A decade into the #PrEP era, efforts to leverage the prevention pill's power to curb #HIV have stagnated, I report for @NBCNews. Among gay men, who account for 70% of new cases, Blacks and Latinos have the highest HIV rates, but use PrEP the least. 🧵⬇️nbcnews.com/nbc-out/out-he…
Only 1 in 200 PrEP prescriptions are for the new injectable PrEP, Apretude, which is vastly superior at preventing HIV in gay men on a public health level. But it's so expensive, few insurers will cover it, while generic Truvada is now very cheap. 2/ nbcnews.com/nbc-out/out-he…
In a clinical trial of Apretude vs daily oral Truvada as PrEP, the injectable drug, which is given every 8 weeks, yielded a 72% lower HIV rate in Black gay men and trans women than the daily oral drug. So if Apretude were covered, it could do much good. 3/ nbcnews.com/nbc-out/out-he…
In Black gay men in the Apretude-vs-Truvada PrEP trial, those randomized to get the oral drug had a high HIV rate: 2 infections per cumulative 100 years of follow-up. This is in keeping with other studies finding low adherence to daily PrEP in Black gays. nbcnews.com/nbc-out/out-he…
Apretude has a much higher rate of breakthrough HIV than daily Truvada--ie: people contracting HIV despite sticking with the medication schedule. If 10,000 gay men similar to those in the trial were followed for 1 yr, perhaps 12 would get breakthrough HIV. nbcnews.com/nbc-out/out-he…
PrEP use has soared, but the growth has largely been among white gay men. Among gay men, whites have the lowest and most quickly declining HIV rate. PrEP has never attained substantial popularity in Black and Latino gay men, despite millions spent promoting it among them. 
Activists falsely claim the cost of Truvada is the primary reason inhibiting PrEP uptake. Generic Truvada has been available, often for <$30, for 2 years now. And the same problems persist. A 2022 CDC study found medication cost was not a major inhibitory factor even in 2018. 1/2
CDC found that in 2018, medication-related costs were a relatively minor factor inhibiting PrEP use. Since 2021, federal law has required oral PrEP to be covered by almost all health plans, with no cost sharing for the drug or the clinic visit or labs. 2/2 nbcnews.com/feature/nbc-ou…
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