Sheila Kuehl is widely known as one of the smartest politicians in California so it was great news when she was elected to be one of the five most powerful people in Los Angeles County last November. She is using her position to enact public policy that will positively impact her constiuents. Karen Ocamb of Frontiers Magazine reports that Supervisor Kuehl is going to propose that Los Angeles County find a way to implement Pre-Exposure Prophylaxis (commonly known as PrEP) to low-income and at-risk individuals.
At next Tuesday's Board of Supervisors' meeting Kuehl is going to introduce this motion which is today's Queer Quote:
Recommendation as submitted by Supervisor Kuehl: Authorize the Interim Director of Public Health, in partnership with the Director of Health Services, to develop and implement a plan for a robust, comprehensive program to deliver Pre‑Exposure Prophylaxis (PrEP) throughout the County, considering a broad range of medical providers, including the Departments of Public Health and Health Services’ operated clinics as well as community‑based organizations and clinics, that can effectively provide PrEP to those at high risk for contracting HIV; instruct the Interim Director of Public Health to report back to the Board in writing within 30 days on the PrEP program implementation plan, including details on program target population, program elements such as robust public education and awareness campaign, the provision of technical assistance to local providers and service delivery elements, specific timeline and milestones for program implementation, program monitoring and evaluation of the plan, and the Departments of Public Health and Health Services’ financed investment strategy; and instruct the Interim Director of Public Health to develop and release a solicitation within 45 days to fully support private‑sector delivery of PrEP services to benefit uninsured and underinsured residents of the County at high risk for HIV infection. (15‑2677)The motion itself goes into far more detail about the necessity of the move and discusses the potential positive impacts it could have on the transmission of HIV in Los Angeles County. For example:
Since the FDA approved PrEP in 2012, Los Angeles County has become home to more PrEP demonstration projects than any other area of the U.S. These projects, including projects at multiple DHS sites, are designed to assess the feasibility, acceptability, and cost-effectiveness of PrEP as an HIV prevention intervention. These demonstration projects show that the delivery of this intervention is, in fact, feasible and that demand is high and growing, particularly among those groups of Los Angeles County residents most at risk for HIV. Outside of these demonstration projects, numerous Los Angeles County residents have been able to access PrEP through their private health insurance plans and Medi-Cal. Despite increasing local access to this intervention, however, many Los Angeles County residents at high risk for contracting HIV, who could benefit from PrEP, are still unable to access this service.
Among the factors contributing to limiting access to PrEP are a lack of knowledge and awareness by consumers and providers, cost, and limited PrEP service delivery sites. The delivery of PrEP as part of a comprehensive public health HIV prevention strategy must include access for high risk uninsured and underinsured individuals in Los Angeles County, especially young African-American and Latino gay men, transgender persons and African-American and Latina women. For these reasons, the Los Angeles County Commission on HIV recommended, in an October 2014 resolution, that this Board authorize and expedite expanded access and comprehensive implementation of PrEP.I'm happy to see this moving forward. I wonder how this will spur other large urban jurisdictions with large HIV-impacted populations like New York City, Atlanta and Chicago to act similarly sooner rather than later?