Senate Democrats are trying to make it easier for communities at risk of HIV transmission to access pre-exposure prophylaxis, or PrEP. PrEP, when taken as prescribed, is 99% effective in stopping the transmission of HIV.
Senator Adam Schiff (D-CA) and Senator Tina Smith (D-MN) introduced the 2021 PrEP access and coverage law to the Senate last week, a bill they say will help overcome some of the barriers to getting PrEP.
Related: Biden Administration Orders Insurance Companies to Cover All Costs Associated With PrEP
The bill would eliminate out-of-pocket costs for PrEP for people who use public insurance plans and some private plans, making it easier to buy drugs.
It would also ban the practice of prior authorization for PrEP. Prior authorization is when doctors and other health care providers are required to justify the decision to prescribe PrEP and obtain approval from the insurance company. It’s one way insurance companies can cut costs, and in the case of PrEP, it puts people at risk of contracting HIV.
The bill would also tackle discrimination in healthcare against people on PrEP, prohibiting private insurers from increasing premiums for someone taking the drug.
Finally, the bill would provide funding to education campaigns and state and local governments to expand access to PrEP.
“Preventive drugs like PrEP and PEP are one of the simplest and most effective ways to protect individuals from HIV,” Schiff said in a statement. “But what isn’t always easy, especially for those most at risk of infection, is getting this drug.”
“Our healthcare system must provide access to these preventive treatments to all patients who need them, regardless of their race, ethnicity, sexual orientation, gender identity, income level or medical coverage. The PrEP Access and Coverage Act would help us fill these gaps, so that no one suffers from a disease that is now preventable.
The bill could also help address inequalities in access to PrEP. A recent study published in the Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report in September found that black and Latino gay and bisexual men were less likely to take PrEP than white gay and bisexual men. 42% of white study participants had taken PrEP in the past year, while 30% of Latino participants and 26% of black participants had.
58% of white participants said they had discussed PrEP with a clinician in the past year, while only 44% of Latino participants and 43% of black participants said they had. Looking only at gay and bi men who spoke to a clinician about PrEP, white men were still more likely to report receiving a prescription and taking PrEP than Latino and black men.
The researchers found that a lack of insurance was not entirely responsible for the disparities.
Another study published in the International Journal of Environmental and Public Health Research this month revealed that while black southern men who have sex with men were disproportionately affected by HIV, they were more likely to face barriers to obtaining PrEP, such as stigma, poverty , mistrust of the medical system, misinformation about PrEP and transportation issues. .
“According to the CDC’s recent HIV surveillance report, the South accounts for more than half of all new HIV diagnoses in the United States,” the authors wrote at The conversation. “Men who have sex with men accounted for 69% of new national HIV diagnoses, with the rate higher among black gay men. Another CDC study shows that half of black gay men in the United States will be diagnosed with HIV in their lifetime.
While PrEP was approved by the FDA in 2012 and the Affordable Care Act requires most insurance companies to cover it, “the nationwide rate of HIV infection among gay men and Black and Latino bisexuals have remained the same over the past 10 years, according to the CDC, “they wrote.
“The PrEP access and coverage law ensures that all people, regardless of the type of health care they receive, have access to PrEP without paying anything out of their own pockets,” said the director. AIDS Institute executive Michael Ruppal in a statement. “Since PrEP was approved by the FDA, adoption has shifted towards privileged groups with better insurance and the ability to pay for drugs and associated costs. This bill will help create more equitable access to this life-saving drug by requiring almost all public and private insurers to cover the drug as well as the lab and doctor visits necessary to start and maintain a PrEP prescription. .