By Dr. Adam Spivak, MD
In 2012, the FDA approved a daily medication for the prevention of HIV infection. Despite evidence that this strategy, known as pre-exposure prophylaxis or PrEP, is up to 99% effective at preventing HIV acquisition, PrEP uptake among at-risk individuals has been very low across the country and HIV incidence has remained largely unchanged. PrEP has been shown to be remarkably cost-effective and is covered by the majority of health insurers. However, those at highest risk of acquiring HIV infection often lack access to health care and very few could afford the $1800 per month out-of-pocket expense for PrEP.
In March 2018, University of Utah faculty members Drs. Susana Keeshin and Adam Spivak founded the University of Utah PrEP Community Clinic. The clinic provides sexual health counseling, STD testing and treatment, HIV testing and PrEP all free-of-charge for at-risk individuals who lack health insurance. The free PrEP clinic aims to directly address existing barriers to care, including the financial burdens of HIV prevention as well as pervasive inequalities inherent in our health care system. This clinic design, combined with a collaborative approach and focus on underserved at-risk populations, has the potential to decrease HIV incidence in Utah in a durable and cost-effective manner. In turn the clinic may serve as a model for other areas of the country where HIV incidence remains steady or is increasing.
The PrEP Community Clinic represents a collaborative effort between the University of Utah, the Utah AIDS Foundation and the Utah Department of Health (UDOH). The clinic is run with the help of student volunteers from the University of Utah Schools of Medicine, Dentistry, Pharmacy and Nursing. The clinic is funded through an active contract with UDOH and generous donations from individuals and community partners. ARUP laboratories, part of the University of Utah Department of Pathology, has provided charitable donations to offset laboratory costs. The Utah AIDS Foundation has been instrumental in referring un- or under-insured patients to the free PrEP clinic. They also partner with community stakeholders including the Utah Pride Center, Equality Utah, the 4th Street Clinic, Comunidades Unidas and Encircle. Patient referrals are always welcome (call 801.585.2512 or Google “SLCPrEPIsFree”).
Together, we believe that we can make HIV history in Utah.
University of Utah faculty, staff, and volunteers on the opening day of the free HIV Prevention Clinic at Redwood Medical Center, March 2018.