U.S. Capitol. (Washington Blade photo by Michael Key)
Democratic U.S. Reps. Robert Garcia and Barbara Lee of California sent a letter Aug. 8 urging the U.S. Preventive Services Task Force to compel health insurers to provide free access to doxy PEP, a drug regimen for the prevention of sexually transmitted infections.
The USPSTF is an independent panel of experts in primary care and preventative medicine organized under the U.S. Department of Health and Human Services whose primary responsibility is to evaluate the evidence on the safety and efficacy of medical screenings, counseling, and preventative medications.
The lawmakers’ letter explains that in 2019, the USPSTF issued an “A-grade” recommendation for prescribing preexposure prophylaxis (PrEP) — a different preventative regimen targeting HIV infections — to “those at increased risk of HIV acquisition.”
As required under the Affordable Care Act, the rating meant health plans were required to offer the drug with no cost-sharing, which “has been enormously beneficial to hundreds of thousands of Americans —particularly members of the LGBTQIA+ community.”
The letter points to disproportionately high rates of bacterial STIs (“chlamydia, gonorrhea, and especially syphilis”) among LGBTQ populations as well as recommendations published last month by the Centers for Disease Control and Prevention instructing providers to counsel certain patients about PEP, with the agency writing that the drug intervention requires “a focused effort for equitable implementation.”
For these reasons, Garcia and Lee said, “we respectfully ask for your full and fair consideration of a USPSTF recommendation for doxy PEP to the populations outlined in the guidelines with an ‘A’ rating,” with those populations being “gay and bisexual men, other men who have sex with men, and transgender women, and who have a history of bacterial STIs in the past 12 months.”
“Surging STIs are disproportionately impacting LGBTQ+ individuals,” Garcia, a gay co-chair of the Congressional Equality Caucus, said in a press release from his congressional office. “We must ensure that these folks have access to doxy PEP, a critical medication that can save lives and prevent these kinds of infections.”
He added, “By making doxy PEP coverage free by insurers, we can prevent infections and stop the spread of disease for those most vulnerable.”
Lee, a vice chair of the caucus, has a decades-long record of pro-LGBTQ advocacy, particularly in the healthcare space and on issues of HIV/AIDS in the U.S. and around the world.
“Widespread use and education about doxy PEP could prevent thousands of bacterial STI cases every year,” she said in the press release. “However, in order to get this treatment to those who need it most, it’s imperative that doxy PEP is covered by insurance plans with no cost to patients.”
“By ensuring doxy PEP is available with grade A rating by the USPSTF, we’re taking a critical step toward promoting health equity and advancing our mission of using informed, evidence-based interventions to support those most in need,” said David Stacy, vice president of government Affairs for the Human Rights Campaign.
David C. Harvey, executive director of the National Coalition of STD Directors, said “providing healthcare providers with the guidance and encouragement they need to implement doxy PEP in accordance with the new CDC guidelines will be crucial in helping us use doxy PEP to address our out-of-control STI epidemic.”
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