Oct 10, 2023 - News

The push for HIV PreP equity

Illustration of a red AIDS awareness ribbon shaped like a "no" sign

Illustration: Sarah Grillo/Axios

Public health researchers are urging politicians and policymakers to make a revolutionary HIV treatment more accessible to Black and Hispanic people in Georgia, one of the states with the highest rates of new diagnoses.

Why it matters: Though no vaccine or cure for HIV is currently available, HIV is preventable and treatable thanks partly to advances in medicine including pre-exposure prophylaxis, or PrEP.

State of play: Black people accounted for 71% of newly diagnosed cases in Georgia in 2021, according to the AIDSVu database, which publishes local and nationwide HIV/AIDS statistics and resources.

  • That could be because some factors that affect risks for HIV infection — poverty and the lack of access and proximity to health care services — are more common among Black and Hispanic people in Georgia, Patrick Sullivan, an Emory University and AIDSVu researcher, told Axios.

Starting and staying on PrEP typically requires patients to have the insurance, transportation and time for medical appointments.

  • To bend the curve on new HIV cases, Sullivan said, the state and other programs need to reach people at the highest risk of acquiring HIV and who lack those resources.

In the weeds: PrEP is intended for people at risk of HIV. Users take a pill or longer-acting injection.

Catch up quick: Since its FDA approval in 2012, PrEP has been shown to reduce the risk of getting HIV from sex by about 99% when taken as prescribed, according to the Centers For Disease Control and Prevention.

By the numbers: Fulton County has the fifth highest rate of new HIV diagnoses among U.S. counties but ranks 343rd among counties in equitable PrEP use.

  • Cobb, DeKalb, Henry and Gwinnett also show the need for more equitable PrEP use, particularly among people aged 13-24.

Zoom out: Black people made up 48% of new HIV diagnoses in the South, according to AIDSVu researchers, but only 21% of PrEP users in the South.

  • There were 23 white PrEP users for every new HIV diagnosis among white Southerners.
  • In comparison, there were only four Black PrEP users for every new HIV diagnosis among Black people in the South.
  • Research shows there were only seven Hispanic PrEP users for every new HIV diagnosis among Hispanic Southerners.

Of note: Sullivan says that states with Medicaid expanded, and programs that cover the cost of starting and staying on PrEP — expenses associated with regular doctor's visits for medical monitoring, for example — have more than double the rates of PrEP use than states with neither program.

  • Georgia this summer launched a limited expansion of Medicaid to people living on low incomes.

The bottom line: "In the end, prevention is cheaper than treatment," Sullivan said.

  • Living in one of the most heavily impacted states, he said, "we need to be sure that our prevention programs are among the most generous and easy to access in the country."

Go deeper: Find PrEP services or explore maps and data about city, county and state HIV statistics


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