Starting Thursday, November 30th; a new partnership between the Will County Health Department’s Community Health Center and the Family Health Services HIV and STD program will launch a special PrEP clinic. It will be in session every Thursday, 9 AM to 4 PM, in the Community Health Center Care Clinic.
PrEP stands for Pre-Exposure Prophylaxis, with the last word meaning “action taken to prevent disease, especially a specific action for a specific disease.” This new PrEP clinic will be offering a pill, to be taken once a day, for the purpose of preventing transmission of HIV virus. Health Department HIV and STD Program Specialist Kendra Coleman says this is part of a State of Illinois initiative called the “Getting to Zero Project.” Its goal is to one day have no newly diagnosed HIV cases in the State of Illinois.
Coleman says the drug Truvada, approved by the FDA for helping prevent HIV in 2012, is a major cog in this battle. “For HIV-positive patients, it has been shown that Truvada, when combined with other drugs, can help suppress the positive person’s HIV viral-load, and get it down to the ‘undetectable’ level. When it’s undetectable, you have ‘lowered to zero’ the chance of spreading HIV to a negative partner. Which drug the Truvada is combined with depends upon the individual.
“Then, for the non-HIV patient,” Coleman continued, “it has been shown that Truvada alone can act as a preventative medicine that allows the negative-HIV patient to avoid contracting it from a positive-HIV partner. That’s why this PrEP clinic has been established: to get Truvada to negative-HIV patients that want to take this precaution.”
Coleman says it is important to mention that the goal of “Getting to Zero” in Illinois will only be reached by treating with the HIV-positive and HIV-negative population. Coleman says many HIV-negative clients she has spoken with at the Health Department are very interested in this new, daily preventative medication.
“Many people are becoming educated about Truvada,” Coleman said. “And you can see it in their eyes that they are excited to know about it. For many, it’s the security of knowing that they do not have to just walk away from and abandon an HIV-positive partner, if they follow the PrEP program.
“The flip side,” Coleman reminds us, “is that at the same time we need to be pushing treatment and access to resources for positive-HIV patients, so we can get that viral-load down to ‘undetectable’ and keep it there. We need to push treatment, and get those that have fallen out of care back into care.”
Coleman says the reasons for a positive-HIV patient to not initiate treatment, or to leave it after starting, can vary. “It might be an insurance issue,” she explained. “Or, perhaps they were tired of the medication’s side effects. (Although the side effects usually dissipate after about a month; they can include severe headaches, diarrhea, or night sweats.) There’s also the possibility of having other health issues to worry about, or wanting to remain anonymous and not come forth as HIV-positive.”
For negative-HIV patients who are very interested in taking Truvada as part of the PrEP program, Coleman says coming to the Will County Health Department’s Community Health Center Care Clinic is probably your best bet. She says a lot of doctor’s offices seem to be hesitant to offer the PrEP treatment.
“Many are shying away from it,” Coleman explained. “It could be a lack of knowledge, or not being confident about this type of medication and what comes with it. It does require a commitment from both the caregiver and the patient. You don’t just give them the Truvada pills and send them on their way. There needs to be follow-up visits and HIV testing every three months.”
Community Health Center Chief Medical Officer Dr. Jennifer Byrd says it is not a surprise to see general practitioners not diving into the PrEP treatment. “HIV and HIV Care are known as specialty or sub-specialty treatments,” Dr. Byrd explained. “Truvada is something new. Sometimes an item new on the market doesn’t apply to what a family doctor usually treats. Perhaps an infectious disease doctor or other specialist would, but not a general practitioner. So then the family doctor might generalize it as ‘something we don’t deal with.’”
Dr. Byrd also agreed with Coleman that the follow-up needed for PrEP program treatment is also a factor. “PrEP cases have to be managed, and private offices have a set number of staff and resources, and may not be able to offer the highly intensive oversight that’s needed.”
Coleman pointed out that many Illinois county health departments that operate in a clinic setting (having examination rooms) are accepting the PrEP treatment. In addition, some not operating in a clinic setting are sending patients to nearby counties that have the facilities. And as always, funding is a big factor in the availability of this program.
Dr. Byrd added that around the country, Federally Qualified Health Centers such as the Will County Community Health Center are definitely excited about the PrEP program. “FQHCs are known as being very proactive. And that means being on the frontlines when it comes to situations like the fight against HIV, where community health care is really needed.”
Will County residents, fortunately, have both advantages: a county health department in a clinic setting that includes the Family Health Services HIV and STD program, and a Federally Qualified Health Center that is part of the department; with both able to team up and work together.
Coleman says PrEP clinic patients arriving at the Will County Community Health Center on Thursdays between 9 AM and 4 PM (starting November 30th, last appointment taken at 3:30 PM) should ask for directions to the Care Clinic. Coleman says this HIV prevention clinic is designed for anyone with or without insurance, and that no one will be turned away. You can make your appointment by calling 815-727-8830.
For more on Truvada, go to https://www.drugs.com/pro/truvada.html
For more on the Will County Health Department’s Family Health Services programs or the Community Health Center, go to www.willcountyhealth.org.