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Board approves $301,600 DPH supplemental to expand PrEP navigators for HIV prevention
Summary
Supervisors approved a fiscal-year 2014–15 appropriation of $301,600 to Department of Public Health to fund navigators helping residents access pre-exposure prophylaxis (PrEP); discussion focused on PrEP effectiveness, access barriers and drug costs.
The Board of Supervisors on Oct. 28 approved a supplemental appropriation of $301,600 from the General Fund Reserve to the Department of Public Health for FY 2014–15 to support PrEP navigators and expand access to pre-exposure prophylaxis, an antiretroviral medication shown to reduce the risk of HIV infection when taken daily.
Supervisor London Breed introduced the appropriation and praised San Francisco’s public-health history in HIV prevention. The appropriation funds navigators who will assist residents in accessing PrEP through insurance, Medicaid/Medi‑Cal and manufacturer assistance programs, and to reduce non‑financial barriers to uptake.
Supervisor Scott Wiener, a co-sponsor, described PrEP as "an important piece of the puzzle," saying daily use can reduce HIV risk substantially when combined with testing, treatment and condoms. Supporters emphasized PrEP’s role within the city’s "Getting to Zero" consortium, a coalition of the Department of Public Health, UCSF and community organizations working to eliminate new HIV infections.
Several board members acknowledged cost and access challenges. Supervisor Wiener and others urged continued pressure on pharmaceutical companies to reduce copays and on the city to ensure assistance for patients who struggle to access benefits. Supervisor London Breed noted the appropriation was reduced from an earlier $800,000 request and said further funding could be addressed in the regular budget process.
Roll call: the measure passed on first reading with 10 ayes and one no (Supervisor Tang opposed).
Why it matters: Supporters said navigators will help overcome barriers — cost, copays and stigma — and accelerate linkage to prevention and care; opponents worried about scope and preferred funding via the regular budget process.
What's next: The appropriation was approved on first reading; the navigators’ program will be implemented by DPH and funded for FY 2014–15 as described.
