PrEP Accessibility

Pre-Exposure Prophylaxis (PrEP) is 99% effective in preventing HIV and has been around since its FDA approval in 2012. However, not enough people at high risk of contracting HIV have access, in particular, Blacks and Latinx; only 5.9% of at-risk Black individuals use PrEP as compared to 42.1% of at-risk White individuals. Numerous barriers to PrEP exist such as the lack of autonomy, in certain states, for nurse practitioners (NPs) and physician assistants (PAs) to prescribe PrEP without the supervision of a medical doctor (MD). A 2017 analysis of scope of practice for advanced practitioners showed that NPs in states that allowed independent scope of practice were 1.4 times more likely to have prescribed PrEP compared to those in states where their prescribing authority is determined by an MD. PAs in states where the law or a state board defined their prescribing authority were more than 2 times as likely to prescribe PrEP compared with those in states where a supervising MD oversaw prescribing rights. 

The PrEP Access and Coverage Act sponsored by Senator Tina Smith and Representative Adam Schiff is a bill that was introduced into the 117th Congress but is currently stalled in committee. The Vannevar Group (TVG) aims to increase access through increased awareness by adding a provision to the bill that would allow all NPs and PAs to prescribe HIV preventive interventions and provide the bill with the momentum it needs. This provision would further decrease barriers to PrEP and produce major cost savings by diminishing the long term costs of treatment. Additionally, the bill will prevent an incalculable number of years of life lost pulled from the workforce, support American pharmaceutical enterprise, ease the burden on an exacerbated medical system, and embolden healthcare workers to save even more American lives.