Mass. Senate passes bill expanding access to HIV-prevention pill without a prescription

In what backers call a significant stride toward ending the HIV epidemic, the Massachusetts Senate passed and sent to the House a bill enabling pharmacists to prescribe, dispense and administer PrEP, HIV pre-exposure prophylaxis, a safe and effective medication that reduces the risk of HIV transmission by close to 100%.

The legislation, sponsored by Sen. Julian Cyr, D-Truro, permits pharmacists to dispense a 60-day supply of PrEP without the need for a prescription, with an added requirement for pharmacists to link customers to primary care providers for ongoing medication and monitoring.

Senate President Karen E. Spilka emphasized the critical role of preventative health care.

Increasing access to health care

“PrEP is a true example of how preventative health care saves lives,” said Spilka. “By allowing pharmacists to prescribe PrEP in Massachusetts, we are expanding equitable access to health care by breaking down another barrier that our residents — and especially our LGBTQ+ community — face when they act to protect themselves from HIV.”

PrEP is nearly 100% effective in halting the spread of HIV transmissions, with the CDC estimating about 25,000 people in Massachusetts who are at high risk and only 36.5% of those prescribed PrEP.

PrEP can help narrow these gaps, Cyr said.

"With greater access, we can help narrow the gap in PrEP utilization we see between LGBTQ and people of color,” he said.

This issue primarily affects members of the LGBTQ+ community, particularly males, who make up 54% of new HIV infection diagnoses from 2018 to 2020. Additionally, individuals using injection drugs are also affected, accounting for 32% of deaths related to HIV infections in 2020.

Dan Gates, the president and CEO of the AIDS Support Group of Cape Cod, explained the importance of swift access to PrEP.

"If someone suddenly realizes they are at risk for HIV and think PrEP would benefit them, they don't have to wait for that first appointment,” said Gates. “This bill removes that waiting period.”

The AIDS Support Group has offices in Provincetown, Hyannis, East Falmouth and Vineyard Haven.

Legislation enacted in 13 other states

The legislation would enable pharmacists to prescribe medication to patients who have tested negative for HIV within seven days, who do not show symptoms of acute HIV infection and are not taking conflicting medications. Each patient can receive a 60-day supply of PrEP once every two years.

If enacted, Massachusetts will join 13 other states, including Arkansas, California, Colorado, Illinois, Kentucky, Maine, Missouri, Nevada, New Mexico, Oregon, Rhode Island, Utah and Virginia, that allow pharmacists to prescribe PrEP. The legislation has widespread support from public health leaders and experts across the commonwealth.

Ben Klein, the senior director of litigation and HIV law at GLAD, GLBTQ Legal Advocates & Defenders, applauded legislative action to expand PrEP access in the commonwealth.

“California became the first state in the country to pass a bill authorizing pharmacy access,” said Klein. “It’s time for Massachusetts to join this effort … Massachusetts should be adopting better policies in the era of PrEP.”

The fight against HIV has a rich history on Cape Cod, particularly in communities such as Provincetown. The town played a key role in the early years of the HIV crisis.

"Provincetown was one of the few communities that treated people living with HIV with dignity, at a time when society had turned its back on those affected by AIDS,” Cyr said.

Despite its efficacy, PrEP faces several challenges, including being underutilized.

Data from the Centers for Disease Control and Prevention reveal that one-third of the individuals who require PrEP in Massachusetts are currently using it. Klein explained how this connects to racial disparities.

“In Massachusetts, only about one-third of all those for whom PrEP is indicated are currently using it, and the racial disparities in access, particularly among Black and Latinx communities, are especially shocking,” said Klein.

Nationally just 13% of eligible Black individuals currently have access to this effective and potentially life-saving preventative, Klein said.

The financial barrier to access to PrEP is the focus of a separate piece of legislation.

Clara Cho is a reporter with the Boston University Statehouse Program.

The Cape Cod Times is providing this coverage for free as a public service. Please take a moment to support local journalism by subscribing to the Times.

This article originally appeared on Cape Cod Times: Mass. Senate approves bill that expands access to PrEP anti-HIV pills