California PrEPs for HIV; New York should follow

I am from a small town in upstate New York and have been seeing the same doctor since I was born.

As a 20-year-old sexually active queer person, I know that Pre-Exposure Prophylaxis (PrEP) is an option for Human Immunodeficiency Virus (HIV) contraception. So when my doctor asked if I was sexually active, I said, “Yes.” When he asked if I was safe, I said, “Yes.” And that is where the conversation stopped. He didn’t ask any further about my activity or if I would like to be tested (which I did).

I knew asking about getting a prescription for PrEP would be a trying experience, but I asked anyway. He told me he didn’t know what it was, Googled it, and then told me he would have to talk to a communicable disease specialist before we could discuss the prescription any further. It has been over a year, and that discussion never happened.

My experience is not an isolated one, and many people who are vulnerable to HIV deal with numerous obstacles to get prescribed PrEP. However, California is alleviating a few obstacles for its residents. Gavin Newsom, the state’s governor, signed legislation on Oct. 7 that I believe is going to save a lot of lives. 

This bill allows pharmacists to provide patients with PrEP and Post-Exposure Prophylaxis (PEP) over the counter, without a prescription, for up to 60 days. The bill also cuts through some red tape that is associated with insurance cost coverage for the drugs. People who do not have access to affordable, comprehensive healthcare will finally be able to be on this life-changing drug.

PrEP is a once-daily pill that, when taken consistently, can reduce one’s chance of contracting HIV. PEP is a 30-day pill regimen that someone can begin taking up to 72 hours after they believe they may have been exposed to HIV. As of right now, PEP can be prescribed at any emergency room to anyone who believes they have been exposed (yes, that means emergency room expenses).

PrEP also requires a prescription, and unfortunately many general practitioners (like my pediatrician) don’t know much about it. Some healthcare providers know about PrEP but are hesitant to prescribe it because they believe it will encourage risky sexual behavior. 

This reasoning is reductive and stigmatizing. California is truly paving the way for access to HIV contraception and de-stigmatization with this bill. By giving more people the opportunity to begin PrEP, California is helping normalize conversations about HIV contraception and doing a lot toward preventing new diagnoses of HIV. 

As of recent information from the Center for Disease Control, one in six men who have sex with other men will be diagnosed with HIV in their lifetime. 

A 2019 study estimated that 14% of transgender women have HIV. These numbers may seem relatively small, but this is a preventable disease. At the beginning of the HIV epidemic, the United States government provided very little funding and left those who had been diagnosed with HIV to suffer. The epidemic began in the ’80s, and contrary to popular belief, never ended.

Here we are, nearly 40 years later, with lifesaving drugs and revolutionary prevention methods that people are still struggling to access. Andrew Cuomo, the governor of New York, introduced a plan to “end the epidemic” in 2014 with one pillar being to facilitate access to PrEP.

As a New Yorker, I can tell you PrEP is not very accessible. Long Island has more AIDS cases than 26 entire states, and a 2014 study estimated that 6,200 people are living with HIV in the Nassau/Suffolk area. Educate yourself, educate others, advocate for members of communities that are more vulnerable to HIV. And most importantly, call your representatives!

Other states need to follow California’s efforts to end the epidemic. The threat of HIV has haunted us for too long.

Dennis van Dunk is the president of Hofstra’s Organization for Sexual Empowerment.