Fulton opens free PrEP clinic

Downtown location one of first in South launched to combat new HIV cases

The statistics are sobering and staggering: Metro Atlanta ranks number five on the list of regions with the most new cases of HIV. As of 2012, approximately 26,000 people were living with HIV in metro Atlanta. Emory University researchers in 2013 found more than 10 percent of young black men who have sex with men in metro Atlanta are contracting HIV each year.

Last week, Fulton County joined a growing list of cities and counties across the country trying to prevent the number of new infections from rising. It opened a new clinic in Downtown to administer an HIV prevention drug called Truvada to people with a high risk of contracting the virus. The county is partnering with the drug's manufacturer, Gilead Sciences, to provide the HIV prevention medication and follow-up visits at no cost.

"We've seen some very sobering statistics about AIDS/HIV across the county and we're now rolling up our sleeves to do something about it," Fulton County Chairman John Eaves says. "We're going to be a leader like San Francisco and Washington, D.C."

Located at the Aldredge Health Center on Jesse Hill Jr. Drive near Grady Memorial Hospital, the clinic will administer a regimen called PrEP, short pre-exposure prophylaxis. Under the program, HIV-negative people who are at high risk of infection take the blue pill daily.

PrEP is not a vaccine. But according to the Centers for Disease Control and Prevention, its presence in the bloodstream can often stop HIV from infecting a person and spreading the virus. PrEP has been found to reduce the risk of getting HIV from sex by more than 90 percent when used consistently and lower the risk of getting HIV from injecting drugs by 70 percent. People who take Truvada should also practice safe sex, medical professionals say.

Dr. David Holland, the clinic's chief clinical officer, says the county follows the CDC's guidelines to determine who is at "high risk": men who have sex with men, or MSM, and women whose partners test HIV positive or who engage in commercial sex work.

Many of the people in these groups are also people of color who have less access to health care than their white counterparts, says Emily Brown of Georgia Equality.

"There's a huge, huge racial disparity between white gay men and black gay men getting HIV," she says. "There's a misconception that white gay men are having fewer sex partners and using condoms more than black gay men. It's not that black men are engaging in risky behavior, it's that they have less access to health care."

Fulton's health department is not the first agency or organization in metro Atlanta to offer Truvada. AID Atlanta has already been offering PrEP. But the center's ability to take on large numbers of people who are at risk for HIV is limited. Brown says many care providers for people at risk of HIV who do have health insurance may not know what PrEP is, or they don't understand the nuances of care for MSM. Some LGBTQ people avoid going to the doctor or seeking health care because traditional providers might marginalize their own patients. There's even a stigma surrounding PrEP over concerns that it could lead to reduced condom use.

Advocates applauded Fulton's decision to launch the program but argue more must be done. Matthew Terrell, a local LGBTQ advocate, says it's vital for the clinic "to find ways to deal with the specific set of issues related to HIV infection in Atlanta ... While we can turn to San Francisco and New York City for inspiration on how to create our city's prevention model, we must realize our problems are specific to Atlanta." Those include finding ways to engage clients who feel "'dirty' or 'sinful' discussing HIV/AIDS" and "finding ways to connect with men who have sex with men who don't identify as being gay."

Holland says the PrEP clinic is "not a silver bullet." "There's no one thing we're going to do that is going to make HIV go away," he says. "It is a piece in a very large puzzle. The part that it plays, though, is that it's the only new thing we've had for HIV prevention in 30 years that really puts the power of prevention in the hands of someone who's HIV negative to protect themselves."

There is no income requirement to receive PReP and insurance is not required. To date, a county spokeswoman says, the clinic has completed 24 assessments and scheduled 21 patients for clinician visits. For more information call 404-613-4708 or visit www.fultoncountyga.gov.

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