Supes Hold Hearing on Public Access to HIV Preventative Drug

Medical professionals and supporters of free access to preventative HIV/AIDS drugs expressed their desire at a San Francisco Board of Supervisors committee hearing today to see such drugs made available regardless of income.

Following a rally by supporters outside City Hall this morning, Supervisor David Campos held a hearing of the board’s Neighborhood Services and Safety Committee to learn how San Francisco could become the first city to provide the preventative drugs to HIV-negative residents who otherwise can’t afford them.

Members of the public and the city’s medical community urged the committee to help pay for the drug for those who cannot afford it.

The pre-exposure prophylaxis (PrEP), often referred to by its brand name Truvada, is the first drug approved by the FDA for preventing the spread of HIV.

Truvada was created by Foster City-based Gilead Science and was approved by the FDA in 2012.

According to the drug’s website, Truvada is designed for HIV-negative people who want to protect themselves from contracting the disease.

Truvada makes it harder for HIV-1 to multiply by blocking a particular enzyme in the body, thus helping lower the viral load and thereby decreasing the amount of HIV in the blood.

Serious side effects can include excessive amounts of lactic acid in the blood, liver problems and other issues, according to Truvada’s website.

Supervisor Scott Wiener said today that he is currently taking the PrEP and that one of the reasons he chose to take the drug is to increase public awareness around it.

Of the 3,000 people who have been prescribed the drug worldwide, about 1,000 of those people are San Francisco residents, according to Wiener.

He said he was shocked to learn how few people are on PrEP, despite how “very effective” it is.

Wiener said there is a dramatic decrease in the risk of infection to those who take it daily, but said there is an “enormous stigma” that surrounds it.

He likened it to the pushback against the HPV vaccine and efforts to expand access to birth control, which some critics say encourages bad behaviors.

Wiener said “shaming” people will not produce good behavior and that blocking access to public health only means that people are going to be less healthy.

Supervisor Campos said PrEP could be the “game changer” needed get to zero new HIV infections in San Francisco and that the city has the chance to be the first city in the country to make PrEP available to everyone.

Campos said that many people who are at high risk of contracting the virus do not have insurance and that PrEP isn’t fully covered by many insurance plans.

Brian Basinger, director of the AIDS Housing Alliance/San Francisco, was among a handful of speakers at the hearing who praised the drug and called for supplemental funds.

Basinger said while he fully supports increased access to the drug, he doesn’t want funds to be removed from other HIV/AIDS-related services. If the funds are awarded, he hopes they will be released expeditiously to help people stay safe immediately, not years from now.

Dr. Robert Grant, chief medical officer at the San Francisco AIDS Foundation, which conducted a clinical trial at the Gladstone Institute in partnership with University of California at San Francisco that was the first to demonstrate the value of PrEP in the prevention of HIV infection, urged the board to stop the spread of HIV in the city by funding PrEP use for all
residents in need.

Grant said both his clinical trials and other trials found the drug to be safe and effective.

He said there is “at least one new HIV diagnoses in San Francisco every day” and that the drug is underutilized in the city.

Nationally, Grant said, about 500,000 people could benefit from PrEP.

The San Francisco Department of Public Health also took the opportunity today to express their full support for PrEP.

Dr. Susan Philip, deputy health officer at the department and an infectious disease physician at San Francisco General Hospital, said there is a high level of demand among San Franciscans for the drug, but because of limited health insurance coverage, many people are not able to start taking it.

Philip said access to the drug would compliment the city’s current approach to combating the virus by providing free access to condoms, clean syringes, behavioral health, STD and HIV testing and other services.

For those concerned about the high cost of providing the drug to every San Franciscan who needs it, Campos said that for every HIV infection prevented, the city saves $355,000, which would have been spent on providing lifelong HIV care and treatment.

Hannah Albarazi, Bay City News

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