\n\tMichael Scaturro<\/span><\/p>\n

A proposed federal policy<\/a> aims to protect older Americans from contracting HIV by offering free preventive medication, the latest effort<\/a> to catch up to much of Europe and Africa in stemming the spread of the virus.<\/p>\n

Under the plan from the Biden administration, Medicare would cover patients\u2019 full cost<\/a> of preexposure prophylaxis drugs, which prevent HIV transmission. The drugs, known by the shorthand \u201cPrEP,\u201d would be free in pill form and \u2014 for the first time \u2014 as long-acting injectables through the government insurance program designed for those 65 and older. Those 50 and over make up half<\/a> of all people in the U.S. already living with HIV.<\/p>\n

The proposed policy change represents a big shift because it means that even new long-acting injectable versions of PrEP drugs, which can cost<\/a> more than $20,000 a year in the U.S., would be covered fully, without requiring patients to kick in copayments. It is not yet clear what the plan would mean for taxpayers, though, either in paying for the medications or in offsetting the costs of caring for fewer Medicare patients with HIV in the future.<\/p>\n

The final green light for the plan was expected Oct. 10, but the Centers for Medicare & Medicaid Services announced it is still working out details of how to transition coverage for patients already taking the drugs.<\/p>\n

The U.S. is decades behind nations in Europe and Africa that are on track to end new HIV infections by 2030. But while the proposal should bring down infections in older Americans, it highlights remaining inequities: Many people under age 65 will still struggle to pay for PrEP. And, at the same time, Republican congressional leaders have threatened to cut funding<\/a> for a federal HIV prevention effort championed by the Trump administration that is intended to help all at risk.<\/p>\n

\u201cWe\u2019ve done a very poor job in the U.S. of assuring that people who could most benefit from PrEP have access to it,\u201d said Justin Smith, who directs the Campaign to End AIDS at Positive Impact Health Centers<\/a> in the Atlanta area.<\/p>\n

Though PrEP has been embraced by gay and trans Americans, it is prescribed less often to heterosexuals over 50 or women of any age. In the first three months of this year, just 8%<\/a> of the more than 300,000 people receiving PrEP in the U.S. were women, according to the Centers for Disease Control and Prevention. The racial gap is large, too: While 66% of white people eligible for PrEP got prescriptions for it in that period, only 8% of eligible Black people and 17% of eligible Hispanic people did.<\/p>\n

Broadening access for gay and bisexual men of color, as well as straight and cisgender women of color \u2014 particularly Black women<\/a>, who represent the majority<\/a> of women with HIV in the U.S. as well as the majority of new infections among women \u2014 is critical for the nation to catch up to the rest of the world, Smith said.<\/p>\n

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\t\t\t\t\tRELATED ARTICLE<\/p>\n

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\n\t\t\t\t\tPrEP, a Key HIV Prevention Tool, Isn\u2019t Reaching Black Women\t\t\t\t<\/a>
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New HIV infections occur disproportionately among Black women, but exclusionary marketing, fewer treatment options, and provider wariness have limited uptake of preexposure prophylaxis, or PrEP, drugs, which reduce the risk of contracting the virus.<\/p>\n
\t\t\t\t\t\t Read More<\/a><\/p>\n
Leisha McKinley-Beach, a national HIV consultant and CEO of the Black Public Health Academy<\/a>, which prepares Black health department employees for leadership positions, noted that the Medicare proposal to cover the cost of injectable PrEP could help many women because a shot given every two months can be easier to manage than a daily pill.<\/p>\n
But it\u2019s just a start. She and others are lobbying for a national PrEP plan that would build on momentum from the recent Medicare proposal to expand free access to other age groups, much as with covid-19 vaccinations. McKinley-Beach also wants the U.S. government to expand the message that anyone can get HIV, encourage drug companies to advertise more on TV to women of color, and fund outreach to dispel medical mistrust in communities of color.<\/p>\n
\u201cGay white men have had a narrative of dignity and respect with regards to HIV treatment, and I would never want to change that narrative,\u201d she said. \u201cBut the message needs to be broadened. Forty-two years into the HIV epidemic, the current HIV prevention model is detrimental to Black women who could benefit from PrEP.\u201d<\/p>\n
Though the U.S. was the first nation<\/a> to approve PrEP, in 2012, it now trails the rest of the world in equitable access. That\u2019s mostly due to the cost of laboratory tests and medical visits. While the cost of the generic form of Truvada, an oral form of PrEP, can be as low as about $30 a month in the U.S., a study<\/a> by University of Virginia researchers reported the cost of starting PrEP is typically about $2,670 for uninsured patients, including about $1,000 for lab tests and medical visits. The new Medicare proposal would cover up to seven counseling visits every 12 months for HIV risk assessment and reduction.<\/p>\n
Meanwhile, PrEP pills are free for people in the United Kingdom and European Union nations<\/a> including France, Germany, Sweden, and Denmark. Those nations don\u2019t yet cover the more expensive shots, although the U.K. is leading a small test on injectable PrEP in people who cannot take it in tablet form.<\/p>\n
The U.S. also lags Western Europe and some nations in Africa in overall HIV treatment and prevention. For example, just 57% of HIV-positive Americans have attained viral suppression, according to the U.S. government website HIV.gov<\/a>, meaning they regularly take medications to make them unable to transmit the virus. That makes PrEP, which is for people who don\u2019t have the virus, all the more important for Americans to stay negative, according to HIV experts.<\/p>\n
In Africa, by contrast, Botswana, Eswatini (formerly Swaziland), Rwanda, Tanzania, and Zimbabwe have already achieved the United Nations\u2019 \u201c95-95-95\u201d targets<\/a> set for 2025 \u2014 95% of people with HIV know their HIV status, 95% of people with diagnosed HIV infection receive sustained antiretroviral therapy, and 95% of people receiving antiretroviral therapy have achieved viral suppression, or the virus is undetectable in their blood \u2014 according to the U.N<\/a>.<\/p>\n
In the U.K., 98% of HIV-positive people<\/a> have achieved \u201cundetectable\u201d status via free antiretroviral medicines and treatment available through the country\u2019s universal health care program, the National Health Service. Moreover, nearly anyone in the U.K. who is HIV-negative and wants to take PrEP can get it at no charge. The U.K. says<\/a> it is now on a path to reduce new HIV infections by 80% by 2025.<\/p>\n
The U.K. changed its PrEP approach after 2015, when Greg Owen founded \u201c iwantprepnow.co.uk<\/a>,\u201d a website that ignited a PrEP movement by helping people in the U.K. and Europe self-source low-priced generic forms of Truvada, the first drug approved as PrEP, from pharmacies in Hong Kong and India.<\/p>\n
\u201cIt became more affordable,\u201d said Owen, now PrEP lead at one of the U.K.\u2019s top HIV and sexual health charities, Terrence Higgins Trust<\/a>. \u201cSoon people demanded it for free on the NHS.\u201d<\/p>\n
In the U.S., Smith said, the lack of a national PrEP program that would make the drugs and associated bloodwork free and a heated political climate around health care have hindered HIV outreach.<\/p>\n
\u201cIn rural areas of the South, especially in places like Georgia or Tennessee, there has been outright hostility toward accepting money from the CDC and expanding Medicaid<\/a> to treat and prevent HIV,\u201d Smith said. \u201cPeople think it\u2019s just politics, but this is having an impact on public health, on people\u2019s lives.\u201d<\/p>\n
Anti-queer sentiment in many quarters also creates an environment of hostility around overall sexual health, said Richard Elion<\/a>, director of clinical research at Washington Health Institute and a professor at George Washington University School of Medicine and Health Sciences. \u201cThere\u2019s a chilling effect for everyone, not just queer Americans,\u201d he said.<\/p>\n
Elion said shame surrounding sex and the feeling of vulnerability that some people get from taking any medicine may also reduce PrEP uptake among older Americans. \u201cTaking PrEP is actually very empowering, and that needs to be the message,\u201d he said.<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"
Michael Scaturro A proposed federal policy aims to protect older Americans from contracting HIV by offering free preventive medication, the latest effort to catch up to much of Europe and Africa in stemming the spread of the virus. Under the plan from the Biden administration, Medicare would cover patients\u2019 full cost of preexposure prophylaxis drugs, […]<\/p>\n","protected":false},"author":1,"featured_media":1956,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7],"tags":[],"class_list":["post-1955","post","type-post","status-publish","format-standard","has-post-thumbnail","category-aging"],"_links":{"self":[{"href":"https:\/\/healthynewsusa.com\/index.php?rest_route=\/wp\/v2\/posts\/1955","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/healthynewsusa.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/healthynewsusa.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/healthynewsusa.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/healthynewsusa.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1955"}],"version-history":[{"count":1,"href":"https:\/\/healthynewsusa.com\/index.php?rest_route=\/wp\/v2\/posts\/1955\/revisions"}],"predecessor-version":[{"id":1957,"href":"https:\/\/healthynewsusa.com\/index.php?rest_route=\/wp\/v2\/posts\/1955\/revisions\/1957"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/healthynewsusa.com\/index.php?rest_route=\/wp\/v2\/media\/1956"}],"wp:attachment":[{"href":"https:\/\/healthynewsusa.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1955"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/healthynewsusa.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1955"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/healthynewsusa.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1955"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}