CAIRO — A once-daily PrEP pill known by the brand name Truvada is a powerful preventative medication for people at high risk of acquiring HIV. But accessing the medication in some rural areas can be especially difficult because of a shortage of providers, high cost, poor insurance coverage and other barriers, experts say.

That's why the SIU School of Medicine and the Southern Seven Health Department have teamed up to improve availability in Illinois’ southernmost counties.

Southern Seven’s Cairo Clinic began offering access to HIV Pre-Exposure Prophylaxis, or PrEP, services for the first time on Wednesday to anyone living within the department’s service area counties of Alexander, Hardin, Johnson, Massac, Pope, Pulaski and Union.

The Food and Drug Administration approved Truvada for HIV prevention in 2012, but “this medication has seen a slow uptake in rural communities,” the health department said in a news release.

“A lot of the folks that live in this area do not have access to medical treatment, especially when it comes to HIV prevention and treatment. This is how we can reach more people,” Shawnna Rhine, the health department’s public relations coordinator told The Southern.

The new PrEP services are made possible by a $50,000 grant to the SIU School of Medicine’s Department of Population, Science and Policy awarded by the Telligen Community Initiative, a national nonprofit that funds research and innovative programs to improve community health, social welfare and educational attainment.

Southern Seven's efforts to increase the availability of PrEP services expand upon those that the Jackson County Health Department helped pioneer in this region beginning two years ago. Paula Clark, director of HIV services at the Jackson County Health Department, said that her agency serves about 60 patients at any given time on Truvada. As the state's designated lead agency for Southern Illinois HIV Care Connect, Jackson County offers HIV treatment and prevention services, including PrEP, to anyone who lives between Mount Vernon and Cairo. 

Clark said she is glad to see Southern Seven adding new PrEP services for patients living in southernmost Illinois, and stressed the importance of collaboration among the respective agencies. 

Christofer Rodriguez, a research project specialist with the SIU School of Medicine department that applied for the grant, said Southern Seven was a good partner fit because the two organizations had worked together in the past and several of the counties it serves have high prevalence rates of HIV.

In 2015, Alexander County had the second highest HIV rate in the state, behind Chicago/Cook County, with approximately 342 cases per 100,000 people. Pulaski and Johnson also have high prevalence rates. 

Anyone who fears they are at risk to be exposed to HIV is encouraged to make an appointment to speak to a physician, to find out if it is an appropriate option for them. Generally, candidates for the drug are people who are HIV-negative, but have an HIV-positive sexual partner, people who may share drug needles with someone who is HIV-positive, and men who have sex with men who engage in unprotected sex. Women with an HIV-positive partner who are considering becoming pregnant are also candidates.

The screening to determine if the PrEP regime is appropriate for a patient involves a confidential sexual history and risk analysis, testing for HIV and other sexually transmitted diseases and tests to determine that the individual has no signs of kidney or liver failure or other complications that would make it unsafe to take. Patients who sign up for the service at the Cairo Clinic will meet with a physician utilizing telehealth, which is similar to a video conference call, to access SIU School of Medicine providers. The testing and provider services are free of charge. 

Approved patients would then receive their medication through the mail. They would be required to return to the Cairo Clinic for routine testing every three months. 

Truvada, the only PrEP drug with FDA approval for the prevention of HIV, is pricey. But there are a number of financial assistance programs available through its maker, Gilead Sciences Inc., which can reduce the cost of the drug or insurance copays drastically, or to nothing. The state of Illinois also offers an assistance program.

The grant funding to expand PrEP services into the Cairo Clinic was allocated for the calendar year, to run from Jan. 1 to Dec. 31, Rodriguez said. He added that the SIU School of Medicine’s Department of Population, Science and Policy is studying alternatives to keep the service operational after that point. 

Currently in Illinois, there are about 35,500 people living with HIV.

To learn more about PrEP, or to schedule an appointment, contact the Southern Seven Health Department in Cairo at 618-734-4167 or visit their office between 1 p.m. and 4 p.m., Monday through Wednesday, at 3014 Elm Street.

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On Twitter: @MollyParkerSI ​



Molly Parker is general assignment and investigative projects reporter for The Southern Illinoisan.

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