This groundbreaking new HIV-prevention law will save lives & improve healthcare access

Rhode Island Governor Daniel McKee (D) has signed a law that protects people’s rights to access HIV medications including pre-exposure prophylactics (PrEP), all of which greatly reduce the chances of contracting or transmitting HIV.

The bill — H7625/S2255, also known as “An Act Relating To Insurance Coverage For Prevention Of HIV Infection” — protects patients from health insurance barriers to accessing such medication.

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The law applies to any HIV medication, and particularly focuses on prohibitive insurance mechanisms like cost sharing, which includes high copays as well as high deductibles; prior authorization requiring insurers to get their company’s approval before allowing patients to access medication; and “stop therapy,” requiring patients to try other medications and treatments before giving them access to their preferred ones.

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Restricting these is particularly important because they serve as common barriers to healthcare. High costs for insurance are unaffordable for low-income individuals, which can be a notable issue due to the higher rates of HIV transmission among poorer people. Additionally, prior authorization can burden patients with long wait times and lots paperwork before they’re able to access the care that they need.

“I have seen firsthand how cost-sharing and prior authorization function as barriers to patients accessing PrEP and the form of the drug that is best for them,” said Joseph Metmowlee Garland, GLAD Board Vice President, in a press release. “Smaller clinics that don’t have the support of a larger health system obviously have a much harder time securing prior authorization for their patients, and often those patients just stop trying to get it.”

PrEP has nearly 100% efficacy in those who take it correctly. It has proved instrumental in lowering HIV infection rates and making patients more aware of other sexually transmitted infections (since PrEP prescriptions often require STI testing once every three months). PrEP has been particularly useful for protecting marginalized groups who may otherwise be at higher risk of infection, including racial minorities and LGBTQ+ individuals.

PrEP’s injectable form has been particularly hard to get for many patients due to insurance restrictions. According to Garland, only 35 patients across Rhode Island were on injectable PrEP.

Garland continued, “S.2255/H.7625 is groundbreaking and incredibly meaningful to our community and it will completely change the landscape of PrEP access in the state. With this law, Rhode Island is demonstrating its commitment to compassionate, high-quality, evidence-based care, and to ensuring that we make every possible tool available to those who need them in the fight against HIV.”

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