USPSTF recommends HIV PrEP

The US Preventive Services Task Force (USPSTF) has announced its recommendation for HIV pre-exposure prophylaxis (PrEP).

The US Preventive Services Task Force (USPSTF) awarded an “A” grade for HIV pre-exposure prophylaxis (PrEP) and recommended that healthcare providers offer or provide PrEP to patients at increased risk of HIV.

That news came in the USPSTF’s draft recommendation released on Tuesday.

The USPSTF uses a proprietary 5-letter medical service rating system based on the degree of certainty of the net benefit derived from the service. The grade “A” indicates a “high confidence” that the benefits are “substantial”.

As stated in the USPSTF bulletin, PrEP is a highly effective way to prevent HIV in people at increased risk of contracting the virus. When taken as directed, it can reduce HIV risk by 99%, and the USPSTF said it encourages healthcare professionals to help PrEP patients understand the importance of taking it as directed.

“Physicians can help protect their patients at increased risk of HIV by prescribing PrEP,” said John B. Wong, MD, USPSTF member and vice chair for academic affairs, chief of clinical decision making and primary care physician at Tufts Medical Center. “The availability of multiple effective PrEP drugs is great news for patients and a positive step toward reducing the impact of HIV in the United States”

The Affordable Care Act (ACA) requires most insurance companies to cover HIV prevention services, such as screening and PrEP. More recently, however, court battles have been fought to limit coverage of PrEP for HIV.

In September, US District Judge Reed O’Connor ruled that the ACA’s mandatory coverage of PrEP is unconstitutional and violates the religious beliefs of a Texas healthcare employer. O’Connor also ruled that the USPSTF recommending ACA coverage of PrEP violated the appointment clause of the US Constitution. The implications of the judgment beyond the plaintiffs were not clearly defined.

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The USPSTF Bulletin also found that black and Hispanic/Latino people are more likely to be diagnosed with HIV but use much less PrEP compared to white people. Given these disparities and the increasing problems with accessing PrEP during the COVID-19 pandemic, the USPSTF calls for more research into breaking down barriers in these and other HIV-affected communities.

“Many people who would benefit from PrEP are not receiving this powerful drug. This is especially true for Black, Hispanic, and Hispanic communities,” said Martha Kubik, PhD, RN, USPSTF Fellow and Professor in the George Mason University School of Nursing. “These injustices need to be addressed to reap the full benefits of PrEP.”

reference

Task Force Releases Draft Statement of Recommendation on PrEP for HIV Prevention. USPSTF. December 13, 2022. Accessed December 16, 2022. https://www.uspreventiveservicestaskforce.org/uspstf/sites/default/files/file/supporting_documents/hiv-prep-draft-rec-bulletin.pdf

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