The Free PrEP Program Is Here

If you want to start PrEP, but have been blocked from doing so because you don’t have insurance, now might be your chance to finally get on the HIV-prevention regimen.

The federal government rolled out a new program this week to help uninsured Americans get PrEP for free, the Associated Press reported on Tuesday. PrEP, which stands for pre-exposure prophylaxis, is an HIV-prevention strategy that involves taking a combination antiviral pill once a day. (“PrEP” is also often used as shorthand for the drug itself.) To obtain meds through the “Ready, Set, PrEP” program, you’ll need to get a valid prescription from a medical provider, test negative for HIV, and go to GetYourPrEP.com to apply. If you meet those qualifications, you’ll get a card that will make it possible for you to fill your prescription at your local pharmacy, cost-free.

When taken as directed, PrEP reduces the risk of HIV transmission through sex by about 99 percent, and it lowers the chance of contracting HIV through injectable drug use by approximately 74 percent. Data shows that gay and bisexual men (as well as men who have sex with men, but don’t identify with any LGBTQ label), Black and Latinx Americans, trans women, and sex workers have a disproportionately high risk for contracting HIV. Despite PrEP’s effectiveness in lowering HIV risk, less than one-fifth of the 1.2 million Americans who would benefit from taking the drug were able to get a prescription in 2018, Health and Human Services Secretary Alex Azar told the AP.

“We have the tools to stop the spread of HIV in its tracks,” Azar said. “It’s about execution.”

The government’s cost-free PrEP program is part of the Trump administration’s greater effort to end the HIV epidemic by 2030. Just over one million people are living with HIV in the U.S. today, about 15 percent of whom don’t know they’re positive. About 38,000 people are newly diagnosed every year.

As part of that effort, Gilead Sciences Inc., the sole manufacturer of PrEP in the U.S., has agreed to donate enough medicine to cover up to 200,000 prescriptions per year over the next decade. Cost is often a barrier preventing uninsured people from taking PrEP, the AP noted, as Gilead charges upwards of $2,000 a month out of pocket for its two brand-name drugs, Truvada and Descovy—though generic (presumably cheaper) Truvada will reportedly become available next year.

Cost is not the only barrier keeping people who want to get on PrEP from taking the drug. Advocates from groups including Positive Women’s Network, ACT UP, and the Center for HIV Law and Policy have warned that free PrEP is not enough to end the epidemic, and that systemic issues like cyclical poverty, housing instability, and laws that criminalize HIV and sex work must be addressed, as well. The fact that people will still need a prescription to qualify for the government’s program means they could still be denied access by a homophobic or otherwise unsympathetic doctor.

“[Ending AIDS is] a three-dimensional issue,” Jacob Schneider, a staff attorney at the Center for HIV Law and Policy, told VICE when the free PrEP program was announced in October. “You can't talk about PrEP access without talking about compounding issues of HIV stigma and HIV criminalization. Any plans without that are not going to move us towards the end of the epidemic.”

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