. The two-part take away for me could not have been any clearer: PrEP works, and there are so many more people who should be using it. Throughout the country, PrEP is disproportionally underutilized by women, African Americans, and Latinos. There are many challenges in getting the word out about PrEP, especially in these populations.
I have said before, if you had told us in the 1980s and 90s that there was a pill that could have prevented HIV, people would have been falling all over each other to get it. So, why not now? Although a growing number of people are beginning to use PrEP as part of their personal HIV prevention strategy, it has not taken off as quickly as one would think. There are a variety of reasons for this, the first clinical trials showed that PrEP was only 44% effective, not all that exciting. However, when they dug deeper into the data it showed to be up to 99% effective for those in the study who actually took the medicine every day as prescribed. Now we’re talking!
Many people, especially in certain populations have still not heard of PrEP, or have not heard how effective it is in preventing HIV. There has also been some stigma related to taking PrEP (similar to birth control when it first came out in the 60s). Early PrEP users were often referred to as “Truvada Whores”. Fortunately, this has begun to wane in the Gay community, where it is now being viewed as a positive thing that a potential sexual partner has been protecting themselves from HIV. Other barriers in getting people on the PrEP bandwagon include the high cost, and medical providers who are not comfortable prescribing it.
While PrEP is very expensive, $1,300 a month, it’s covered by most health plans including Medi-Cal. There are also patient assistance programs that can help with co-payments. Although many non-HIV specific doctors are not knowledgeable, and therefore uncomfortable, prescribing PrEP (or even talking to their patient about sex), we are fortunate here in Sonoma County to have several local health centers that are eager to talk to their patients about starting PrEP. California just passed a law requiring HIV test counselors to tell every person who tests negative about PrEP.
Face to Face does the majority of HIV testing in the county. We’ve been handing out PrEP brochures, and referring people to PrEP providers for quite a while. We are strong advocates for using every tool out there to end HIV transmissions in Sonoma County, and believe PrEP is our most powerful prevention tool yet. Each time we deliver the news that someone is HIV positive, I wonder if this person had heard of PrEP, considered it, thought they didn’t need it, or couldn’t afford it. A person does not need to be at high risk for getting HIV, they just have to be at risk.
The PrEP vs condoms controversy: Can’t people just use condoms? Sure, and many people do and feel comfortable with that level of protection. However, condoms don’t work at all if they’re left in the bedside drawer, just like PrEP doesn’t work if you don’t take it. Many people have a hard time (pun intended) with condoms, and therefore don’t use them regularly. Most see PrEP as an extra layer of protection and use them in conjunction with condoms. Some choose to use PrEP only, and do not use condoms. Yes, public health folks are concerned about increases in other sexually transmitted diseases. And, while there is currently a significant spike in Chlamydia, Syphilis, and Gonorrhea in California and in Sonoma County, it has not been shown that PrEP is to blame. And remember, these sexually transmitted infections are all curable, whereas there is still no cure for HIV.
- So, PrEP is effective. There has been only one known case of someone contracting HIV while on PrEP, owing to a rare Truvada-resistant strain of HIV.
- And, PrEP is safe. Most people experience no side effects and those who do say they are mild and last less than a month.
- And, PrEP is available locally, and in most cases, affordable.
The enthusiasm and hope of ending HIV at the National PrEP Summit got me thinking about myself. I’m a single Gay man. I’m 62, and not quite as “popular” as I was in my 20’s, but couldn’t I use another layer of protection? Why not take PrEP myself? I called my doctor, got labs done to make sure I’m HIV negative, a full STD screening, checked my kidney function and bone density (all good tests I haven’t had in a long time), and now I’m ready to start my once a day pill. Who knows, maybe I’ll become more “popular” because of it, lol.
If you, or someone you know is curious about PrEP, come in and talk to one of our HIV Test Counselors. Get more information, have your questions answered, and if you’re ready, get a referral to a local provider. Test Counselors are available on a drop-in basis, Tuesday through Friday from 9:00 am to 4:30 pm at the Face to Face office at 873 Second Street, Santa Rosa.
Rapid HIV Testing at Face to Face
Tuesdays through Fridays
9am – 4:30pm at the Face to Face Office
Face to Face offers FREE confidential or anonymous HIV testing at our office located at 873 Second Street in Santa Rosa. We use the rapid HIV test, with results ready in just twenty minutes!
Lorelle will provide an overview of the newly created monthly group sessions she will be hosting at Face to Face.
Monthly session will be held every second Thursday at at 2:15 pm.
Lorelle Saxena graduated in 2008 from Pacific College of Oriental Medicine with a Master of Science degree in Traditional Oriental Medicine. She is a State of California-licensed acupuncturist. Her clinical internship work included training at the San Diego Hospice, the UCSD Owen Clinic for HIV and AIDS patient care, and a community clinic for low-income senior citizens.
Lorelle’s focus is on compassionate, empowering healthcare–care that gradually facilitates the body’s own ability to heal itself, education that helps patients understand how to enact preventive medicine in their day-to-day lives, and support that allows patients to work towards optimal health in a safe, comfortable environment.
Lorelle has been voted Best Acupuncturist in Sonoma County Three Years in a Row by the Bohemian.
PrEP (Pre-exposure Prophylaxis)
What is PrEP? Pre-exposure prophylaxis (PrEP) is a way to prevent HIV. With PrEP, people who are HIV-negative take a medication (Truvada) once a day to reduce the risk of getting infected if they’re exposed to HIV. PrEP is an additional method that can be used with other HIV prevention strategies such as condoms.
PrEP clinical trials have been conducted, or are currently being conducted, all over the world. Research has very clearly demonstrated that PrEP offers high levels of protection against HIV 1nfection if you taken it regularly. But, if you don’t take it consistently, PrEP can’t protect you from HIV.
Questions About PrEP
- Why do we need HIV prevention tools like PrEP?
- Aren’t condoms good enough?
- What are the side effects from PrEP?
- How can I afford PrEP?
- Where is PrEP available now?
Interested in Starting PrEP?
Visit your primary care physician to begin the conversation. PrEP is covered by most medical insurance companies, including Kaiser, Medical Cal, and Medicare.
If you are on Medical Cal, visit any one of the following F2F community partners:
Not sure what to ask? Here is a handy resource to get your conversation stared.
If you are not ready to speak to you healthcare provider but would like to learn more about PrEP from F2F, visit our office Tuesdays – Fridays from 9am-4:30pm for your regular HIV test and ask your test counselor for more information.
Back in the 80’s and 90’s, if you told us there was a pill you could take that would prevent HIV/AIDS, the news would have been met with great celebration, overwhelming interest, and huge media coverage. So why not now? Why has the news about a medical breakthrough in HIV prevention been so cautious, so quiet? HIV has not gone away. Although the health outcomes of someone living with HIV are so much better today, the number of new cases has not gone down, people are still getting HIV, and there are more people today living with HIV in Sonoma County than ever before. The risk of getting HIV is still very real.
In June, 2012 the FDA approved the drug Truvada for use as a preventative for HIV infection for those at risk, Pre-exposure Prophlyaxis (PrEP). It had already been shown to be very effective as a post-exposure treatment (PEP) when taken in the first 72 hours after exposure. Then in May, 2014 the CDC recommended Truvada as an effective prevention option. And yet, the number of people getting prescriptions for PrEP is quite small, even in communities of people who are significant risk of getting HIV. In the Gay community there has even been stigma attached to taking PrEP with names like Truvada Whore attached to those taking the drug. This stigma, akin to that of the early years of birth control, has the unfortunate effect of suppressing healthy dialogue and discouraging those who would likely benefit.
A couple of months ago, we put together three community forums here in Sonoma County about PrEP. Although many service providers attended and learned more about it, there were almost no individuals present to explore the option for themselves. Perhaps it was too soon, or maybe it’s too personal an issue for a public dialogue. But I’m willing to bet we would have had a full house 10 or 20 years ago!
Let me break right here for a full disclaimer: Although I am an HIV Test Counselor and educator, I have no medical degree or training, and am not recommending that everyone use PrEP. This is a conversation that anyone interested should have with their doctor. It’s a very personal decision, and you need to figure out if it’s right for you.
How effective is PrEP? The latest studies show that Truvada is more than 90% effective of preventing HIV infection when taken daily. It needs to be taken daily to work! You can’t just take it on the weekends when you’re sexually active, or every other day to save money.
How expensive is it? It aint cheap, and this may be a barrier, but many insurance plans and MediCal are covering the cost of the prescription, and there is also a medication assistance programs from the manufacturer.
What about side effects? Most people have few or minor side effects that go away in a couple of weeks. Truvada can affect some people’s kidneys, so your doctor will monitor you kidney function to make sure you’re OK.
Is it PrEP vs condoms? No, studies show that many people using PrEP have increased their use of condoms. For them it is another layer of protection. Some people have stopped using condoms when on PrEP. Some were not using condoms consistently before, so with PrEP their level of protection has dramatically increased.
How do I find out more? Check out this info -http://www.projectinform.org/prep/ and http://prepfacts.org/ Come in and talk to one of our HIV Test Counselors, and pick up some info. And get a free HIV test while you’re here – results in just 20 minutes. Here’s an interesting article in Newsweek.
Each year, Beerfest is an extravaganza with more than 60 of Northern California’s best craft breweries featuring over 120 unique brews. VIP tickets enter the festival one hour before the general admission guests and take home a collectible mug.
VIP tickets: $60
General admission tickets: $50
Visit the Beerfest website for more information or buy your tickets below:
Sunday, November 27
Luther Burbank Center for the Arts
50 Mark West Spring Road in Santa Rosa
Since 1990, the acclaimed San Francisco Gay Men’s Chorus (SFGMC) has been coming “Home for the Holidays” to Sonoma County to sing in benefit of F2F HIV prevention and care services programs.
The 2016 concert was nothing short of spectacular and was especially poignant this year coinciding with the anniversary date of the Chorus’s first performance on the steps of San Francisco City Hall at the candlelight vigil for Harvey Milk and George Moscone who had been assassinated on November 27, 1978.
“Home for the Holidays” is always a festive, heart-warming concert and simply a not-to-be-missed extravaganza! Check back here in late summer/early fall for the 2017 concert date.
News from the San Francisco Gay Men’s Chorus:
Recognizing a rapidly shifting climate in the United States marked by an increase in dangerous and divisive rhetoric against vulnerable minority populations, such as the LGBTQ community, the San Francisco Gay Men’s Chorus has announced the launch of its 2018 “Lavender Pen Freedom Tour.” In an effort to reaffirm its ever-present message of equality and inclusiveness, and the value in treating all individuals – irrespective of differences – with dignity, the Chorus will take their message across several southern states.
Learn more about the Lavender Pen Freedom Tour