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Estimated coverage to address financial barriers to HIV preexposure prophylaxis among persons with indications for its use, United States, 2015.

Estimated coverage to address financial barriers to HIV preexposure prophylaxis among persons with indications for its use, United States, 2015.
Author Information (click to view)

Smith DK, Van Handel M, Huggins R,


Smith DK, Van Handel M, Huggins R, (click to view)

Smith DK, Van Handel M, Huggins R,

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Journal of acquired immune deficiency syndromes (1999) 2017 08 22() doi 10.1097/QAI.0000000000001532

Abstract
BACKGROUND
An estimated 1.2 million American adults engage in sexual and drug use behaviors that place them at significant risk of acquiring HIV infection. Engagement in health care for the provision of daily oral antiretroviral medication as preexposure prophylaxis (PrEP), when clinically indicated, could substantially reduce the number of new HIV infections in these persons. However, resources to cover the financial cost of PrEP care is an anticipated barrier for many of the populations with high numbers of new HIV infections.

METHODS
Using nationally representative data, we estimated the current national met and unmet need for financial assistance with covering the cost of PrEP medication, clinical visits, and laboratory costs among adults with indications for its use, overall and by transmission risk population.

RESULTS
This study found that, of the 1.2 million adults estimated to have indications for PrEP use, <1% (∼7,300) are in need of financial assistance for both PrEP medication and clinical care, at an estimated annual cost of $89 million. An additional 7% (∼86,300) are in need of financial assistance only for PrEP clinical care at an estimated annual cost of $119 million. CONCLUSION
This information on PrEP care costs, insurance coverage, and unmet financial need among persons in key HIV transmission risk subpopulations can inform policy makers at all levels as they consider how to address remaining financial barriers to the use of PrEP and accommodate any changes in eligibility for various insurance and financial assistance programs that may occur in coming years.

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