Uninfected young people who admit to unsafe sex practices are being prescribed a powerful prophylactic drug with the hope of preventing HIV infection, part of a new program at a Long Island treatment center.
The Northwell Health system’s Center for Young Adult, Adolescent and Pediatric HIV Care has received a $2 million grant from the New York State Department of Health’s AIDS Institute to help curb the spread of HIV among high-risk individuals in Nassau, Suffolk and Queens.
People from midteens through early 20s will be offered the prescription drug therapy called PReP, a combination therapy of two HIV drugs, which doctors say can prevent infection with the virus. The drug’s acronym stands for pre-exposure prophylaxis.
Dr. David Rosenthal, the center’s medical director, said the therapy is part of a larger push to dramatically drive down new HIV infections statewide by 2020.
Over the next five years, Rosenthal said, the grant will provide $400,000 annually, split between Queens and Long Island.
Two years ago, Governor Andrew M. Cuomo issued a three-point plan to end the AIDS epidemic in New York. Key among tenets in that resolution was a call for an all-out effort to reduce the number of new HIV infections. Rosenthal — and other doctors — think PReP is one way to do that, especially when vulnerable populations are treated.
In recent years, studies have shown that the leading age group developing HIV is made up of young people in their teens and early 20s. Most are homosexual young men, but young heterosexual women, many of them African-American and Hispanic, also are at risk, Rosenthal said.
“We’re unfortunately seeing an increase in young people who are not having safe sex, and the methods we have used for many years have not decreased new cases of HIV in young adults,” he said.
The pill therapy, which is taken daily, is sold under the name Truvada. Although used in the treatment of some people who are already infected, the medication was approved by the U.S. Food and Drug Administration in 2012 to help prevent an HIV-negative person from contracting the virus from a positive partner.
“Basically this program is for individuals who are at high risk of developing HIV,” Rosenthal said. He noted that in addition to the drug therapy, patients also will be taught how to “navigate safe sex practices.”
Dr. Roy Steigbigel, an infectious disease specialist at Stony Brook University Hospital, said the drug therapy works, but not always.
“It’s one of the antiretrovirals, which inhibits the replication of HIV,” he said of the mechanism the drug uses to thwart infection.
Steigbigel said there are limitations to the drug’s effectiveness because numerous strains of HIV are highly resistant to many of the widely used medications. If someone contracts a resistant strain, PReP therapy will be of little use, he said.
Rosenthal noted that the treatment is a step in the right direction and will help lower the infection rate in a vulnerable population. He said the number of new HIV infections has been declining for people aged 25 and older.
On Long Island, there are nearly 6,000 people of all ages living with HIV infections. In Queens the estimate is 16,900, Rosenthal said, adding that his youngest patient is 15.