Nancy A. Melville

November 05, 2017

DALLAS – Planned Parenthood is in the crosshairs of federal plans to defund it, but the nonprofit has new partners and plans to expand care.

A grant from Gilead Sciences will help fund HIV prevention efforts, including awareness about pre-exposure prophylaxis. The company manufactures Truvada, the prominent PrEP combination of tenofovir disoproxil fumarate and emtricitabine.

This is the first significant corporate grant of its kind for Planned Parenthood.

It will fund a multiphase pilot program to expand HIV prevention and education efforts at 11 Planned Parenthood affiliates over 18 months, said Raegan McDonald-Mosley, MD, chief medical officer of Planned Parenthood.

"The bottom line is that we have the tools to get rid of HIV, but we have to continue to fight and hold the line," Dr McDonald-Mosley said during a plenary talk here at the Association of Nurses in AIDS Care (ANAC) 2017 meeting.

"Black women are more than 20 times more likely to acquire HIV in their lifetime than white women in the United States, and Hispanic women are more than four times more likely," she reported.

Women at Risk

"However, many programs that focus on HIV prevention are not addressing the needs of women. We aim to fill some of this gap," she explained.

"The Planned Parenthood affiliate covering Minnesota, North Dakota, and South Dakota entered the project providing no PrEP services at all. But in just 3 months, PrEP was rolled out at 19 of the health centers across three states," she reported.

"Their staff was very surprised by the unmet need for PrEP that they are now seeing," Dr McDonald-Mosley noted.

As part of the initiative, Planned Parenthood is also partnering with the Black AIDS Institute to expand resources in black communities that have been hit hardest by the HIV/AIDS epidemic. A report on the mobilization of the initiative and the outcomes will ultimately be published.

Another change underway is a notable addition to Planned Parenthood's patient population — men.

Growing Patient Demographic of Men

"The patient demographic that is growing the most rapidly right now in our health centers is men, making up more than 10% of our patient base," said Dr McDonald-Mosley.

Transgender individuals are also an increasing segment of the patient population, because they can seek health services that might not otherwise be available.

In 2015, Planned Parenthood centers saw 2.4 million patients, provided more than 4.2 million tests for sexually transmitted infection, including HIV screenings, provided more than 320,000 breast exams and 295,000 Pap tests, and provided birth control to nearly 2.0 million women, Dr McDonald-Mosley reported.

"Even as we're making these leaps forward in our services, it is so disheartening to see politicians working to reverse the progress we have made and block people from getting the care they desperately need," she said.

If efforts to defund Planned Parenthood come to fruition, she speculated, the full extent of contraception services currently provided by the organization will become all too clear, with the burden of care shifting to potentially unprepared health centers.

Burden of Contraceptive Care

"Whereas the average Federally Qualified Health Center offering contraceptive care serves an average of 320 contraceptive patients per year, the average Planned Parenthood health center serves an average of 3000 contraceptive patients per year," Dr McDonald-Mosley pointed out.

"If Planned Parenthood was defunded, federally qualified health sites that provide contraceptive care would have to double their capacity to provide these services, taking on an additional 2 million patients per year," she said.

Planned Parenthood's website has vastly expanded the group's reach, she reported.

"We see 2.4 million patients at our centers ever year, but we have 6 million visitors per month through our website, which provides everything from sex education, to intervention tools, to help finding a health center. Patients now can book appointments online, as well," she explained.

Sex Education

Planned Parenthood disseminates potentially life-saving information, particularly to the LGBTQ community, in an era when laws restrict such information, said Dalmacio Dennis Flores, PhD, a postdoctoral research fellow at the University of Pennsylvania School of Nursing in Philadelphia and a member of the ANAC board of directors.

For example, in North Carolina, the Healthy Youth Act of 2009 mandates that sex education be taught in the context of heterosexual and monogamous relationships.

"This does a great disservice to sexual minority youth who have emergent same-sex attractions and desires, because the policy doesn't allow their questions to be recognized or answered," he told Medscape Medical News. "It also stigmatizes them and conveys a message that these same-sex attractions and behaviors are somehow inferior, wrong, and thus unmentionable.

Sexual minority youth have questions just like their straight peers, Dr Flores ointed out. "They crave answers and opportunities to know more about what being LGBTQ is, but they don't get the same level of support and education from families, schools, and society."

Planned Parenthood acts as one of the resources in the community that youth can turn to for factual information about their sexual health, and it provides services such as HIV and STI education and testing, he noted.

Teen Voices, a youth-focused workshop in North Carolina, is one such program. "The workshop is inclusive of all sexual orientations and presents sexual behavior along a nonjudgmental continuum," he explained.

Dr Flores praised Dr McDonald-Mosley's talk as an inspiration for the many nurses with a shared mission of providing compassionate care.

"Dr Mosely reminded me of the great contributions nursing has consistently played in family planning and sexual health," he said. "As ANAC nurses, we carry the torch that Margaret Sanger started in the early 1900s. I am proud to belong to such a vibrant community of sexual health advocates."

Association of Nurses in AIDS Care (ANAC) 2017. Presented November 3, 2017.

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