Free PrEP for senior citizens

I’m not making this up

I almost titled this “Free PrEP for seniors,” but then I realized that might sound like I’m referring to PrEP for high school seniors, which would be unsurprising given recent events, but this article is actually about subsidizing PrEP for “older Americans” via Medicare. (h/t Marilyn)

US to Cover HIV Prevention Drugs for Older Americans to Stem Spread of the Virus

A proposed federal policy aims to protect older Americans from contracting HIV by offering free preventive medication, the latest effort to catch up to much of Europe and Africa in stemming the spread of the virus.

Under the plan from the Biden administration, Medicare would cover patients’ full cost of preexposure prophylaxis drugs, which prevent HIV transmission. The drugs, known by the shorthand “PrEP,” would be free in pill form and — for the first time — as long-acting injectables through the government insurance program designed for those 65 and older. Those 50 and over make up half of all people in the U.S. already living with HIV. (Emphasis mine)

That demographic data are actually super interesting. First, they mention nothing about “new infections” among “older Americans,” which would presumably be important to know because PrEP is indicated specifically to (allegedly) prevent new infections. Also, Americans over fifty make up only a third of the population, yet fully half of the HIV-positive population. I’d love to know how many of those HIV-positive people over fifty received their diagnosis in the 1990s or even earlier, and how many are “retained in care.”

Another oddity is that this program is specifically designed for Americans over sixty-five, given the involvement of Medicare, yet the figure is given for people over fifty. Not only that, but an actual NIH webpage also gives the figure for “fifty and over.” I can find the number over 65 that are HIV-positive. (If anyone reading this knows, please pass it on.) I can’t prove that this is statistical trickery, but it’s suspicious.

I’ll just cover a couple more points, because it’s all propaganda by now.

The U.S. also lags Western Europe and some nations in Africa in overall HIV treatment and prevention. For example, just 57% of HIV-positive Americans have attained viral suppression, according to the U.S. government website HIV.gov, meaning they regularly take medications to make them unable to transmit the virus. That makes PrEP, which is for people who don’t have the virus, all the more important for Americans to stay negative, according to HIV experts.

I will once again point out the anomaly that, in the U.S., only 57%—slightly over half—have “attained viral suppression,” yet there is no longer even the hint of an AIDS epidemic in this country like we saw in the eighties and nineties. Why is that? It can’t possibly be because the “lifesaving drugs” if 43% aren’t even taking them, either consistently or at all.

And finally—PrEP is empowering now?

Elion said shame surrounding sex and the feeling of vulnerability that some people get from taking any medicine may also reduce PrEP uptake among older Americans. “Taking PrEP is actually very empowering, and that needs to be the message,” he said.

I’m sure we can all sleep better at night knowing how “empowered” a PrEP regimen would make us feel. Maybe our benevolent government should just hand it out to everyone who will take it. That couldn’t possibly go sideways.

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