Getting more Detroiters on HIV prevention medication
Though the revolutionary HIV prevention medicine is covered by most insurers, there still are huge barriers to access in Detroit and across the United States.
Why it matters: There's no cure for HIV, but it's preventable and treatable thanks partly to pre-exposure prophylaxis, or PrEP.
- PrEP, shown to reduce risk from sex by about 99%, can be taken via a pill or injection.
What they're saying: Allan Frank, an associate medical director at LGBTQ+ medical center Corktown Health, tells Axios there are three main problems slowing PrEP uptake.
- Physicians need to be educated to offer most people PrEP, not just gay men, because they're not the only ones at risk — most people having sex outside a long-term monogamous relationship are at some risk, as well as injectable drug users. At Corktown Health, all patients are offered it but can opt out.
- Most insurance and Medicaid programs cover PrEP, but the coverage processes can be difficult and lengthy and may not cover the best types of the medicine.
- There also are racial inequities in access. "This extends beyond PrEP, for all medical needs … Black Americans access care less and there are social stigmas and barriers to this," Frank says.
By the numbers: In Michigan, seven out of 100,000 people, or 633 total, were newly diagnosed with HIV in 2021, the most recent year available from AIDSVu.
- But the rate is higher in Detroit — 10 people per 100,000, or 334 total, as of 2020, the latest year available. The people diagnosed were 71.6% Black, 20.1% white and 4.8% Hispanic/Latinx.
Between the lines: The PrEP-to-need ratio is widely used to compare usage to the population's overall need. The lower the number, the higher the need.
- In Wayne County, for every one person diagnosed with HIV in 2022, there were 7.2 people on PrEP — up from 4.2 in 2019.
- Michigan's figure is 11.5, up from 6.6.
Context: While AIDSVu's PrEP data doesn't filter by race at the county level, across the Midwest, Black people accounted for 12% of PrEP use but 48% of new HIV cases.
The bottom line: "We can try to create … a welcoming, affirming clinic where persons of all backgrounds can feel welcome," Frank says. "There's posters up, flyers up that speak to a lot of different backgrounds. They are accepted and not judged."
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