SACRAMENTO, Calif.—The New York Times has reported that "Gov. Andrew M. Cuomo declared that New York is on track to meet its goal to end the AIDS epidemic in the state by 2020," since there were just 2,481 new HIV cases reported in the state in 2018, 11 percent less than in 2017 and 28 percent less than in 2014—and it looks like something similar can be said for California.
According to the Centers for Disease Control and Prevention, in 2016, there were just 15.2 new HIV cases reported per 100,000 population, and it appears that that rate is decreasing, not only in California but nationwide—and one of the reasons for that may be the increased availability of pre-exposure prophylaxis drugs (PrEP), which if taken regularly block the ability of the human immunovirus (HIV) to infect the body.
That's why it's particularly good news to hear that under the recently passed Senate Bill 159, sponsored by state Sen. Scott Weiner of San Francisco—the assembly version was introduced by San Diego's Todd Gloria—California will be leading the pack in allowing PrEP drugs like Truvada to be sold over-the-counter at pharmacies without the need of a prescription.
The new law couldn't come at a better time, since Gilead Sciences, which created Truvada, has recently gotten approval to market its new PrEP drug, Descovy, which may lead to a significant price drop for the "old drug," making it affordable to many who were unable to obtain it previously.
According to the new law, pharmacists will have to undergo special training in how to use the PrEP drugs properly, and after completion of the course, will be able to sell 60-day supplies of the drugs to customers without a prescription. The stores will also be allowed to sell post-exposure prophylaxis (PEP) drugs as well, which may be effective in preventing HIV infection if taken soon after exposure.
"All Californians deserve access to PrEP and PEP, two treatments that have transformed our fight against HIV and AIDS," said Gov. Gavin Newsom, who signed the bill into law on Monday. "I applaud the Legislature for taking action to expand access to these treatments and getting us closer to ending HIV and AIDS for good."
Weiner expressed relief at the enactment of the bill.
"There are big swaths of California where it is hard to get a doctor’s appointment, and sometimes people have to wait months," he told The New York Times. "Giving people the option of going into their neighborhood pharmacy and getting a 60-day supply to start on PrEP will make a big difference."
However, the Times article warned that it is crucial to test for HIV before starting PrEP or PEP.
"If a patient who has HIV takes those drugs, the virus can become resistant to key ingredients that are also found in medicines used to treat the virus," the Times wrote, referencing Morgan Carvajal, a legislative advocate at the California Medical Association. "That could limit a patient’s treatment options down the road. She added that regular medical checkups for PrEP users are also essential to check renal function every six months—the drug can have adverse side effects on the liver, kidneys and bones—and to test for other sexually transmitted diseases."
The new law will also require Medi-Cal, the agency that aids those who are unable to afford the high costs of medical care, to cover PrEP and PEP, and prohibits insurance companies of those who are insured from requiring prior authorization before cover the drugs' cost.
"I think what California is doing is exactly the kind of innovative response that we need in order to end the epidemic of H.I.V. infections," opined Dr. Aaron S. Lord, a professor of neurology at the NYU School of Medicine—and the founder of a campaign to make Truvada more affordable by getting the government to rescind Gilead's patent on the drug.
