A rise in newly diagnosed HIV cases in Alaska is driving local efforts to make it easier for Alaskans to access a medication that can dramatically reduce a person’s risk of contracting the virus.
The Alaskan AIDS Assistance Association is launching a new initiative to begin offering daily, drop-in services and resources that include rapid HIV testing and starter packs of pre-exposure prophylaxis, also known as PrEP, medication that’s highly effective at preventing an HIV infection.
“What we really want to do is reach people who are not connected to health care or PrEP providers, and provide them with free same-day, low-threshold access to the medication,” said Robin Lutz, executive director of the Alaskan AIDS Assistance Association, or Four A’s.
The nonprofit’s Anchorage office, located at 1057 W. Fireweed Lane, will be offering these services five days a week from 9 a.m. to 4 p.m. beginning the first week of December, Lutz said. HIV testing is also available at the agency’s Juneau and Wasilla offices.
Lutz described a recent rise in Alaskans being diagnosed with HIV, or human immunodeficiency virus, a virus that attacks the body’s immune system. If left untreated, HIV can progress to AIDS, a late and severe stage of the infection.
In 2022, Alaska saw 37 new HIV infections, a jump from 30 new cases in each of the previous two years, according to Dr. Liz Ohlsen, a staff physician with the state health department.
Lutz attributed the rise to barriers to accessing PrEP around the state, including a lack of health care providers who knew how and when to prescribe the medication, and a lack of awareness about who PrEP is for and how to access it.
Anyone who is sexually active and doesn’t have HIV can use PrEP. At-risk groups include people who don’t always use condoms, people who have multiple sex partners, and people who have been recently diagnosed with another sexually transmitted infection, according to the federal Centers for Disease Control and Prevention.
“PrEP is an incredible tool that is 99% effective at preventing HIV transmission, and everyone should have access to that that needs and wants it,” Lutz said.
Late last year, a cluster of new HIV cases in the Fairbanks area prompted a public health advisory published in January by the Alaska Section of Epidemiology.
Three new cases were reported in a four-week period, the alert said. Six cases were reported between October and December of last year, occurring among young military service members who had reported using dating apps.
The cluster prompted a visit in October from CDC officials, who conducted interviews with the people who’d been infected and with providers in the state, according to Dr. Ben Westley, an infectious disease physician based in Anchorage who participated in some of those conversations.
That visit revealed a lack of awareness about PrEP and barriers to accessing it, particularly among younger men who have sex with men, Westley said.
“The most common new patient that we are seeing are young men who have sex with men, who have not been accessing PrEP, and become infected,” Westley said.
“Many voiced either not being aware that there were very effective interventions that could prevent them from getting HIV, specifically PrEP, or that they had tried to obtain it from their local providers and were basically told that they couldn’t get it, or that the providers didn’t know how to prescribe it,” he said. “And then sadly, they ended up becoming infected later.”
Westley said getting the word out to younger Alaskans who may be at risk of contracting HIV but aren’t routinely visiting a primary care physician is a challenge. Training providers on how to talk to patients about PrEP and answer questions they might have is also important, he said.
He said there also seemed to be some misperceptions about who PrEP is for.
“There is a misconception that it’s only for gay men who are ‘promiscuous,’ which is a derogatory term, frankly,” he said. “But anybody who has multiple (sex) partners, especially unprotected partners, and anybody who is injecting drugs, should consider PrEP.”
The rise comes amid a broader state and national trend of increasing rates of other sexually transmitted infections, including syphilis, chlamydia and gonorrhea in recent years that state health officials have linked to a change in sex habits among adults, as well as a lack of awareness and education.
“We want to make sure specifically that people know that Four A’s is a place where people who are part of the LGBTQ community or part of other marginalized populations feel comfortable, and know that they’re going to be treated well in an affirming way and in a positive space,” Lutz said.
“Widespread, readily available testing that is free of stigma or judgment and is frequently utilized; and easy-to-access, free medicine and medical care for those at risk of HIV,” could help reduce infections, Westley said.
With HIV, early detection is key. If it’s identified early enough, life expectancy for someone with HIV is the same as for someone without it, he added.
Alaskans interesting in learning more about PrEP can reach out to Four A’s, and can use an online tool to search for providers who are able to prescribe the medication.
If they live in an area without a provider, they can reach out to doctors in Anchorage and other urban areas who are often able to prescribe the medication remotely via telehealth, Westley said.
The medicine is covered by most insurance plans.
Uninsured or underinsured Alaskans can also access free or reduced health care through local public health centers. In Anchorage, the city health department provides sliding scale fees based on need, as does the Anchorage Neighborhood Health Center.
Alaskans can also visit iknowmine.org for free STI screening kits mailed to their homes.