The Biden-Harris administration has a historic opportunity to help end HIV. New, cutting-edge drugs that prevent HIV are hitting the market, but insurance companies are trying to twist the rules to deny access to these remarkable therapies.
The White House could stop these abuses and put the country on the right course for decades ahead and prevent hundreds of thousands of new HIV transmissions.
Pre-Exposure Prophylaxis (PrEP) drugs represent one of the strongest tools we have to combat HIV. These highly effective therapies can reduce the risk of contracting HIV by up to 99%. So far, the FDA has approved two once-daily PrEP pills, and in 2021 approved the first long-acting version of PrEP. Other groundbreaking PrEP innovations, such as a biannual dosage form, are in active development.
PrEP is a major reason why new HIV infections dropped 12% from 2018 to 2022. Yet there’s still work to do. Currently, just 36% of people who could benefit from PrEP are using it. Racial and ethnic groups face wide disparities in PrEP uptake. For example, Black individuals constitute 39% of new HIV diagnoses but only 14% of PrEP users. Hispanics make up 31 percent of new HIV diagnoses, but only 18 percent of PrEP users.
A new federal directive, if properly enforced, could help close these gaps. In August 2023, a panel of prevention experts issued an updated recommendation to clinicians, recommending PrEP — including long-acting forms of the drugs — to people who want to prevent HIV acquisition. Under the Affordable Care Act, most newly issued private health plans must cover without patient cost-sharing to comply with this recommendation beginning this month.
Yet many HIV experts and patient advocates have raised concerns that insurers could misinterpret — or downright ignore — the task force’s decision and keep barriers to PrEP in place.
One top concern is that insurance companies could decide to cover only one kind of PrEP, even though the task force’s recommendation isn’t
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