Nurx allows patients to request a prescription without having to see a doctor in bid to reduce stigma surrounding preventative drug, founder says

A San Francisco startup described as an “Uber for birth control” is expanding its services to offer Truvada for PrEP, a daily pill that has been shown to be more than 90% effective in reducing HIV infection from sex.

From Tuesday, Nurx will allow patients in California to obtain a prescription for PrEP (which stands for pre-exposure prophylaxis) through a mobile app without having to see a doctor.

“It’s really difficult for people who want PrEP to get PrEP,” said Hans Gangeskar, one of Nurx’s co-founder. He cited stigma and a lack of information as a reason for the lack of widespread adoption of PrEP, as well as a shortage of doctors who will prescribe the drug.

Nurx’s streamlines the process by allowing patients to request a prescription and fill out a health survey through the app. The information is then reviewed by a doctor, remotely, who will decide whether or not the patient is a good candidate for PrEP.

A patient must complete blood tests for HIV and renal function prior to receiving his prescription. But Nurx is experimenting with sending a phlebotomist in an Uber to the patient’s home to draw their blood, making the process as quick and easy as possible.

Gangeskar said: “PrEP has been available for three years, and the CDC [Center for Disease Control] says people should be taking it, but they aren’t.”

In November, the CDC issued a report finding that more than 1.2 million people in the US should be taking PrEP, whereas only about 21,000 peopleare currently taking it. The CDC recommends PrEP for people at “very high risk” of HIV infection, which includes about one in four men who have sex with men, one in five adults who inject drugs, and one in 200 sexually active heterosexual adults.

Gankeskar says the company has focused on PrEP and birth control because “these are both failures of the current healthcare system”: medications that are not as widely available as they should be to the populations who need them. According to the CDC, a third of primary care doctors and nurses heave never even heard about PrEP.

Nurx’s doctors can communicate with patients, either by phone or text, but Gangeskar says that reducing the human interaction between doctor and patient can actually improve the standard of care, because people are more honest if they don’t feel judged.

“People have concerns about going to the doctor and talking about anal sex or having to justify not using condoms,” he said. “You’re able to ask questions that you wouldn’t ask face to face.”

Robert Grant, a professor of medicine at the University of California, San Francisco, who led the first clinical train for HIV PrEP, signed on as a volunteer adviser to Nurx when he learned about the startup. “I like that Nurx makes PrEP available to people who may be afraid of doctors or may be afraid of the judgment that they’ve experienced from doctors,” he said. “We need to work to make medical services as friendly as possible and try to eliminate the shaming that comes with going to the doctor.”