New Mecklenburg HIV infections are rising. Will free drug program help stop new cases?

The medication will be available to those who members of vulnerable groups

By Steve Harrison, The Charlotte Observer

With new HIV infections believed to be increasing, Mecklenburg County’s Health Department is launching a pilot program to give 320 high-risk people a drug designed to reduce the risk of getting the virus.

The county is partnering with drug-maker Gilead, which will distribute daily doses of Truvada to people believed to be at risk of contracting HIV. While Gilead will cover the drug’s cost, the county will spend $233,000 over six months to pay for the clinic visits and testing for people participating in the trial.

“We’re trying to get it off the ground as fast as we can,” said county Health Director Gibbie Harris.

She said the county will target populations who have been most at risk of getting infected: African-Americans; men who have sex with men; and people who have sex with multiple partners. The target population also doesn’t have insurance.

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Truvada is also known as PrEP, short for Pre-Exposure Prophylaxis. It’s 90 percent effective at stopping new transmissions of HIV through sex, according to the Centers for Disease Control and Prevention. The county program is scheduled to last for two years.

In Observer articles last year, commissioners and LGBTQ advocates questioned why the county didn’t move faster to distribute the drug. Commissioners set aside money for PrEP last year and health departments in at least five North Carolina counties offer it to patients.

Mecklenburg’s rate of 30.4 new HIV infections per 100,000 is more than twice the national average. At least 6,630 people in Mecklenburg County are living with HIV, a more than 30 percent spike since 2012, the county has said.

There were 24 new cases in 2016. Harris said she doesn’t have the final numbers for 2017, but she said the number of new infections is “creeping up.”

In her presentation Friday, Harris said one problem is that HIV has “become a bit of a chronic disease” in that less attention is paid to it than in the past.

She said doctors need to discuss HIV with people at their annual checkups as a precaution. Harris said a study found that 1 in 4 physicians haven’t heard of Truvada, or PrEP.

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Harris discussed the pilot program at a county retreat Friday. Commissioner Trevor Fuller asked why the county couldn’t set a target of having no new infections.

“Until there is a vaccine, I don’t think we’ll ever get to zero,” Harris said. “We don’t have that kind of control (over people) – and I’m not sure we should.”

Commissioner Bill James said he is worried that people receiving Truvada might sell it instead of taking it themselves. Harris said she didn’t think there would be a market for it, since other low-income people at risk could get it for free.

Harris said the county’s clinics need to be faster about getting results to people who come for HIV testing. The current turnaround time – two weeks – is too long for some people.

“We lose people,” she said.

Harris also said there is no discussion about starting a needle exchange program. She said “only three to five” of the new HIV cases came from people sharing infected needles.

The program will be launched from four clinics: Ballantyne Family Medicine; Eastowne Family Medicine; C.W. Williams Community Health Center; and Charlotte Community Health Clinic.

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Posted by The Charlotte Observer

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