Can Ending HIV Start at Home?

This National HIV Testing Day, June 27, there’s a different infectious virus dominating the news. While the world struggles to understand and contain the novel coronavirus that causes COVID-19, we can also celebrate the life-saving strides made in HIV prevention and treatment. This diagnosis that was a death sentence in the 1980s is now a manageable condition, and people with the virus live long and healthy lives. There’s even a daily pill that is 99% effective at preventing HIV: the medication PrEP, which earlier this month received the endorsement of the esteemed US Preventive Services Task Force.  

But despite these major advances, stigma and lack of access to quality care prevent many of those who are most at risk from protecting themselves. Even though we know how to prevent the spread of HIV, more than 38,000 Americans contract the virus each year. 

Making PrEP Convenient and Stigma-Free

PrEP is a safe and reliable way to prevent the spread of HIV — it’s up to 99% effective when taken as prescribed — but obstacles often stop those at risk from accessing the medication. At Nurx our PrEP patients have told us stories of encountering stigma when trying to get PrEP prescriptions elsewhere. “I knew I wanted to get on [PrEP] for extra protection–not that my lifestyle is crazy, I just want to have extra security,” says Jason, a current Nurx patient. “But I grew up in a very conservative area in New Jersey. Trying to find a doctor where I’d be accepted was hard. If I asked for PrEP, they’d say ‘I don’t prescribe that. I don’t believe in that lifestyle’.” Nurx helps people like Jason access PrEP without potentially uncomfortable doctor or pharmacist interactions, by prescribing online and delivering to patients’ homes. 

Another reason that people who could benefit from PrEP don’t use it: Staying on the medication requires blood tests every three months to ensure that the patient is HIV-negative and has healthy kidneys. Going to a lab is inconvenient and, depending on where the patient lives, can mean more discomfort or prejudice. Nurx eliminates that barrier by sending test kits to PrEP patients’ homes in discreet packaging. They can collect a few drops of blood on a collection card from the privacy of home and return to our partner lab by mail.

Stubborn Barriers to HIV Testing 

Of course, a crucial step to reducing new HIV infections is making sure everybody at risk gets tested. But many people are either unable or unwilling to get an HIV test, evidenced by the statistic that 1 in 7 Americans with HIV don’t know they have it, and half of teens and young adults with HIV don’t know they’re infected — which means they can’t benefit from life-saving medications and may be passing the virus to others. 

We asked Christopher Hall, MD, MS, a Senior Medical Advisor at Nurx and an infectious disease specialist, why so many people at risk remain in the dark about their HIV status “The stigma around HIV . . still drives the way people approach testing,” says Dr. Hall. “There’s a sizable number of people who because of stigma are reticent to access available testing services and, in particular, walk into a brick-and-mortar clinic or discuss their level of risk with their primary care provider.”  Dr. Hall admits that even as a doctor he personally avoided getting tested for many years. “Bringing up personal STI/HIV risk with my own provider remains challenging, despite my years of training and specific expertise. Years of internalizing the stigma of HIV and shouldering personal fear of the disease have taken their toll, and that’s true for many people I know.”

Testing That Meets People Where They Are

One way to reduce anxiety around HIV testing is to make home testing simple and convenient. That’s why Nurx offers PrEP Home Test Kits (for people taking or starting on PrEP), and STI Home Test Kits that offer tests for HIV as well as other common STIs including syphilis, gonorrhea, chlamydia, trichomoniasis, and Hepatitis C. 

Once the test results are in patients have unlimited access to the Nurx medical team to go over the results and, if necessary, arrange treatment, in a way that’s private, personalized, and entirely stigma-free. “The Nurx medical team possesses a level of STI knowledge and expertise that you’re unlikely to find in most in-person medical settings,” says Dr. Hall. “And because secure, bi-directional messaging is the primary means of communication between patient and provider, the whole process of getting your results, and arranging treatment if necessary, can be done on a patient’s terms and timeline.” 

While the causes of the ongoing HIV epidemic in America are complex, we at Nurx know that private and accessible home testing will be an essential part of the solution. “It turns out many folks seek a high level of privacy and autonomy to get tested regularly, and that’s why the home testing that Nurx offers is so important,” says Dr. Hall “It meet people where they are, both literally and psychologically, because even though we’ve come so far in how we think and handle HIV, that stigma is still with us.”

Learn more about accessing PrEP or STI testing through Nurx. 

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