Helping Consumers Get PrEP
Pre-exposure prophylaxis (PrEP) is antiviral medication that is prescribed to prevent HIV in people who don't have HIV.1 PrEP is highly effective and plays a key role in preventing the spread of HIV.2-6 However, PrEP can work only if people take it—and they can take it only if they get a prescription for it and get that prescription filled. This article explains how to make sure that the people in the United States who need PrEP can get their PrEP, even if they don’t have health insurance.
Who Needs PrEP?
Healthcare providers should tell all sexually active adults and adolescents about the value of PrEP.1 This talk can encourage patients to talk freely about their own risks (sexual behaviors or drug use). It may also encourage the patients to tell their friends and family members about PrEP.
Does Health Insurance Cover PrEP?
Most health insurance plans and state Medicaid programs cover PrEP.8 Consumers who have health insurance can get PrEP by making a general appointment with their healthcare professional. Generally, health insurance should cover the clinic visits and the laboratory tests needed for PrEP, as well as the PrEP medication.
If there is a co-pay, the patient can ask for assistance from the following resources:
- Their state government. Some states cover the costs of clinic visits and lab tests related to PrEP. For more information, visit the National Alliance of State and Territorial AIDS Directors’ (NASTAD) guide to state PrEP assistance programs
- The drug manufacturer’s co-pay assistance program
How Can Uninsured People Get PrEP?
Systems have been set up to give people in the United States access to PrEP in pill form. In December 2019, the US Department of Health and Human Services launched its Ready, Set, PrEP Program to provide free PrEP to qualifying people in the United States, including tribal lands and territories.9
Ready, Set, PrEP is headed by the US Department of Health and Human Services. This program is part of the federal government’s attempts to end HIV in the United States. Visit the Ending the HIV Epidemic in the US government website for more information.
People can qualify for Ready, Set, PrEP if they:
- Live in the United States, including tribal lands and territories
- Test negative for HIV before starting the program
- Have a prescription for PrEP
- Don’t have health insurance coverage for prescription drugs
To enroll in the program, consumers should talk to a healthcare provider. If they don’t have a healthcare provider, they should visit a community health center, a clinic that specializes in sexual health and sexually transmitted infections, or another nonprofit or governmental health clinic. They may also contact a telehealth service that provides PrEP. To find a clinic that prescribes PrEP, visit the HIV.gov Clinic Locator. Once consumers have a prescription, they should visit the Ready, Set, PrEP website or call toll-free (855) 447-8410 to qualify and enroll in Ready, Set, PrEP. When consumers complete the enrollment form, they must fill in the name of the provider who prescribed their PrEP.
PrEP Via Telehealth
Some people find it hard to travel to a clinic. For those patients, there are telehealth services that offer PrEP. Telehealth—sometimes called telemedicine—is a way for healthcare professionals to provide care to patients without an in-person office visit.10 Telehealth is done primarily online, through a computer, tablet, or smartphone. Telehealth was invented to provide healthcare to remote rural areas. However, it has become enormously popular during the COVID-19 pandemic. Telehealth has become an important way to provide HIV-prevention services, including PrEP.11 NASTAD provides a list of telehealth PrEP services by state.
Telehealth has become an important way to provide HIV-prevention services, including PrEP.11
Telehealth is convenient, especially for people who cannot drive or do not have a vehicle. Telehealth is private, especially because patients are not seen entering or leaving the clinic. Telehealth also allows patients to have access to professionals who are specifically trained and experienced in providing care related to HIV.
In 2017, the Iowa Department of Public Health and the University of Iowa partnered to launch a regional telehealth program (Iowa TelePrEP). Its goal was to improve access to PrEP in rural areas and small towns in Iowa.12 The program began as a local initiative with a single public health department. It was then expanded to include public health departments in various parts of the state. The program was designed to overcome barriers related to distance and stigma. Iowa TelePrEP refers clients from the public health service to a network of services for HIV counseling, testing, and referral, as well as to disease intervention specialists and partner services. The program refers people either to a telehealth service or to PrEP providers in their community. During telehealth visits, University of Iowa pharmacists provide PrEP counseling and prescribe PrEP. Laboratory testing is done through a statewide network of public health sites. The PrEP medication can be picked up at a local pharmacy or delivered by mail.12
In November 2020, Stanford Children’s Hospital launched its Virtual PrEP Program, which offers sexual health care to adolescents and young adults in California. This program also provides webinars to train pediatricians and family medicine providers about how to prescribe and monitor PrEP.11 The Virtual PrEP program provides care remotely by using the patient’s mobile device or computer. After the initial virtual visit, patients are mailed an at-home HIV testing kit. The patient will then have ongoing laboratory tests performed at a local laboratory. Prescriptions for PrEP are filled at the patient’s local pharmacy. Patients will have biweekly calls with their dedicated PrEP Navigator.13
HVUWCNT220008 August 2022