Meck Health Department To Start Offering HIV Prevention Drug

Jan 5, 2018

In exam rooms at the Cabarrus Health Alliance patients can get information about PrEP.
Credit Alex Olgin / WFAE

More than 300 uninsured people in Mecklenburg County will soon be able to get a drug that can prevent them from getting HIV. The county is funding this as part of a pilot project to reduce the spread of the deadly virus. Even though new infections have decreased in recent years, the county still has a new infection rate of 30.4 per 100,000 people. That's more than double the national average.

Roughly 6,600 people in Mecklenburg County are known to be living with HIV. The county’s new infection rate between 2014-2016 is the second highest, to Bertie County in the northeast part of the state.  A relatively new weapon to fight the spread of HIV is commonly known as PrEP, which is short for pre-exposure prophylaxis. As part of the treatment, patients take a medication called Truvada once a day. The Centers for Disease Control says it lowers the chances of contracting HIV by as much as 90 percent

It gave Deonté Wilbourn comfort when he was in a relationship with a man who had HIV. He stopped taking Truvada four months ago, when he lost his insurance while in between jobs. 

“Then Truvada cost an arm and a leg, which it still does,” he said.

About $ 1,500 a month without insurance. Wilbourn said he has had some scares because not everyone with HIV is careful.    

“People who may have it may still not care about doing it without a rubber," Wilbourn said. "It’s scary.”

But the drug hasn’t been so easy to get in the Charlotte area. The county health department says there are just 12 providers in Mecklenburg. One is primary care doctor Tagbo Ekwonu. He treats about 400 HIV patients.

“There is always a concern that they may infect their spouse or someone else they engage in sex with," he said. "So I think it’s very helpful for that population who [have] partners who are negative. It's an extra layer of protection from getting an infection.”

Ekwonu's practice is one of four locations the county is contracting with to treat about 320 people deemed at high risk for HIV and who don’t have insurance. It’s a pilot program the county intends to start at the end of the month. Mecklenburg would be only the fourth county to offer the treatment. Cabarrus Health Alliance started offering it to patients a little more than a year ago.

“It was a no-brainer," says Tamara Staehler, the Alliance's communicable disease manager, adding, "It's core public health."

She said patients ask for Truvada, and patients are asked about  risk factors like sexual activity and drug use to see if they are good candidates.   

“A lot of times we will see people in our STD clinic and that is where the actual risk is assessed," Staehler said. "Risk again is relative to the person who is talking about it. And what I see as somebodies risk might not be what they see as their own risk.”

As of December, CHA had prescribed Truvada to 16 patients, and as Staehler said, not all from Cabarrus  County. She said at least one person drove two hours to get the medication. People also drive to Duke University’s Infectious Diseases Clinic to get on PrEP. Dr. Mehri McKellar is the medical director of the PrEP clinic there, which started offering it is late 2015 and now has about 170 patients.

“We’ve partnered with community based organizations," McKellar. "And they have been extremely helpful bringing patients to us and we also attend all their community events, we have tables, distribute flyers, talk at 1 in the morning about PrEP to people. It’s actually been a lot of fun for me.”

The CDC reports gay and bisexual men account for 70 percent of new HIV infections nationwide.  Which is why McKellar advertises the clinic on the popular gay dating app Grindr.

Mecklenburg County's two-year pilot PrEP program will use social and other media to try and reach people at high risk for getting HIV. Public Health Director Gibbie Harris spoke to county commissioners at meeting last month about the PrEP program. 

“This is a beginning to a process," Harris said. "We understand that this will won’t serve the entire needs in our community. And there are other prevention efforts that need to be considered.”  

The county dedicated $248,000. Most of the money will pay for doctors’ visits and ongoing HIV testing. Like other clinics, the county plans to cover the cost of the medication through the drug makers assistance programs for qualifying patients.