CDC OKs "mornings-after" pills for risky sex--so why won't the med establishment wake up?
In January, the feds cranked out new guidelines for offering
post-exposure prophylaxis (PEP)—the emergency anti-HIV regimen for
folks likely exposed to the virus within the previous 72 hours. The new
recommendations expand its long-approved use (a triple combo for 28
days—hence, mornings after) for so-called occupational accidents, such
as hospital needlesticks to include the far larger number of slipups by
civilians—needle sharing and, especially, high-risk sex. While
well-informed doctors and bold city health departments, such as San
Francisco’s, have offered PEP for unsafe sex since the late ’90s, the
CDC’s move is an official stamp of approval, directing medical
providers to inform at-risk patients of its availability.
“We
sent a press release [announcing the guidelines] through all major
medical media,” says Ronald Valdiserri, MD, CDC deputy director.
But POZ’s random
sampling of top HIV facilities nationwide indicates that the CDC needs
to step up its PEP PR because Valdisseri’s memo has largely gone
unread, and many providers do not know a PEP pill from a pep cheer.
Beacon
Clinic in Boulder, Colorado, and El Rio Community Health Center in
Tucson, Arizona, offered no PEP at all. In Charleston, South Carolina,
neither the top ASO nor the health department knew where to get PEP. A
St. Louis HIV clinic provided PEP, but only to people who knew their
partner was HIV positive. AID Atlanta, Georgia’s biggest ASO, just
minutes from CDC headquarters, helpfully redirected POZ
to two local hospitals, but both offered PEP only to its hospital
employees. A local health department staffer had never even heard of
PEP.
On the other hand, in New York City, a St. Vincent’s Hospital rep told POZ
that all walk-ins can readily get PEP. A Cleveland clinic even said it
offers PEP up to a week after exposure. “I wish all we had to do was
issue guidelines,” Valdiserri says, “but it takes ongoing education.
Providers need to take some responsibility, too.”
