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A Silicon Valley startup with Chelsea Clinton on its board is launching the first at-home test for an HIV prevention drug, and you can try it right now

A Silicon Valley startup with Chelsea Clinton on its board is launching the first at-home test for an HIV prevention drug, and you can try it right now

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Nurx
  • Nurx, a Silicon Valley prescription drug delivery startup that once solely dispensed birth control, is launching a new service that allows patients who want HIV-prevention drug Truvada to do the required testing at home.
  • It’s a big move for the company, which recently raised $36 million and added Chelsea Clinton to its board of advisers.
  • It’s also a big deal for people seeking HIV-prevention drugs, who currently battle stigma and potentially wait months to get the medication.

In a move that could hint at bigger plans for prescription drug delivery, Silicon Valley startup Nurx on Wednesday launched the first at-home test of its kind for HIV-prevention drug Truvada.

Getting the daily pill, which is estimated to reduce infection among high-risk people by more than 90%, is no easy task. It can take several months for someone who wants PrEP to actually receive the drug. Nurx’s new service is designed to shrink that waiting period to just a few days.

After starting as a birth control-only delivery service in 2015, the California-based startup added a second medication, Truvada (also known as PrEP), to its list of available medications last year.

Last month, Nurx raised $36 million with help from top Silicon Valley venture capital firms. It also added Chelsea Clinton to its board of advisers.

There are a handful of startups offering quick on-demand delivery of prescription medications. But this is the first time one of these companies has tackled at-home lab testing – the hardest part of getting access to PrEP.

“This is a game-changing step towards preventing the spread of HIV,” Hans Gangeskar, co-founder and CEO of Nurx, told Business Insider. “It takes away a key barrier to treatment, and so we really hope to reach the folks that great places like community clinics are still missing.”

Currently, access to PrEP is limited. Beyond simply requiring access to a health care provider, getting a prescription also requires patients visit a clinic, ask about PrEP (which can be a scary conversation for many), and hope the provider can prescribe the drug. Oftentimes, patients are referred to infectious disease specialists who require several visits and extensive testing.

“There’s a big drop off in potential PrEP users at the stage when they need to physically show up for lab testing,” Jessica Horwitz, Nurx’s head of clinical development, said. “Getting in the door in the first place is often the hardest part. We’re missing whole swaths of people who need access.”

How to get PrEP with Nurx

To get PrEP, patients first visit the Nurx website and fill out an assessment with a healthcare provider in the startup’s network to figure out if the drug is a good idea.

Over 1.2 million people in the US have HIV, and men who have sex with men are at the highest risk. Heterosexual men and women who have unprotected sex or use injectable drugs are also at risk.

Then, patients get a testing kit from Nurx in the mail. In a process that’s somewhat similar to at-home genetics testing services like Ancestry or 23andMe, patients collect personal samples and mail them back to Nurx’s certified lab partner for processing. Instead of simply taking a spit sample, the Nurx kit requires patients to also send along small samples of blood and urine. This is done to make sure patients aren’t HIV positive and to ensure their kidneys are functioning properly, both of which are requirements for the drug.

Once those steps are complete, patients get PrEP delivered straight to their door – all without ever stepping foot in a physical clinic.

The ‘GrubHub for prescriptions’ model is gaining steam

The no-visit-required model for prescription drug delivery is a big trend across the US right now.

In June, Amazon inaugurated its latest push into the healthcare industry by buying online pharmacy PillPack.

Just days earlier, pharmacy giant CVS Health announced a plan to deliver prescriptions from nearly 10,000 of its retail stores to customer homes by contracting with the US Postal Service. And a handful of startups like Nimble and Capsule currently provide similar services with independent pharmacies using courier delivery services.

Although Nurx currently dispenses only birth control and PrEP, Horwitz told Business Insider there are plans to expand to other medications.

nurx PrEP Truvada testing kit

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Nurx

“PrEP was the next logical step for us because it can be done seamlessly through telemedicine, but our balance in terms of growth is finding clinical areas where there’s need and where access is an issue,” Horwitz said.

The new at-home testing kits for PrEP will be available in 19 states and Washington, DC as of Thursday; Nurx’s birth control delivery service is currently available in 20 states and is covered by most forms of health insurance – meaning that for most of its customers, the service is free.

The Nurx team is currently looking at adding sexual health screenings, something it plans to do by the end of the year. Horowitz said next year will be dedicated to thinking more about avenues for growth in primary care.

“We’re always thinking about new avenues where we can disrupt things,” she said.

Girls make up two-thirds of HIV-infected teens

Girls make up two-thirds of HIV-infected teens

Every three minutes, a girl between the ages of 15 and 19 is infected with the virus that causes AIDS (acquired immune deficiency syndrome), said a United Nations (UN) report on July 25, 2018, which warned of a “crisis” fuelled by gender inequality.

Girls and young women made up two-thirds of 15- to 19-year-olds infected with HIV (human immunodeficiency virus) in 2017, according to data unveiled at the 22nd International AIDS Conference in Amsterdam, the Netherlands.

Henrietta Fore, head of the UN Children’s Fund (Unicef), referred to it as a “crisis of health”.

“In most countries, women and girls lack access to information, to services, or even just the power to say no to unsafe sex,” she said.

“HIV thrives among the most vulnerable and marginalised, leaving teenage girls at the centre of the crisis.”

Last year, 130,000 youngsters aged 19 and under died from AIDS, while 430,000 – almost 50 every hour – were newly infected, the agency said.

While AIDS-related deaths have decreased since 2010 in all other age groups, they have remained stubbornly constant among older adolescents aged 15 to 19.

About 1.2 million 15- to 19-year-olds were living with the immune system-destroying virus in 2017, three in five of them girls, said Unicef.

“The epidemic’s spread among adolescent girls is being fuelled by early sex, including with older males; forced sex; powerlessness in negotiating about sex; poverty; and lack of access to confidential counselling and testing services,” it pointed out.

Actress and activist Charlize Theron raised the issue in an address to conference delegates on July 24, 2018.

The AIDS epidemic is “not just about sex or sexuality”, the South African celebrity said. “We know it is linked to the second-class status of women and girls worldwide.”

Youth bulge

Robert Matiru, director of operations for Unitaid, which funds HIV drug projects, said young people are disproportionately affected by the epidemic that has claimed some 35 million lives since it erupted in the 1980s.

“They are the most affected now, across sub-Saharan Africa in particular,” he said.

“Unless we can reach young people and curb the epidemic among them… then we’re not going to meet the targets” of the UN to end AIDS as a public health threat by 2030.

This requires limiting infections to 500,000 per year by 2020, yet last year they numbered 1.8 million.

A recent report of the International AIDS Society (IAS) highlighted the epidemic’s “extraordinary impact” on adolescent girls and young women.

“Four in 10 adolescent girls (aged 15-19) in Africa have experienced physical or sexual violence from an intimate partner, and the evidence is that gender-based violence is associated with a significantly greater risk of acquiring HIV,” it said.

“Yet few countries have invested in comprehensive programmes to combat gender-based violence or to ensure ready access to adolescent-friendly sexual and reproductive health services.”

According to IAS president Linda-Gail Bekker, “in young people, it (the AIDS epidemic) is far from over”.

“In certain parts of the world, we are about to go into the youth bulge, so we’ll have more young people than we’ve ever had in the world before,” she said.

“Young people have grown up, they are incredibly mobile, they are moving, they have forgotten that HIV is a risk factor… we can’t let up on that message, otherwise it just blows up again.” — AFP Relaxnews

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