How the Republican Healthcare Plan Could Limit Access to PrEP

Trump’s recently proposed revoking of the Affordable Care Act (ACA) and introduction of the Republican Health-Care Plan – often dubbed at Trumpcare – could mean the cost of anti-HIV retroviral drug PrEP could become more expensive and limit working class users to the vital medication.

The move could jeopardise access to PrEP for low-income people in 31 states who rely on the upcoming Medicaid expansions the ACA offers. Trump’s Bill would begin phasing out federal funds for the expansion in 2020, which would most likely lead to new applicants for PrEP being blocked. As of yet, access to PrEP costs $1,500 without medical insurance and anywhere from nothing up to $500 with it.

Lindsey Dawson, senior HIV policy analyst of the Kaiser Family Foundation explained to TIME that the proposed repeal of ACA’s cost-sharing assistance (the system that allows paid inures to reduce stress caused by those enrolling based on their personal income) would make coverage more expensive for poorer people in America.

Pre-Exposure Prophylaxis (or Truvada) works by interfering with an enzyme that HIV infected cells use to make new viruses. Using the daily drug has been shown to reduce the risk of HIV by 92 per cent according to the Centers for Disease Control and Prevention with a recent study concluding that daily access to PrEP to 25 per cent MSM (men who have sex with men) would reduce new HIV cases by 44 per cent. The CDC also indicated that one in four gay men in the US should be on PrEP to protect from virus contraction, citing the drug as “powerful”.

Noël Gordon Jr., a senior program specialist for HIV prevention and health equity at Human Rights Campaign told Money that there has been an exponential growth in PrEP users, with 80,000 users between 2012-2015.

PrEP benefits those with multiple sexual partners to those in relationships with HIV+ people. But of course, it is far more than just gay men who are at risk of contracting HIV and the drug will benefit people from all corners of society. Recreational drug users are at high risk of HIV with clumsy shared needle usage and higher chances of sexual assault and abuse. Similarly, sex workers are paired in a myriad of sexual encounters that may put them at risk. For ethnic minorities who are still more likely to contract HIV and those who are economically not able to fork out private healthcare funds for the drug, providing PrEP readily will inevitably change and benefit the lives everywhere you go.

Vice President Mike Pence – a man who has previously advocated for the cutting of funds for HIV foundations and suggested that said funds be directed into gay conversion therapy – has been widely blamed for rising HIV cases in Indiana, where he was the Governor between 2013-2017. His cuts, in wake of public health spending saw the defunding of Planned Parenthood, leading to there no longer being a place for the county’s 24,000 residents to get tested. The cuts led to an obvious outbreak in HIV, with 20 cases being reported each week at the height of the outbreak.

PrEP is vital and integral to the global and national prevention of HIV. The virus isn’t a death sentence anymore, but the stigma ruins lives and it is the duty of the American government to have the medical desires of the public at best interest. Low income LGBT+ people in America are now at threat, with vital access jeopardising their health and, thus forth, sees Trump yet again marginalising and dismissing the needs for LGBT+ people.

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