California approves bill turning HIV drugs into OTC

Amidst of HIV epidemic, the state government of California has signed a bill that allows citizens to purchase anti-retroviral medication for HIV, even without a prescription.

The bill was part of the advocacy of Sen. Scott Wiener, a Democrat politician representing San Francisco. He wrote on Twitter that PreP and PEP are a key to end this problem, but its accessibility is quite a hindrance, especially among persons of color.

California Gov. Gavin Newsom said that all Californians deserve the availability of HIV care to fight against the epidemic. He even applauded the legislature for taking measures to make this possible.

There are two types of this anti-retroviral currently available in the market: pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP).

According to the report of the Centers for Disease Control and Prevention, PrEP can eliminate the risk of contracting HIV through sex by almost 99%. Its effectivity has been tested by many states in U.S. In fact, this drug is considered as the key pillar of New York's succeeding war against HIV epidemia. The city even said that they could eradicate HIV by 2020.

PEP, on the other hand, must be taken immediately within 72 hours in case of suspected HIV exposure.

According to Courtney Mulhern-Pearson from San Francisco AIDS Foundation, many insurance plans had doctor's authorization requirements before the clients can enjoy the HIV-related medical attention benefits. It usually takes at least 72 hours to get one. But under this bill, this will be prohibited.

Another policy requires pharmacists to inform the client about these drugs, including its proper usage and the possible side effects.

Before its passage, it was initially opposed, primarily by physician groups like California Medical Association, due to safety concerns as it meant shifting the power over prescription from the doctors to the pharmacists. But in Newsom's defense, he explained that this would help the rural community that lacks medical advancement.

"Either they don't have primary care physicians, they don't know one, or it takes time to get an appointment," said Newson.

But ease the concern, the final bill ended up requiring the patient to seek prescription after the first wave of PrEP provided by the pharmacist. HIV tests must be conducted too, and if the result shows reactive, the test administrator or the pharmacist should refer them or offer a list of nearby HIV care providers or clinics.

Many advocates celebrated the bill's passage, including the bill's co-sponsor Equality California, an LGBTQ civil rights organization. The Executive Director, Rick Zbur, said that this will serve as a "giant step forward in getting to zero transmissions, zero deaths, and zero stigma".

In 2016, the local Department of Public Health in California estimated that PrEP could benefit at least 22,000 to 24,000 citizens, but less than 4% are taking the drug. CDC, on the other hand, reported that at least 1.1 million American aged 13 and older are reactive, and at least two-third of reported cases are men who practice unprotected sex with another men.

From 2012 to 2016, California has observed a consistent decline in the HIV-reactive population. This bill is expected to speed it up further.