Earlier this week, California Gov. Gavin Newsom (D) signed a law that expands access to HIV prevention medications in an effort to reduce the number of new infections in the Golden State.
The bill, SB 159, sponsored by Sen. Scott Wiener (D-San Francisco) and Assemblymember Todd Gloria (D-San Diego), goes into effect in January, and authorizes pharmacists to furnish at least a 30-day supply, and up to a 60-day supply, of pre-exposure prophylaxis, or PrEP, and a complete course of post-exposure prophylaxis — which typically lasts 28 days, but must be started within 72 hours after exposure to HIV — to people who wish to access it, without requiring a physician’s prescription.
“Recent breakthroughs in the prevention and treatment of HIV can save lives,” Newsom said in a statement. “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 closer to ending HIV and AIDS for good.”
While both PrEP and PEP have been hailed by medical and public health experts as important to ending the spread of HIV, access to the drugs remains limited, especially for people of color. Studies have shown that PrEP reduces the risk of getting HIV from sex by about 99% when taken on a daily basis.
Additionally, while HIV infections in California have decreased, there remains a significant disparity between infection rates among gay men of color and white gay men. PrEP and PEP could potentially be effective in decreasing that gap. Yet, even though the California Department of Public Health’s Office of AIDS estimates that there are 220,000 to 240,000 Californians who meet the risk criteria for PrEP, data suggest that only 9,000 people were regularly taking PrEP as of late 2016.
Although some local health departments have implemented programs to increase access to the medications, many parts of California do not have enough resources to meet potential demand. Several California health plans also require documentation to request prior authorization every three months in order to access PrEP. That requirement places HIV-negative people on PrEP at risk of delays and interruptions, potentially risking PrEP’s efficacy and creating burdens on providers who must issue the prior authorization before the drug can be obtained by patients.
The risk is even potentially more severe for those requiring PEP, as the medication must be started within 72 hours from the time exposure to ensure a person won’t seroconvert, or become HIV-positive.
With Newsom’s signature, the new law will allow pharmacists to keep enough supply of PrEP and PEP on hand to ensure access to those who need it and ensure compliance, which lessens the risk of HIV transmission.
Equality California, the statewide LGBTQ organization and a co-sponsor of the bill, hailed the measure as 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,” Equality California Executive Director Rick Zbur said in a statement.
“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,” Wiener said in a statement, adding that the bill “will keep more Californians HIV-negative and help us end this epidemic.”
“With PrEP, we can end new cases of HIV in California. The challenge we face is access — more Californians should have easy and equitable access to this life-saving medication,” Gloria said in a statement. “SB 159 breaks down barriers so more Californians can access PrEP which puts us closer to eradicating HIV/AIDS.”