Why aren’t HIV prevention pills going to the people who need them?

When Truvada was introduced four years ago as a way to prevent HIV, public health leaders didn’t welcome the drug with open arms. The head of the AIDS Healthcare Foundation panned the once-daily pill as a “party drug.” Other health officials claimed that taking Truvada would cause a wave of wild unprotected sex. Even members of the LGBTQ community parroted the criticism, with one gay journalist (regretfully) labeling some users “Truvada whores.”

But the last four years has seen a shift in attitude. More and more Americans are embracing pre-exposure prophylaxis (PrEP), the HIV prevention method that requires a daily dose of Truvada to reduce viral risk. And more and more prescriptions are being written for the antiretroviral drug. While PrEP is growing in popularity, a new study out of the University of California released last month suggests that the populations most at risk of HIV infection are not the ones benefitting from the prevention strategy.

In a survey of gay and bisexual men in California, only a handful of participants reported having taken PrEP. PrEP use was highest among young white men, at 13.9 percent. For young Latino men, that figure was cut by more than half, while young black men represented less than 10 percent of people who started PrEP.

“This is not reflective of the HIV epidemic at all,” says Shannon Weber, founder of Please PrEP Me, an online directory of over 230 clinics in California that provide PrEP. “It is reflective about access, and where and how people are getting that information.”

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