A new Philly HIV prevention program will make PrEP medication available for free — with no in-person visits

A new telehealth program by Einstein Medical Center and the Philadelphia Department of Public Health aims to increase access to HIV prevention medication at no cost.

Pre-exposure prophylaxis, or PrEP, is a medication that’s highly effective at reducing the risk of contracting HIV. Yet the health department estimates that just over a third of Philadelphians who are at high risk for getting HIV are on the medication. Lack of insurance, providers who are unfamiliar with PrEP, and stigma all contribute to what the department calls “Philadelphia’s PrEP gap.”

The Philadelphia PrEP program addresses many of those barriers: It’s free regardless of insurance status, has providers trained to serve patients of all lifestyles, and doesn’t require the patient to leave the house, according to Einstein.

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Through Philadelphia’s sexual health website, Philly Keep on Loving, people at high risk for HIV can connect with a “PrEP navigator” to start the process. The navigator will take relevant medical and sexual history, schedule a virtual visit with a provider, and offer options for HIV testing.

Most patients who are eligible should be able to get the medication within a week.

“People can do the visit from wherever they want,” said Hussein Safa, the program’s medical director. “It gives people a kind of freedom.”

People who take PrEP as prescribed reduce their risk of HIV from sex by 99% and from sharing syringes by about 75%, according to the Centers for Disease Control and Prevention. A key to PrEP’s efficacy is taking the medication continuously.

PrEP also increases people’s sense of control over their health, promotes emotional intimacy, and reduces sexual anxiety.

The Food and Drug Administration approved PrEP in 2012 as a daily pill. In December 2021, the FDA approved an injectable version that lasts two months. The TelePrEP program offers both options with counsel from a provider.

PrEP is recommended for people who are at risk of getting HIV from sex or drug use. That includes people whose sexual partner is HIV positive and those who don’t use condoms consistently.

The Philadelphia health department estimates that roughly 8,200 people in Philadelphia are candidates for PrEP — meaning that they are at high risk for HIV — but only 37% of them took the medication in 2019. In its “Ending the HIV Epidemic” plan, the city set a goal to increase uptake of the drug to 50% by 2025.

Men who have sex with men, people who use drugs, and transgender women are disproportionately at risk of getting HIV. More than 60% of newly diagnosed people in 2021 in Philadelphia were Black.

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The collaboration shows what’s possible when public health agencies and the medical community “come together to re-think programming and center the community’s needs,” said Javontae Williams, a prevention program manager for Philadelphia’s AIDS Activities Coordinating Office.

Safa said he has heard from patients that they felt judged by previous providers. As the director of Einstein’s Pride Program, which provides health services to the LGBTQ+ community, it’s critical for him that care is affirming, and patients feel comfortable. That’s why all providers are trained in taking patient history in an affirming and sex positive way to make sure that no patient feels judged.

To start PrEP, patients need to take a test for HIV to ensure they are negative.

Through the new TelePrEP program, patients have the option to do the blood work at Einstein, at a local lab, or receive a home test by mail. Once the test results return, patients meet a clinician via telehealth to discuss the results and the best PrEP option for them.

“PrEP is for everybody and not just certain group. There are options for everyone,” Safa said.

For more information on this program, visit PhillyKeeponLoving.com or contact the Health Information Helpline at 215-985-2437.