AIDS United Public Policy Committee Calls for Scale-Up of PrEP

The largest and longest-running national coalition of community-based HIV/AIDS organizations, the AIDS United Public Policy Committee (PPC) calls for the scale-up of pre-exposure prophylaxis, or PrEP.

A breakthrough in biomedical HIV prevention, PrEP involves a once-daily medication that, when taken as directed, reduces the risk of HIV infection by upwards of 90 percent. The PPC commits to raising awareness of and reducing barriers to full scale-up of PrEP as a critically important prevention tool for people faced with substantial risk of HIV infection.

"Our scientific knowledge that PrEP works and is a substantial tool to prevent HIV just keeps getting stronger," said Michael Kaplan, President and CEO of AIDS United. "Our task must now be to educate people at risk of HIV infection, leaders and policymakers about PrEP and make PrEP accessible and affordable throughout the United States."

The PPC covers jurisdictions that include more than two-thirds of people living with HIV/AIDS. Late November marked the four-year anniversary of their iPrEx study, the first randomized controlled trial that found PrEP effective in reducing HIV infection risk.

In 2012, the Food and Drug Administration (FDA) approved Truvada as PrEP. Earlier this year, the Centers for Disease Control and Prevention (CDC) recommended the use of PrEP for those at substantial risk of HIV infection.

Furthermore, preliminary findings from two ongoing studies of PrEP in Europe, PROUD and IPERGAY, both bolster the growing evidence for the effectiveness of PrEP. The time for debate on the effectiveness of PrEP is over.

"Skepticism about PrEP persists among many in the communities hardest hit by the epidemic," said Kelsey Louie, CEO of Gay Men's Health Crisis (GMHC), an AIDS United PPC member. "Some even argue it is a 'gateway drug' to sex without condoms. In fact, PrEP is a gateway drug to primary care. Its use requires seeing one's doctor regularly and testing for HIV every three months. It's likely that people on PrEP will see their doctors more often and be more aware of their health than if they were practicing other forms of safer sex alone. Can you imagine how quickly we would have embraced a pill for prevention that was over 90 percent effective in the '80s and even the '90s? How many lives could we have saved? No matter what skeptics might say, taking one pill per day while at risk for infection beats a lifetime of treatment."

While the body of science showing PrEP to be effective has grown, it remains unknown and underutilized by people most likely to benefit from it.

A September 2014 survey by the Kaiser Family Foundation found that 80 percent of gay and bisexual men knew "only a little" or "nothing at all" about this important HIV prevention tool. People most at risk for HIV infection need to have full and accurate information to make an informed decision about PrEP, as well as support for access and adherence to the daily medication.

PPC members are moving beyond debate as to whether PrEP should be supported and are now focusing on how to scale up its appropriate use. Efforts going forward include raising awareness among their constituents about the benefits of PrEP, reducing barriers to access by ensuring insurance coverage, and helping the medical community understand who stands to benefit most from this proven prevention tool.

The PPC invites other AIDS service organizations and HIV advocates to share their experiences, barriers and perspectives about what will be required to fully scale up PrEP using the social media hashtag #PrEPWorks.

The AIDS United Public Policy Committee (PPC) is the oldest continuing federal policy coalition working to end the HIV/AIDS epidemic in the United States since 1984. It is the largest body of community-based HIV/AIDS prevention, treatment, research, education and service organizations and coalitions in the United States.

The PPC has been instrumental in creating and developing important programs, including the Ryan White Program and the National HIV/AIDS Strategy. Its national membership covers jurisdictions that include more than two-thirds of people living with HIV/AIDS and advocates for the millions of people living with or affected by HIV/AIDS in the United States and the organizations that serve them.

Created by a merger between the National AIDS Fund and AIDS Action in late 2010, AIDS United's mission is to end the AIDS epidemic in the United States, through strategic grant-making, capacity building, formative research and policy. AIDS United works to ensure access to life-saving HIV/AIDS care and prevention services and to advance sound HIV/AIDS related policy for U.S. populations and communities most impacted by the epidemic.