As part of the Los Angeles County Board of Supervisors’ vote earlier this month to expand funding for prevention measures against the spread of AIDS/HIV in high risk communities, Dignity Health St. Mary was named a recipient of a $90,000 grant this week.
The money will help the hospital fund a Pre-Exposure Prophylaxis (PrEP) center as part of its C.A.R.E. (Comprehensive AIDS Resource and Education) Program to service the Long Beach community, which is considered to be one of the most HIV-impacted communities in Los Angeles County.
Expanding the HIV prevention program was spearheaded by Supervisor Sheila Keuhl, and once implemented, the $11.5 million dollars allocated for the expansion will push the number of locations providing PrEP services into the double digits from the previous total of four. St. Mary’s was one of nine hospitals and clinics selected to receive funding by the Los Angeles County Department of Health.
“LA County continues to experience the second largest HIV epidemic in the country,” Kuehl said in a statement. “No single prevention program will completely curtail the spread of HIV, but expanding the use of PrEP could significantly reduce new infections. I am very glad to see our efforts go beyond the County’s own Public Health clinics, to engage our community-based health providers who can effectively reach the populations at greatest risk, including those who lack insurance.”
The move has the potential to help thousands of people who previously lacked access to these kinds of services, as it will allow hospitals and clinics to hire more nurses and social workers to help patients make appointments and correctly take their medications. An estimated 60,000 people in the county live with HIV and the county’s previous efforts to combat this issue showed better engagement by HIV patients.
One of the services that will be provided by the PrEP center is the disbursement of drugs like Truvada, a once-a-day pill that has been shown to be nearly 90 percent effective in preventing the spread of HIV among high-risk populations. The drug was approved in 2012 by the United States Food and Drug Administration.
C.A.R.E. will offer these services to uninsured and underinsured patients with the help of the grant money from the county, services that the hospital said would be otherwise cost-prohibitive. According to multiple sources including drugs.com, an independent medicine information website that helps patients price out medications, the cost of a 30-day supply of Truvada is about $1,540.
Ace Robinson, Executive Director of the C.A.R.E. Program, said that with the help of the grant, St. Mary's would be able to provide the prescription for as low as $15-$30 for insured patients with premium plans, but for those that are uninsured, the drug could ultimately end up being free. According to the City’s Health and Human Services website, Truvada can be acquired from its Sexual Health Clinic on a sliding income-based scale for anywhere between $100 and $165 per visit.
"We cannot allow for people of higher resources or better insurance to have these options when people of no means don’t have access," Robinson said. "It just won’t work that way."
Robinson lauded the success of other clinics in the state, most notably the one in San Francisco that has seen about 1,000 people engage the program in the first nine months of its existence. He said that C.A.R.E currently writes less than 50 prescriptions for PrEP, but he's hopeful that number could jump to about 500 with the influx of funding. He added that the key to helping infection rates in Long Beach, especially those among people of color, down—something that some health experts have likened to those in Africa—was making the resources available to communities that needed them most. The grant, he said, is a "game changer."
"It's like saying "we have this magic cardiac medicine that will prevent heart attacks' but it's only available to people who do yoga everyday and are vegan," Robinson said of the program's ability to help prevent more people from becoming HIV positive. "Now this is saying is 'we don't ever want to see you in our offices' especially if you're currently HIV negative."
The program will require that those prescribed PrEP to be tested on a quarterly basis, something that can both ensure that HIV or other sexually transmitted infections are caught before they're transmitted to others. Robinson said that data estimates that for every person living with HIV that is diagnosed two other infections are averted.
Post-Exposure Prophylaxis (PEP), treatment given to patients who may have recently exposed themselves to HIV in the past three days, will also be offered to individuals. Additionally, existing services like help with navigating the insurance system to help patients enroll in Medical and Covered California, assistance for behavioral health needs and a risk-reduction model aimed at those trying to address substance abuse will also be covered.
Editors note: The previous story has been altered to reflect the addition of comments from C.A.R.E. Executive Director Ace Robinson.