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Posted: February 07, 2018

Under fire, Publix reverses decision to deny coverage for HIV prevention drug

Last year, the Centers for Disease Control and Prevention predicted that if current rates continue, one in two African-American gay and bisexual men will be infected with HIV, the virus that causes it AIDS. If you’re wondering how that could be given the success of lifesaving antiretroviral medication, given the decades of research and education, I get it. Dr. David Malebranche, an associate professor of medicine at the Morehouse School of Medicine who has been working with HIV prevention and treatment for the past 16 years, says there are reasons for this. For one thing, Malebranche is a “same gender loving man” and, at 48, he has had nearly his entire life to consider the cost of loving men. He’s seen some things. Even so, his re-introduction to Atlanta’s HIV epidemic in 2000 was like stepping back in time. “It was like being in New York 15 years ago, ” Malebranche said recently. “We would hospitalize people for opportunistic infections that people in New York hadn’t seen in years.” And that in many ways, he said, speaks to the essential issue of why black men who have sex with men have long endured the brunt of the epidemic. In this gay rights movement, which coincided with the HIV movement, people forgot that black MSM are in fact, still black men.

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By Fiza Pirani

The Atlanta Journal-Constitution

Publix announced Tuesday that it would reverse itself after coming under fire for denying preventative HIV drug coverage to one of its employees in Metro Atlanta. 

» RELATED: 9 facts about HIV/AIDS everyone should know

The drug, Truvada PrEP, is more than 95 percent effective in preventing the contraction of HIV, which can result in AIDS. It’s typically prescribed to HIV-negative gay men and those at high risk of infection.

“If everyone took PrEP, there would be no more HIV. It’s that potent, that strong,” Dr. Scott Parry with Intown Primary Care, one of the top providers of PrEP, told Channel 2 Action News.

» RELATED: Stigma still fueling rising rate of HIV among blacks 

The issue came to light when a website, The Body, reported that the former employee was denied coverage. Since 2015, Fulton County Board of Public Health’s HIV prevention program has prescribed Truvada for PrEP 255 times, said Dr. David Holland, chief clinical officer for communicable diseases for the program.  Holland confirmed to AP that the former Publix employee, a Georgia resident, had been denied coverage — the only such case he'd seen. 

Publix did not respond to the Associated Press’s calls and messages last week.

Human rights groups spoke out against the chain, calling its denial for PrEP insurance coverage discriminatory.

» RELATED: Despite progress, Atlanta’s HIV epidemic is worse

“It is not a stretch of the imagination to think that this could actually be a discriminatory practice that targets members of the LBGT community for their sexuality,” Jeff Graham with Georgia Equality told Channel 2.

However, following a meeting with Publix officials to address the issue, Florida state Rep. Carlos Guillermo Smith, D-Orlando, an openly gay legislator, took to Twitter Monday to detail how the talks went. He wrote that company officials confirmed the decision to deny coverage but wouldn’t say if it “was based solely on cost or some absurd moral objection they have to PrEP.”

Publix responded early Tuesday, and said it had reconsidered its decision and would cover the drug. “We regularly evaluate what is covered by our health plan and have made the decision to expand our health plan’s coverage of Truvada to include Pre-exposure Prophylaxis (PrEP),” the company tweeted. “We are working with our pharmacy benefits manager to implement this change.”

» RELATED: New study on STDs finds Georgia among ‘most diseased’ states

"I think they know and understand that this is the right thing to do for their employees," Smith said.

According to HIV specialists and gay rights groups, the drug is almost universally covered by large employers who provide prescription drug coverage for their workers. Gilead Sciences, its manufacturer, estimated U.S. usage at 120,000 people last year.

The average lifetime cost of treating a person who becomes HIV positive at 35 is $449,000, and that doesn’t include treating anyone else the person might infect, according to Atlanta-based Centers for Disease Control and Prevention.

» RELATED: The silent epidemic: Black gay men and HIV

"Whether or not it is illegal, it is misguided from both a health perspective and an economic perspective,” Scott Schoettes, HIV project director at gay rights organization Lambda Legal, said. “You don't have to be a rocket scientist to know that it is better and cheaper if someone isn't infected.”

The Associated Press contributed to this story.


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