Marcus Berry, a gay man from Philadelphia, had a close call with HIV two years ago.
After learning that a man with whom he had unprotected sex was HIV-positive, Berry said he immediately went to the health department to get tested, where he found out he was negative.
“I was really wild,” Berry said. “I thank God I didn’t contract anything.”
After getting a negative test, Berry went to Philadelphia FIGHT, a comprehensive AIDS-service organization. He heard FIGHT had just started a program for pre-exposure prophylaxis, called PrEP. It’s a combination of medicines, including tenofovir and emtricitabine, in the form of a daily pill that’s shown to be effective at preventing HIV. It’s meant for people who do not have the virus.
Berry has taken the medication ever since as a precaution.
Berry shared his story with about 50 people Oct. 29 in the ballroom of the William Way LGBT Community Center. They gathered for a town hall meeting about PrEP, which was organized by state Rep. Brian Sims, who represents Center City, including the Gayborhood. Mazzoni Center, FIGHT and William Way partnered on the event.
Dr. Helen Koenig and Caitlin Conyngham, who both work on PrEP programs at FIGHT, spoke alongside Dr. Robert J. Winn, medical director of the Community Health Center at Mazzoni.
Medical professionals from FIGHT said PrEP received FDA approval in 2012.
“It’s a pill we’ve used for many, many years to treat HIV,” Koenig said, noting Truvada is the brand name of the pill used in PrEP programs. “We actually do know a lot about it. It’s not a new, experimental drug. This is medication that we’re very familiar with and comfortable with as clinicians.”
Koenig said there is a small difference between using Truvada for prevention versus treatment. She said, in treatment, people take Truvada with a third active medication. For prevention, Truvada alone is sufficient, she said.
“PrEP is like birth control for HIV,” Conyngham said.
It takes at least 21 days for the medicine to be effective for vaginal sex and up to seven days for it to be effective in anal sex, she said. People are still advised to use condoms during sex.
The pill works by not allowing the RNA that makes up the HIV virus to transform into the DNA that makes up a person’s body. If the virus does not become part of a person’s DNA, it usually cannot take hold in the body.
The medicine has also been shown to be effective at preventing HIV in people who inject recreational drugs.
Winn said doctors who administer PrEP monitor their patients for side effects like decrease in kidney function and bone density. The medicine also has some effect on the liver.
He said most insurance companies cover the medicine in some way. They usually require a copay of $50-$100. The manufacturer of PrEP pills also offers a copay-assistance program up to $150, Winn said.
Sims said he plans to introduce legislation in November to require insurance companies in Pennsylvania to cover PrEP. He said his office receives criticism from some people for supporting PrEP; some contend it condones sex with multiple partners or encourages people to have sex without a condom. Sims called it important to correct these misconceptions.
“There are 20-30 years worth of LGBT people who aren’t here to talk about PrEP because they’re all dead. There’s no way around that,” Sims said. “Every time someone gives me [flak] about supporting this, I always say, ‘We could sit down and have a very high-minded conversation with those people who are on PrEP right now because they’re alive to have that conversation.’ It’s that simple.”
Audience members noted it might be a challenge to convince underserved populations — like poor people, black and Latino communities — to investigate PrEP. Koenig said it’s the Marcus Berrys of the world who would help make that job easier because people respond to members of their own communities.
Berry said it was a little strange, at first, to explain the situation to his family. His brothers didn’t understand why he was taking medicine for a virus he didn’t have. He told them it was another level of protection for him. He’s also talked to his boyfriend and friends about PrEP.
“I started taking my health seriously,” Berry said.
He said PrEP can help anyone in the gay or straight community feel secure, including people in the medical profession who may work around blood and needles.
For more information about the PrEP program at Philadelphia FIGHT, visit www.fight.org/programs-and-services/special-programs.