Pre-exposure prophylaxis therapy, or PrEP, is a proven safe and effective method that can provide at-risk patients protection from HIV transmission. Still, the drug therapy is not widely utilized by physicians or the populations that could most benefit, according to the American Medical Association's LGBT Advisory Committee.
PrEP consists of a once-a-day dose of tenofovir/emtricitabine that offers significant protection from HIV. Though the treatment was approved by the U.S. Food and Drug Administration in 2012, a 2015 CDC survey found 34 percent of primary care physicians and nurses had never heard of the treatment.
Here are three things that stall wider PrEP adherence:
1. Collective unawareness: In addition to the 34 percent of nurses and physicians that are unaware of PrEP's existence, so too are 75 percent of gay and bisexual men.
"What's really interesting about it is a lot of people haven't heard about it," said Magda Houlberg, MD, chief clinical officer of the Howard Brown Health Center in Chicago, at an educational session on the subject held at the 2016 AMA Annual Meeting. "You'd think people would want to shout it from the mountains."
2. Low perception of risk among vulnerable populations: While PrEP could benefit more than a million Americans, approximately four percent have used the treatment.
Noël Gordon Jr., HIV specialist with the Human Rights Campaign — an LGBT advocacy group — said, "I once talked to a friend and asked him what he thought his risk was, and he said low. Then I asked him if he used condoms on a regular basis, and he said no. I just can't reconcile those two things in my mind."
3. Stigma and cost: In the educational meeting, Mr. Gordon stated that the stigma associated with HIV remains strong despite social progress. Mr. Gordon added that even though PrEP insurance coverage is widespread, many patients associate the treatment with high cost.
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