Black college students in D.C. cite the high cost of PReP, a drug used to prevent HIV, for why they have spurned the medication.
PReP, which stands for Pre-exposure Prophylaxis, reduces the chances of getting HIV by 92 percent in individuals who display high-risk behaviors, or people who have unprotected sex.
Remi Roberts, 22 of northwest D.C. said the pill might help diminish the HIV epidemic in the District but is unsure of its success in Black communities, where about 10,000 have been diagnosed with HIV, according to D.C’s 2017 Epidemiology and Surveillance Report.
”What I wonder is the accessibility to this pill,” Roberts said. “As we know, this is a business, so you’re trying to target a population and of course the population affected by this virus is a population that has lower income.”
According to the Centers for Disease Control and Prevention (CDC), while two-thirds of people who could potentially benefit from PrEP are African American or Latino, they account for the smallest percentage of prescriptions to date.
Approximately 500,000 African Americans “could have potentially benefited from PrEP” but 7,000 prescriptions were reportedly filled at retail pharmacies or mail order services for African-Americans, the CDC said.
Michael Kharfen, a health professional at the D.C. Department of Health, said most Blacks lack financial access to the medication, which is one underlying cause for this trend.
”So I would say what we know nationally, PrEP has not been more available to members of the Black community,” Kharfen said. “Its primary users so far have been White gay men. But here in D.C., we believe PReP can be of use to a wide range of persons.”
Kharfen said they started outreach in D.C. universities and community centers within Black and Latino communities and that most patients at D.C.’s Health and Wellness Center, one of the DOH’s testing facilities that offers PREP, are from these communities.
Phill Wilson, founder of the Black AIDS Institute, told The Informer in 2015 that it was crucial to improve outreach techniques among young groups.
”If we’re talking about getting to the endgame, if we’re really going to be serious about ending the epidemic for everybody — not some bodies — we are going to involve young people, we’re going to need to communicate in different ways and we’re going to need to ensure they understand and we incorporate new technologies,” Wilson said at the time.
Deen Ajib, a Howard University student, said he considered using PReP but “heard it’s costly.”
”I could just continue to use condoms as my protection,” Ajib said. “If insurance were to cover all of it, I would greatly consider using it. HIV or AIDS should not be looked over as a minor thing. It seems like the chances of PReP helping to prevent it is very useful and should be used if one is able to.”
Gilead, Inc., manufacturer of the PReP medication Truvada, offers a co-pay program for individuals with private insurance. The co-pay card can grant individuals up to $4,800. Government-insured individuals “may be eligible for other sources of support through independent co-pay foundations.”
The Kaiser Family Foundation reported in 2016, however, more non-elderly uninsured Blacks are ineligible for coverage than their White counterparts.
Kharfen explained how students might have reservations about using PReP if they are still on their parents’ insurance.
”They are likely on their parents’ insurance plans and they don’t want their parents to know,” Kharfen said.
A way around that obstacle is a D.C. public health law which guarantees privacy of sexual health information and prevents insurance companies from releasing information to guardians.
”Our priority is to make PReP available in D.C. and to not to have any barriers to get it,” Kharfen said.