USPSTF Recommends HIV PrEP

The US Preventive Services Task Force (USPSTF) granted an “A” grade for HIV pre-exposure prophylaxis (PrEP), recommending that health care providers offer or provide PrEP to patients at increased risk of contracting HIV.

This news came in the USPSTF’s draft recommendation statement published on Tuesday.

The USPSTF uses its own 5-letter grading system for medical services based on the level of certainty regarding the net benefit gained from the service. An “A” grade indicates a “high certainty” the benefits are “substantial.”

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

“Health care professionals can help protect their patients at increased risk for HIV by prescribing PrEP,” said John B. Wong, MD, member of the USPSTF and vice chair for academic affairs, chief of the Division of Clinical Decision Making, and primary care physician at Tufts Medical Center. “The availability of multiple effective PrEP medications is great news for patients and a positive step to helping reduce the impact of HIV in the United States”

Under the Affordable Care Act (ACA), most insurance companies must cover preventative services against HIV, such as screenings and PrEP. However, recent court battles have been fought to limit the coverage of PrEP for HIV.

In September, US District Judge Reed O’Connor ruled that required coverage of PrEP under the ACA is unconstitutional and violates a Texas health care employer’s religious beliefs. O’Connor also ruled that the USPSTF, which recommends PrEP coverage by the ACA, violates the appointment clause of the US Constitution. The ruling’s impact beyond the plaintiffs was not clearly defined.

The USPSTF bulletin also noted that Black and Hispanic/Latino individuals are more likely to receive an HIV diagnosis, but have much lower rates of PrEP use compared with White individuals. With these disparities and worsened PrEP access issues during the COVID-19 pandemic, the USPSTF is calling for more research on how to reduce barriers in these and other communities affected by HIV.

“Many people who would benefit from PrEP are not receiving this highly effective medication. This is especially true of Black, Hispanic, and Latino communities,” said Martha Kubik, PhD, RN, member of the USPSTF and professor with the School of Nursing at George Mason University. “These inequities must be addressed to achieve the full benefit of PrEP.”

Reference

Task force issues draft recommendation statement 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