California will become the first state in the country to allow pharmacies to dispense H.I.V.-prevention drugs without a doctor’s prescription, a move that supporters say is an important step toward ending the AIDS epidemic in the United States.

Under a new law, pharmacists who undergo special training will be able to provide 60-day supplies of pre-exposure prophylaxis, commonly called PrEP and sold under the brand name Truvada, as well as doses of post-exposure prophylaxis, or PEP, meant to be used in an emergency after possible exposure to the virus, without a prescription. Studies have found that the drugs are very effective, but many people at high risk of infection do not take them.

A major clinical trial found that injections of long-acting cabotegravir given every eight weeks resulted in nearly 70% fewer new cases of HIV than daily Truvada pills taken as a pre-exposure prophylaxis (PrEP).

The trial compared ViiV Healthcare’s long-acting injectable with the daily tablet Truvada (tenofovir disoproxil fumarate/emtricitabine). Upon seeing the evidence of cabatogravir’s success, researchers halted the blinded, placebo-controlled phase of the trial among transgender women and cisgender men who have sex with men (MSM).

Several late-breaking studies at the 23rd International AIDS Conference (AIDS 2020: Virtual) showed the extensive impact of COVID-19 on PrEP services and use, with lockdowns and shelter-in-place orders contributing to substantial reductions in sexual activity, partner numbers and associated PrEP use in gay men in both the USA and Australia.

Relatively few people had difficulty accessing PrEP, with many services switching to telemedicine or phone services, and temporarily going without routine lab testing while these services were swamped by coronavirus testing. In presentations from both countries, concern was expressed that there could be an upswing in HIV transmission if countries and states leaving lockdown do not put plans in place to manage timely resumption of PrEP.