Federal Judge Rules against Mandated HIV PrEP Coverage

In a recent court ruling, United States District Judge Reed O’Connor declared that mandated HIV PrEP coverage impedes religious freedom. This ruling provides a precedent for employers to refuse HIV PrEP coverage. This case — referred to as the Braidwood v. HHS case — has many implications for patients at risk of contracting HIV.

PrEP is short for pre-exposure prophylaxis. For patients at risk for HIV, HIV PrEP can reduce the risk of contracting the virus. According to the CDC, there are three available HIV PrEP medications: Truvada, Descovy, and Apretude. Truvada and Descovy are pills, while Apretude is an injection.

PrEP is 99% effective in preventing the contraction of HIV through intercourse. The CDC recommends PrEP for the following people:

• people who have been sexually active in the last six months that have not used a condom consistently, who have been diagnosed with an STD in the past six months, or who have had sex with a partner who has HIV
• people who inject drugs and share syringes, needles, or other hypodermic equipment

According to the CDC, until this ruling, “most insurance plans and state Medicaid programs cover PrEP. Under the Affordable Care Act, PrEP must be free under almost all health insurance plans. That means you can’t be charged for your PrEP medication or the clinic visits and lab tests you need to maintain your prescription.”

This ruling makes access to PrEP more difficult and exposes patients to an increased risk of developing HIV. Patients who contract HIV may develop flu-like symptoms, and if left untreated, this viral infection can lead to AIDS.

There are no available cures for HIV; those who contract it will have the disease forever and can potentially spread the virus to their partners. That being said, HIV prevention mechanisms such as safe sex education and PrEP are some of the most effective tools used to minimize the viral spread and impact.

An article in the Texas Tribune states, “O’Connor’s ruling could threaten access to sexual and reproductive healthcare for more than 150 million working Americans who are on employer-sponsored health care plans. It is likely to be appealed by the federal government.”

As this ruling is implemented and appeals occur, patients and healthcare professionals will watch closely. Providers are urged to visit the CDC website, which provides information on resources such as Ready, Set, PrEP, ViiVConnect, and PrEP assistance programs to help fund access to this life-saving resource and share the information with patients.