More people in Florida are using an HIV prevention drug, but the Sunshine State still lags behind other regions of the country despite having one of the nation's highest rates of new infections.
A new interactive data map released by AIDSVu shows that about 32 out of every 100,000 people in Florida were PrEP users in 2016. PrEP, which stands for pre-exposure prophylaxis, is for people who don't have HIV but are at high risk for the virus – they take a daily dose of the HIV medicine Truvada to lower the chances of infection. When taken consistently, PrEP can reduce the risk of HIV infection in people by up to 92 percent, according to the federal Centers for Disease Control and Prevention.
Compared to Southern states, Florida's rate was pretty high – 21 people out of every 100,000 used it in Texas; 25 out of every 100,000 in Georgia; and 11 out of every 100,000 people in South Carolina.
But Florida's rate pales in comparison to some Northern states – 48 people out of every 100,000 used it in Rhode Island; 59 out of every 100,000 in Massachusetts and a whopping 76 out of every 100,000 in New York.
The data show significant disparities in the use of PrEP, particularly in the South, says Amanda Castel, an assistant professor in the epidemiology and biostatistics department at George Washington University.
"Southern states account for half of new HIV diagnoses but only accounted for 30 percent of all PrEP," she says. "The rates of PrEP use in the Northeast are two times the rates of PrEP use in the South and Midwest."
While HIV rates have plummeted nationwide, Florida had the second-highest rate of HIV diagnoses among adults and adolescents in 2015, with about 28 new cases per 100,000 people, almost double the national transmission rate. That same year, the Sunshine State saw more people newly diagnosed with HIV than anywhere else in the county with 4,849 new cases. Both Orlando and Miami rank among the top 10 cities in the country for their high rates of new HIV diagnoses.
"I think PrEP is a revolution in HIV prevention," Castel says. "We know if people use PrEP they can reduce their risk as high as 90 percent. By being able to provide these data where there are significant disparities across regions and different subgroups, we can help health officials and the community really use the data so they can better understand who has access to PrEP and decrease the barriers around PrEP use."
The Florida Department of Health announced last year that the agency would begin providing PrEP for free throughout the state by the end of 2018. Castel says the data show Florida has increased the number of PrEP users dramatically from 2012 to 2016 – almost six times over.
In 2012, the state only registered 838 PrEP users. Four years later, Florida had 5,638 PrEP users.
But Castel adds that the nationwide numbers also show PrEP use has declined slightly among women, which, she adds, is not surprising, but it is concerning. The CDC recommends PrEP for a number of groups, including: people with HIV-positive partners; non-monogamous gay and bisexual men who've had anal sex without a condom or been diagnosed with an STD in the past six months; non-monogamous heterosexual men, heterosexual women and women with bisexual male partners who don't regularly use condoms during sex with partners of unknown HIV status; and people who have injected drugs using shared needles during the past six months.
A recently released CDC analysis also found disparities in PrEP use by race. Researchers discovered that although two-thirds of people who could potentially benefit from PrEP were African American or Latino, those groups accounted for the smallest percentage of prescriptions.
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