PrEP as an HIV Prevention Tool in Queer Communities of Color: Barriers and Opportunities BACKGROUND Joanne Stekler, MD MPH.

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Presentation transcript:

PrEP as an HIV Prevention Tool in Queer Communities of Color: Barriers and Opportunities BACKGROUND Joanne Stekler, MD MPH

Lifetime risk of HIV in U.S. Source: Centers for Disease Control and Prevention

What is PrEP? Pre-exposure prophylaxis = HIV-negative people taking HIV medications before getting exposed to prevent them from getting HIV infection. Daily oral tenofovir-emtricitabine is currently the only medication FDA-approved for PrEP.

Does PrEP work?

PrEP side effects and safety Nausea, headache, or fatigue may occur in first 2-4 weeks “Startup Syndrome” Monitoring at least every 6 months recommended Renal Safety TDF-FTC associated with small change (~1%) in bone density No increase in fractures seen Bone Effects Source: US Public Health Service. Clinical practice guidelines for PrEP. May 2014.

Paying for PrEP Project Inform: www.projectinform.org

Who is PrEP for? Anyone with an HIV-positive sex partner or injecting partner Recent bacterial STI (chlamydia, gonorrhea, or syphilis) “High” number of sex partners Inconsistent or no condom use Commercial sex work Anyone in an area with a high prevalence of HIV infection

PrEP uptake by race/ethnicity Bush et al (Gilead), ICAAC 2016, session 371

Barriers to PrEP uptake Knowledge about PrEP Perception of risk Cost and access to healthcare insurance and providers Mistrust of medical community Need for daily adherence Stigma (e.g. “Truvada whore”)