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A pharmacist in California can distribute HIV prevention drugs to any person who has proof they’ve been tested for the virus in the past 7 days. Getty Images
  • A new California law allows pharmacists to distribute HIV prevention drugs without a prescription.
  • Experts say the law is an effective way to help reduce a recent increase in HIV rates.
  • Experts say rising costs and accessibility to medication have been obstacles to more people using HIV prevention drugs.

A drug that can prevent 99 percent of new HIV infections can now be obtained without a prescription in California.

Governor Gavin Newsom signed the law into effect on Oct. 9. It authorizes pharmacists to distribute pre-exposure prophylaxis (PrEP) drugs, including the medication known by the brand name Truvada, without a doctor’s prescription.

The new law is the kind of change that advocates hope will increase the use of the lifesaving medication.

“California’s bill is a win in the HIV community because it lowers the barriers to the lifesaving drug by making it accessible to those who are most at risk for infection, yet were unable to obtain the drug due to complex socioeconomic factors… such as lack of insurance, rural residence, stigma from healthcare providers, and lack of general awareness and education about PrEP,” Wendasha Jenkins Hall, PhD, an HIV and AIDS researcher and educator with the Georgia Health Policy Center in Atlanta, told Healthline.

“Allowing pharmacists to provide PrEP without a prescription brings us steps closer [to] making the drug more accessible to those who need it most,” Hall said. “Pharmacists will serve as a link between patients and healthcare providers as they navigate using PrEP as an effective HIV risk-management strategy.”

People with known risk factors for HIV are reportedly more aware of the availability of PrEP drugs and are open to using them.

In July, the Centers for Disease Control and Prevention (CDC) reported that awareness of PrEP among men who have sex with men — a population with a high risk for HIV — rose from 60 percent to 90 percent between 2014 and 2017 in 20 urban communities.

Use of PrEP drugs in the same population rose from 6 percent to 35 percent, the CDC reported.

Still, HIV prevention advocates say that only a small percentage of people at risk for HIV transmission take PrEP drugs.

The most prominent PrEP drug is Truvada, which is manufactured by Gilead Sciences. It was approved for prevention of HIV in 2012, the first such drug approved by the Food and Drug Administration (FDA).

Cost has long been a barrier to use of the drug.

People lacking health insurance could pay up to $1,800 a month for the drug in the United States, although it’s available in other parts of the world for $75 per year.

Facing harsh criticism over the cost of Truvada, Gilead Sciences announced in May that it would release its patent on the drug next year, and granted Teva Pharmaceuticals the right to manufacture a generic version of the medication.

Teva will have 6 months of exclusive rights to make the generic version of Truvada. No big price reduction is expected until 2021, when manufacturing will be open to more pharmaceutical companies.

“The cost of the drug really is a secondary issue at this point, as we have learned the true barrier is firstly getting the prescription,” Josh Robbins, a spokesperson for DatingPositives and an HIV and LGBTQ activist, told Healthline.

“By California eliminating the need for a prescription, we can now focus on lowering the cost to continue to help get PrEP into the hands of those who need it most,” he said. “I’m excited to see if other states follow California’s lead, especially given the rise of HIV cases in recent years.”

Another state that’s been proactive in breaking down barriers to PrEP drugs is Florida, which announced in 2018 a plan to distribute the drugs for free to people at risk for HIV. People wishing to get Truvada through the program must first undergo a risk evaluation administered on a sliding-fee scale.

And Iowa has established a telemedicine program called TelePrEP to improve access to the HIV prevention drugs for residents of rural communities.

PrEP drugs have been shown to prevent nearly all new HIV infections when taken daily as directed.

A second PrEP drug from Gilead Sciences, called Descovy, was recently approved by the FDA.

Post-exposure prophylaxis (PEP) drugs such as azidothymidine can prevent infection if taken within 3 days of exposure to HIV and continued for the prescribed 28 days.

The California law requires the person seeking PrEP or PEP drugs show proof to a pharmacist that they’ve been tested for HIV within the past 7 days in order to receive the medication.

Those who have tested positive for HIV will be referred by pharmacists to a clinic or primary care physician for treatment.

The bill’s approval comes as the California Department of Health reported last week that the rate of sexually transmitted diseases (STDs) in the state has risen to its highest level in 30 years.

A broad coalition of California public health and community groups issued a consensus statement on reducing STD transmission, which included easing access to PrEP and PEP drugs.