Given the increased risk of HIV, a new arsenal of medicines is recommended

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An expanded arsenal of drugs that can prevent HIV should be prescribed for patients at higher risk for the disease, an influential national task force recommended Tuesday. Newer oral and long-acting injection versions of HIV PrEP, or pre-exposure prophylaxis, have the potential to improve uptake and adherence to drugs that have proven highly effective, the group said. Recommendations from the U.S. Preventive Services Task Force, a powerful group of health experts, generally influence health insurance coverage and become standard medical practice.

PrEP for adults at high risk of getting HIV is among the preventive services most health insurers must cover without cost-sharing under the Affordable Care Act — a coverage guarantee now under threat from a recent lawsuit. Task force member John Wong, an internist at Tufts University School of Medicine, said patients will benefit from having better access to more options.

“I have some patients who are already taking a daily pill and so adding another pill would be rather easy for them,” said Wong. “I have patients who have no trouble with shots and they may prefer the simplicity of getting a shot every other month.”

The task force updated its PrEP recommendations based on findings from 20 randomized trials involving more than 35,000 patients demonstrating that the newer versions are highly effective and safe. While an earlier version of PrEP — along with the doctor’s visits and lab tests required to get a prescription — was supposed to be fully covered under ACA rules, some patients have reported trouble getting their insurers to pick up the full tab.

Sen. Tina Smith (D-Minn.) and Rep. Adam Schiff (D-Calif.) introduced the PrEP Access and Coverage Act in June aimed at ensuring coverage, although it’s not clear the measure will gain traction in a divided Congress.