In 2012, PrEP was approved by the FDA.
“When PrEP came out, it was a really exciting development in the fight against HIV: medication that will prevent someone from becoming infected with HIV,” Aliveness Project executive director Matt Toburen says.
PrEP (pre-exposure prophylaxis) is a daily pill that is highly effective at preventing HIV, reducing the risk of contracting the infection by more than 99%. “And about seven years ago the Minnesota Department of Health came out and officially endorsed it,” Toburen says.
For more than 30 years, the Aliveness Project has been a community center for and by people living with HIV. The nonprofit organization offers free at-home and onsite testing, and one of their recent goals has been to raise awareness and get people connected to PrEP. There aren’t many PrEP providers in Minnesota, and the price is often a barrier, especially for those who don’t have insurance: Prescription PrEP can cost between $3,000-$4,000 a month out of pocket.
Aliveness Project’s goal is to be as barrier-free as possible, getting folks who aren’t connected to PrEP now or don’t have a trusted relationship with a medical provider the treatment they need. “We asked ourselves, what could we do to really get more people on PrEP, to help prevent the spread of HIV?” Toburen explains.
The answer is THRIVE at Aliveness, the first free PrEP clinic in Minnesota.
THRIVE launched earlier this month after the Aliveness Project spent some time looking at other free clinic models around the country. There aren’t many, but there’s a pharmacist-run clinic in California, another in Texas, and a nurse-run clinic in Iowa's Quad Cities. Matt Hoppe, Clinical Services Director for Aliveness and an HCMC nurse who helped launch the free PrEP clinic, explains that THRIVE is also nurse-run: “I see the patients, I do the physical assessment, I do the blood work, I process the blood work, I start them on PrEp,” he says.
“Obviously we can’t just copy and paste to Minnesota—Minnesota is different, the Twin Cities is different,” Toburen says. What’s been beneficial to Aliveness is identifying providers and physicians who are excited about this idea and willing to volunteer their time.
“This is a coalition of people who are committed to this cause, personally or for other reasons, and that’s been the story of the fight against AIDS for the past 40 years," he says. "This is just another reflection of that fight—of communities from all over the nation and the state coming together to help us launch this and really put an end to HIV in our state.”
The free clinic's launch comes at a crucial time, as Hennepin and Ramsey County and the Duluth area are all in the midst of ongoing HIV outbreaks, according to the Minnesota Department of Health. As of September 21, there were 63 confirmed cases in Hennepin and another 17 in Ramsey.
The department announced 13 cases within 30 miles of Duluth back in March, the Grand Forks Herald reports. That number rose to 17 by July and currently sits at 21. For context, the Herald says the number of new cases each year is typically between zero and five.
“It’s historic news, and I keep telling folks, if it wasn’t for a global pandemic that we’re living through right now, this would be front-page news,” Toburen says. “That’s also what’s motivating us, is that we’re in the midst of an HIV outbreak, and it’s 2021… We have been so effective in bringing down the rates of new infections in Minnesota, and now we’re losing ground.”
In addition to volunteers who operate the clinic, Aliveness needs help to reach communities who might not otherwise seek out their services, including people who are using injection drugs, and Black men who have sex with men, whose infection rate is one in two—there’s a 50% chance they’ll be diagnosed with HIV in their lifetime. (Anyone interested in helping Aliveness with that outreach is encouraged to contact them.)
At a launch party at The Saloon earlier this month, 15 new patients signed up with THRIVE, and now almost 30 people are using the free clinic. “Lots of people came up to us and said that they live in rural Minnesota, they come into the cities for fun and to go out—but they don’t have access to the type of service out in rural Minnesota,” says Dylan Boyer, Aliveness’s events and communications manager. Others stopped taking PrEP during the pandemic, and they’re looking to get reconnected to care.
“PrEP is for everybody—it’s not just for gay men, it’s not just for LGBTQ folks,” Boyer says. He gets lots of questions from young queer and trans people who don’t think they can or should be on PrEP, but it’s approved and available for anyone who may be at risk for HIV, including people who are having casual sex, people having sex with someone who has an HIV-positive partner, and those who use intravenous drugs. “That’s what Aliveness is here to do, and that’s what THRIVE is here to do, is provide this for every single person," Boyer says.
Toburen says that this latest way of caring for the community gives him hope that an end to HIV is in sight. Free access to PrEP is another tool in eradicating HIV, along with preventative work and testing, getting people connected with care, and following up with and supporting folks who’ve fallen out of care. “We know that if we can get people tested, know their status, and get them into care, that they can live long and healthy lives,” he says. With the right treatment, they can get to a place of viral suppression, making it impossible for them to pass HIV to someone else.
“We have the knowledge, we have the tools to end HIV in Minnesota,” Toburen says. “We just really need to drive our efforts and will and energy into doing that.”
THRIVE at Aliveness is open Monday to Friday from 9 a.m. until 4:30 p.m. Call 612-822-7946 to schedule an appointment.