The American Academy of HIV Medicine Denounces Last Week’s Ruling That Threatens PrEP Access, Other Preventive Medical Care

The American Academy of HIV Medicine Denounces Last Week’s Ruling That Threatens PrEP Access, Other Preventive Medical Care

WASHINGTON, DC – The American Academy of HIV Medicine denounces last week’s court ruling on the Braidwood Management v. Becerra case. Judge Reed O’Connor of the U.S. District Court for the Northern District of Texas ruled that the U.S. Preventive Services Task Force (USPSTF) violated the appointments clause and is not a legally appointed body, effectively blocking enforcement of USPSTF recommendations. The judge also ruled that the plaintiffs, Braidwood Management and Kelley Orthodontics, do not have to provide insurance coverage for HIV pre-exposure prophylaxis (PrEP) because doing so would violate the plaintiffs’ rights under the Religious Freedom Restoration Act.

The case has already been appealed to the Fifth Circuit Court of Appeals, and the Academy applauds the Biden Administration for its quick action against the ruling.

“This ruling, if upheld on appeals, will create an undue financial and health burden on those most at risk for HIV, especially those BIPOC communities already disproportionately impacted by HIV and worse health outcomes generally,” said Bruce J. Packett, executive director of the American Academy of HIV Medicine. “Not only would this ruling create serious barriers to evidence-based, preventive health care, but making HIV PrEP cost-prohibitive will most certainly increase HIV infections and potentially set back the hard-won gains made through HIV prevention efforts over the years.”

In December, the USPSTF had issued draft recommendations on PrEP, recommending with an “A” rating that clinicians offer PrEP “with effective antiretroviral therapy to persons who are at high risk of HIV acquisition.” Those recommendations included long-acting injectable PrEP in addition to daily, pill-based oral PrEP. The recommendations would have ensured insurance coverage without cost sharing for PrEP. Now, this incredibly effective prevention intervention could become inaccessible for many people.

Not only does this ruling affect HIV prevention, but also it affects the lives of those who have HIV. The USPSTF recommendations covered a range of prevention services, including cancer screenings and screenings for sexually transmitted infections (STIs). By taking away guaranteed cost-free insurance coverage for those screenings, the ruling jeopardizes the health and longevity of those with HIV, who are at higher risk for certain cancers and are at risk of increased morbidity and mortality if they are co-infected with an STI.

“Here at the twilight of another major global pandemic, where we learned so much about the importance of disease prevention generally, it is most certainly an ill-timed and unfortunate judicial intervention into public health prevention measures meant to keep all Americans safer,” Packett concluded.

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About the American Academy of HIV Medicine

The American Academy of HIV Medicine is the nation’s leading independent organization of health care professionals dedicated to providing excellence in HIV care and prevention. Our membership of practitioners and credentialed clinicians manage the health of the majority of people with and at risk of HIV in the United States.