AHF Questions Wisdom, Ethics of App to Deliver Prescriptions for PrEP Without Any Direct Contact With a Medical Provider

In News by AHF

As STD rates skyrocket, particularly among young people using hookup apps like Grindr and Tinder, AHF challenges wisdom of an app that allows people to order drug to prevent HIV as readily as ordering pizza.

LOS ANGELES (March 29, 2016) Advocates from AIDS Healthcare Foundation (AHF) expressed concern today over news of a Bay Area start up company that has developed an app that allows individuals to order medical prescriptions online for pre-exposure prophylaxis (PrEP) to prevent HIV infection without any direct contact with a medical provider or physician.

According to the San Jose Mercury News, the start up, named Nurx, can eliminate, “ … time-consuming and potentially embarrassing face-to-face doctors visits for PrEP,” noting that a “ …user will log on to the app, answer a handful of questions about his or her sexual history and health, and visit a lab or community clinic for blood work to test for HIV, hepatitis and kidney problems.” 

“While the goal to improve access to effective HIV prevention tools is admirable, removing any or all direct contact with a physician or medical provider is not,” said Michael Weinstein, President of AIDS Healthcare Foundation, which has criticized and cautioned against the widespread deployment of PrEP as a community wide public health strategy, such as the CDC’s recommendation that 1.2 million individuals go on PrEP, but supports its use on a case-by-case basis decided upon between a medical provider and his or her patient. “At a time when STD rates are skyrocketing, particularly among young people using hookup apps like Grindr and Tinder, we challenge the wisdom and ethics of an app that allows people to order a drug to prevent HIV as readily as ordering pizza. PrEP is not simply a pill taken in isolation: It is a four-part HIV prevention strategy that can be highly effective, but one that offers no protection against any other STDs. Eliminating primary contact with the physician or medical provider from this equation is really a disservice to the patient.”

PrEP as a prevention strategy includes use of Gilead Sciences’ successful AIDS treatment medication Truvada to prevent HIV infection in non-infected individuals.

Gilead’s Truvada was first approved for treatment of HIV/AIDS patients in August 2004. The FDA formally approved use of Truvada as PrEP on July 16, 2012. Guidelines issued by the FDA for PrEP for individuals include 1) an initial baseline negative HIV test; 2) daily adherence to the Truvada medication; 3) ongoing periodic HIV testing to ensure the individual on PrEP remains HIV-negative; and 4) continued use of other prevention methods, such as condoms.

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