On average, between 210 and 230 Oregonians are diagnosed with HIV each year. A new bill for the upcoming 2020 Oregon legislative session aims to lower that number, by allowing pharmacists to prescribe HIV prevention drugs.
If passed, House Bill 4116 will make Oregon just the second state in the country in which pharmacists can prescribe PrEP—a daily pill that greatly reduces a person’s risk of contracting HIV—to people who test negative for HIV. (California lawmakers passed a similar bill last year.) The bill will also allow pharmacists to prescribe PEP, a course of drugs people can use after they have been exposed to HIV.
HIV/AIDS advocates hope that the bill will remove some of the hurdles people at risk of contracting HIV often face when trying to access the drug. While people living in the Portland metro area have access to a wide range of medical resources, some rural parts of the state aren’t as well-served. And people seeking PrEP and PEP in those areas might still face a high level of “stigma,” according to Tyler TerMeer, chief executive officer of the Cascade AIDS Project.
“Access continues to be one of the number one areas that we anecdotally hear from our patients about why they aren’t using PrEP,” TerMeer tells the Mercury, “or why certain patients who come to our LGBTQ+ health center here, Prism Health, drive for multiple hours across Oregon to come and get their culturally safe services from our primary care providers.”
If HB 4116 passes, insurance companies will be required cover the cost of a consultation with a pharmacist who prescribes PrEP—even if the pharmacy is outside of the insurance provider’s network.
Rep. Margaret Doherty, one of the bill’s chief sponsors, said that allowing pharmacists to prescribe PrEP lends an extra layer of anonymity to the process, which can be valuable for people living in close-knit communities.
“If you’re more in a rural area,” Doherty says, “it makes it a little more accessible, because you don’t have to go to your doctor who might have known you since you were five.”
Doherty remembers attending a high school class reunion in the 1980s and learning that five of her old classmates had died from AIDS-related complications. She calls PrEP “the greatest thing since sliced bread.”
The Oregon Health Authority’s End HIV Oregon campaign seeks to bring new annual HIV infections down to zero. According to a recent report from the campaign, 300 Oregon doctors were trained in HIV testing and prevention services last year; over half of them work in rural parts of the state.
Adding pharmacists to the list of people who can test for HIV and prescribe PrEP will mean “more timely and more accessible” services for people at risk of contracting HIV, TerMeer says—but the work won’t stop there. The Cascade AIDS Project plans to soon start offering tele-consults with doctors in other parts of the state. It will also use technology to help patients perform HIV tests and consult with doctors without having to leave their homes.
“PrEP has revolutionized the way we will be able to respond to the impact of HIV in our communities,” TerMeer says. “Because of how effective PrEP is in those who have continual access, we can potentially begin to curb the epidemic.”