Further disparities in PrEP uptake reveals;ed among Medi-Cal beneficiaries

Further Disparities in PrEP Uptake Revealed Among Medi-Cal Beneficiaries

Differences Found by Age, Gender, Race/Ethnicity and Geographic Region

LOS ANGELES — Despite large increases in PrEP use across California, a new study funded by the California HIV/AIDS Research Program finds sharp differences in uptake by age, gender, race/ethnicity and geographic region. In this first look at PrEP prescription data among beneficiaries of California’s Medicaid program, Medi-Cal, researchers we are able to document that from 2012 through 2016, PrEP uptake was lower among Blacks, Hispanics, women, and people between the ages of 13-24. Disparities were also identified with regard to geographic region. Uptake was highest in San Francisco County, followed by San Diego and Los Angeles Counties.

Key findings include:

• Rates of PrEP uptake are much lower for the youngest age group, ages 13-24, than for those ages 25-34 or 35-44 years.
• Rates of uptake for women and those ages 65 and older are slow to rise and appear to have be leveling for women.
• Rates of PrEP uptake for non-Hispanic Blacks are consistently lower than observed for Whites; yet new diagnoses among Blacks/African Americans are over 4 times that of Whites
• Hispanics have the lowest overall rates of PrEP uptake even though HIV rates for Hispanics in the state are 1.5 times those of Whites.
• Increased rates of PrEP uptake were found in the 3 largest counties and both rural and urban areas. The steepest increase was found in San Francisco County which, in second half of 2016, outpaced uptake in Los Angeles and San Diego by more than 5 times.

Senior author, Nina Harawa, PhD, MPH of UCLA and Charles Drew University shared, “Even when accessible, PrEP’s reach into communities most impacted by HIV continues to fall short. If increased PrEP use is a key strategy for California’s plan to get to zero new infections, it is critical that we examine these disparities and remove social and logistical barriers to PrEP use for young and old, women as well as men, and black and brown communities.”

These findings echo data from Gilead Pharmaceuticals, the maker of the currently approved PrEP regimen, Truvada®. In 2017, Gilead noted that PrEP uptake varies by demographic characteristics, risk group, and region in the U.S. This work also undescores finding from a prior study by the Southern California HIV/AIDS Policy Research Center that identified racial/ethnic disparities in PrEP uptake among gay, bisexual, and other men who have sex with (MSM) in California and indications of a significant association between higher income and PrEP usage. Both full reports can be found at chprc.org.