Julie Ball

jball@citizen-times.com

ASHEVILLE - Physicians at Western North Carolina Community Health Services have begun prescribing a pill shown to lower the risk of HIV infection.

The health center this year launched a PrEP or pre-exposure prophylaxis initiative, according to Scott Parker, with WNCCHS.

The pill, known as Truvada, is for those at high risk of infection. It contains a couple of medicines used to treat HIV, according to the Centers for Disease Control website.

PrEP has been around for a number of years, but not widely prescribed outside of large urban areas, Parker said.

According to a list compiled by the North Carolina AIDS Training and Education Center, Western North Carolina Community Health Services was one of just two PrEP providers west of Charlotte. The other is Mission Infectious Disease Associates.

“We are the first primary care setting west of Charlotte that has a PrEP program,” Parker said.

A lot of people are not aware of the pill including many who would benefit, said Dr. David Wohl, professor in the UNC School of Medicine Division of Infectious Diseases and director of the North Carolina AIDS Training and Education Center.

“There’s really a gap in understanding and knowledge,” he said.

The drug makers haven’t marketed it widely, Wohl said.

Research shows it is “highly effective,” when taken every day, said Dr. Jennifer Mullendore, medical director for Buncombe County Health and Human Services.

The CDC says it can reduce the risk of infection by up to 92 percent when taken consistently. It provides another level of protection in combination with condoms.

Mullendore said health care providers still encourage people to use condoms because the drug won’t protect against other sexually transmitted diseases.

“This is a great effective tool, but again one tool against one particular infection,” she said.

Parker echoed that.

"PrEP is not intended to encourage folks to stop practicing safer sex, but is intended for those who are a high risk. PrEP does not replace condoms. ... It adds an extra layer of security to prevent the spread of HIV,” he said.

Parker said about a dozen WNCCHS patients are taking the Truvada pill to reduce their risk of infection.

The center’s primary care physicians carefully evaluate a patient’s potential risk.

“Taking a comprehensive sexual history and normalizing that as part of primary care is key to getting to the needs of each patient,” Parker said.

Those who might benefit from PrEP include couples where one person in the relationship is HIV positive and one person is negative. PrEP can help reduce the risk of transmission to the negative partner.

“Other high risk individuals include IV drug users who may share needles and individuals who do not always practice safe sex,” Parker said.

The U.S. sees about 50,000 new HIV infections each year, according to Parker.

“This could be a way to reduce those numbers finally,” he said.

In Buncombe County, 21 new HIV infections were reported in 2014, the most recent year for the data. The number has been up and down since 2010 when 14 new infections were reported.