In August, the U.S. Preventive Services Task Force (USPSTF) recommended that health care providers prescribe all approved pre-exposure prophylaxis (PrEP) methods for people at risk for HIV.
The recommendation adds daily tenofovir alafenamide/emtricitabine pills (TAF/FTC, or Descovy) and long-acting cabotegravir injections (Apretude) to its 2019 recommendation of daily tenofovir disoproxil fumarate/emtricitabine pills (TDF/FTC, or Truvada and generic equivalents).
All three PrEP options are highly effective, reducing the risk of HIV acquisition by more than 99% if used consistently. Truvada and Apretude are approved for all individuals at risk for HIV. However, due to a lack of evidence, Descovy is not approved for people who are at risk for acquiring the virus via vaginal sex.
The expanded recommendation received an A grade, meaning it is well supported
by scientific data. The Affordable Care Act requires insurers to fully cover recommended prevention services with an A or B grade.
Health officials and advocates hope the recommendation will help increase PrEP uptake, especially for groups such as Black gay men, who have a higher HIV incidence but lower PrEP use. However, the coverage requirement is jeopardized by a lawsuit from conservative business owners who claim it violates their religious freedom.
“The current court challenge to the preventive services coverage requirement, if successful, would put more people at risk for HIV and other serious infectious diseases and would be a major setback to efforts to end HIV as an epidemic,” said Carlos del Rio, MD, of the Infectious Diseases Society of America, and Michelle Cespedes, MD, of the HIV Medicine Association.