Legislation introduced by Senator Scott Wiener (D-San Francisco) and Assemblymember Todd Gloria’s (D-San Diego) granting accessing HIV preventative medications pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) was signed into law Monday by California Governor Gavin Newsom.
SB159 will reduce barriers to accessing HIV preventative medications. The bill authorizes pharmacists to furnish to patients without a physician prescription. (Pharmacists are already authorized to furnish emergency contraceptives and the birth control pill without a prescription).
The legislation also prohibits insurance companies from requiring patients to obtain prior authorization before using their insurance benefits to obtain PrEP or PEP. Both provisions will expand access to PrEP and PEP by increasing the places where people can access these medications, increasing the number of healthcare professionals who can provide it, and removing onerous and unnecessary insurance barriers.
“Recent breakthroughs in the prevention and treatment of HIV can literally save lives,” said Newsom via a statement released by his office Monday. “All Californians deserve access to PrEP and PEP, two treatments that have transformed our fight against HIV and AIDS. I applaud the legislature for taking action to expand access to these treatments and getting us close to ending HIV and AIDS for good.”
In 2014, Senator Wiener publicly disclosed that he takes PrEP as an HIV prevention strategy. He did so in order to increase awareness of this important HIV preventative and to reduce the stigma around discussing sexual health.
“We must do more to increase access to revolutionary medicines that help keep people HIV negative, and that’s exactly what SB 159 does,” Wiener remarked in July upon hearing that the legislation had cleared the Assembly Committee on Health with a 13-0 vote last July. “By allowing pharmacists to furnish PrEP and PEP, we will help more people, especially low-income people and people of color, stay negative. California has some of the highest disparities between communities of color and white communities around HIV infections. SB 159 will help close that disparity by increasing access for everyone.”
PrEP is a once-daily pill for HIV-negative people that almost entirely eliminates the risk of contracting HIV. PEP, on the other hand, is medication that a person takes after being exposed to HIV, in order to prevent the virus from taking hold. PEP is a 28-day course of drugs that, if started within 72 hours after exposure to HIV, significantly reduces risk of infection. Both PrEP and PEP are critical strategies to prevent new HIV infections and to ultimately end the epidemic
For years, medical and public health professionals, as well as HIV advocates, have demonstrated the efficacy of PrEP and PEP in dramatically reducing the transmission of HIV. A 2011 study of gay men and transgender women, found that drug levels corresponding to daily use of PrEP are associated with 99% protection against HIV.
“The more individuals who are able to access these medicines, the fewer new HIV infections we will see throughout California,” Wiener said. “To end new HIV infections, we must dramatically expand access to PrEP and PEP, yet far too many Californians who need these drugs struggle to access them. SB 159 will keep more Californians HIV-negative and help us end this epidemic. I applaud Governor Newsom for signing this first-in-the-nation legislation to remove barriers to these critical HIV-preventatives.”
The California Department of Public Health, Office of AIDS (OA) estimates there are 220,000 to 240,000 Californians with an indication for PrEP, but data suggest that only 9,000 people were taking PrEP in late 2016. Additionally, a recent report found that while new HIV infections have decreased, there were still large disparities between black and Latino gay men and their white counterparts. Latino men were almost twice as likely to contract HIV as white men, and black men were over 3 times as likely. Increasing access to PrEP and PEP is particularly important to reduce new HIV infections in communities of color.
SB159 was co-sponsored by the San Francisco AIDS Foundation, APLA Health, the Los Angeles LGBT Center, Equality California, and the California Pharmacists Association.
“The HIV epidemic is still a pressing issue today — especially for LGBTQ people of color and folks in rural communities,” said Equality California Executive Director Rick Zbur. “But with Governor Newsom’s signature, SB 159 is a giant step forward in getting to zero transmissions, zero deaths and zero stigma. By increasing access to life-saving HIV prevention medication, California — unlike the White House — is leading the country in the race to eliminate HIV. We owe a debt of gratitude to Senator Wiener and Assemblymember Gloria for their leadership and tireless advocacy.”