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Getting to 0 New Infections in Mecklenburg
County: The Promise of PrEP for HIV Prevention

TBy Meagan Zarwell, PhD, Alexandra Patton, MPH, Brian Witt, PhD, and Patrick Robinson, MD
he HIV epidemic continues to disproportionately PrEP is 99 percent effective in preventing the sexual
affect young people of color in the southern United transmission of HIV. Currently, the FDA has approved two
States. More than half of the 40,000 people newly brand name medications for PrEP: Truvada (emtricitabine

diagnosed with HIV in 2018 lived in the south and tenofovir disoproxil fumarate) and Descovy

and 20 percent of new diagnoses were reported among (tenofovir alafenamide and emtricitabine). While an

young people ages 15-24. HIV disparities in Mecklenburg estimated 1.2 million people in the country meet clinical

County mirror the national epidemic: New diagnoses are guidelines for PrEP, uptake of PrEP remains low.

highest among young people of color, particularly gay, Moreover, many healthcare providers have yet to adopt

bisexual and other men who have sex with men (MSM). PrEP in their clinical practices.

The CDC estimates one in two Black MSM and one in four Widespread PrEP uptake has the potential to alter the

Latino MSM acquire HIV during their lifetime. course of the HIV epidemic in the south, yet the PrEP

“Getting to Zero” is a community plan developed in 2017 uptake remains under-utilized in Mecklenburg. “Getting

to reduce HIV in the county, which leads the state of to Zero” strategies to improve PrEP uptake include

North Carolina in new diagnoses. The Mecklenburg County expanding PrEP access to prioritized populations,

Health Department, University of North Carolina at evaluating administration practices among providers

Charlotte’s Academy for Population Health Innovation, who currently provide PrEP, and identifying

clinicians and community members are working barriers and facilitators to PrEP within primary

together to 1.) raise awareness of the importance of care settings. One of the early successes of

HIV testing and expand access to testing services, 2.) these efforts was the establishment of the

increase viral suppression among people living with PrEP Initiative. Over two years, this initiative

HIV, and 3.) improve the uptake of pre-exposure has made PrEP accessible to more than 300

prophylaxis (PrEP) — a daily medication to prevent uninsured individuals by using county funds to

HIV infection. In 2019, the federal initiative “Ending partner with several local clinics.

the HIV Epidemic: A Plan for America” launched with “Getting to Zero” meets on the last Tuesday of

the goal to target 48 hotspot counties and seven rural each month to discuss the progress of these goals.

states. Mecklenburg County is the only county in North Carolina that is a To get involved with the community working group or to learn

part of this 10-year federal initiative. The aims of “Ending the Epidemic” more about the progress of local efforts to end HIV, visit http://g2z.

include significantly reducing new HIV infections by 2030, in alignment mecknc.gov/ or reach out directly to G2ZMeck@mecknc.gov with

with the goals of “Getting to Zero” in this county. any questions.

UNCC Evaluation Project: Barriers to PrEP Among Primary Care Providers

Researchers from the Department of Confidential phone interviews will last Please feel free to share this opportunity
Public Health Sciences and the Academy for approximately 45-60 minutes and participants with primary health care providers who do
Population Health Innovation at the University will receive a $100 e-gift card for participation. not currently prescribe PrEP practicing in
of North Carolina at Charlotte (UNCC) are Confidential online surveys will last approximately Mecklenburg County.
conducting an evaluation project to learn 15 minutes and participants will receive a $65
about barriers and facilitators to prescribing e-gift card for participation. Eligible participants Please email Meagan Zarwell, PhD,
pre-exposure prophylaxis (PrEP) for HIV include primary health care providers in at mzarwell@uncc.edu to learn more
prevention in Mecklenburg County. Study Mecklenburg County who do not currently provide about the evaluation project or to schedule
findings will be used to understand local PrEP (including providers in family medicine, a phone interview.
barriers to prescribing PrEP among primary internal medicine, pediatrics, OB-GYN, and
health care providers. physician assistants, and nurse practitioners).

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