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Little blue pill has potential to end HIV infection in Texas

By Dr. Sandra Guerra, Chief Medical Officer of Texas Health Action

Did you know there is a pill to prevent HIV?

Ten years ago, on July 16, 2012, the FDA approved the first HIV prevention medication in the United States. The little blue pill known as PrEP (pre-exposure prophylaxis) had the promise of decreasing new HIV diagnoses and preventing HIV transmission when taken before a potential exposure. A decade of a revolutionary medication has changed countless lives, but we must increase access to this medication to end HIV in Texas.

Texas continues to be among the top 10 states in the U.S. with new HIV diagnoses. According to the Centers for Disease Control and Prevention, 4,302 people were diagnosed with HIV in 2019. Texas carried 12% of new HIV diagnoses in the United States, the same percentage as California and Florida. Expanding access to PrEP is the key to preventing these new diagnoses.

But the trend is improving since the use of PrEP has gained acceptance and popularity in some parts of the state, particularly among gay and bi-sexual men. However, black and brown communities—especially in rural areas—continue to be disproportionately impacted by HIV.

In Texas:

  • Black men are four times more likely than white men to contract HIV.
  • Black females are almost 14 times more likely than white women to contract the virus.
  • Latinos are twice as likely as white men to receive an HIV diagnosis.
  • Latinas are nearly four times as likely as white women to test positive for HIV.

These communities face significant healthcare barriers including cultural stigma, lack of insurance and affordability. The rural aspects of a state as large as Texas do not help.
In fact, a 2019 study in the American Journal of Public Health found that substantial portions of Texas had areas with limited access to PrEP providers, also known as “PrEP deserts.” In these PrEP deserts, patients would have to drive more than an hour to find the nearest provider. Texans have a long road ahead toward health equity.

What needs to happen next? Telehealth services, funding, education, and community engagement are key to expanding access to PrEP in Texas and preventing the spread of HIV.

To reach more patients in rural areas, Texas Health Action launched a sexual telehealth service called TeleKind in April 2021. These services provide discreet care that is free of judgment and stigma. Patients don’t have to travel and can speak with a provider in the comfort of their home.

In March, the Biden Administration announced the proposed budget for 2023 including $9.8 billion toward expanding access to PrEP. While this funding is most welcome, it must be paired with a strategic plan that covers not just medication, but the essential services PrEP patients need to maintain care, including access to labs and appointments with providers. (TeleKind provides medical services to all free of charge.)

Healthcare professionals must become comfortable talking about sexual health and prescribing prevention methods. Dedicated visits for discussing sexual health with adult patients can help ensure focused, stigma-free, trauma-free conversations.

Community-based organizations, such as Texas Health Action, should be key partners to employers, and other agencies to address HIV prevention and resources available. Sexual health services are medical services that working professionals need.

It is up to all of us to educate ourselves and come together as a community. Sexual health is not just about pregnancy prevention. Talk to friends and loved ones about PrEP and resources available.

Together, we can stop the spread of HIV in Texas.

Dr. Sandra Guerra is the Chief Medical Officer of Texas Health Action, a community-informed nonprofit dedicated to providing access to culturally affirming, quality health services in a safe and supportive environment with an expertise in serving people impacted by HIV.

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