Insurance- and provider-related obstacles keep at-risk populations from continuing PrEP

For immediate release.

Pre-exposure prophylaxis (PrEP) is one of the most effective methods for HIV prevention among at-risk populations such as gay and bisexual men. When taken daily as directed, PrEP provides a 92-99 percent reduction in HIV risk. Research shows, however, that many gay and bisexual men begin a PrEP regimen and discontinue the medication shortly thereafter.

To investigate this phenomenon, a research team led by CUNY SPH doctoral student and CUNY Institute for Implementation Science in Population Health (ISPH) project coordinator Alexa D’Angelo and Investigator Christian Grov conducted a study into the challenges that arise for PrEP users. The findings were published in Translational Behavioral Medicine.

The researchers conducted qualitative interviews with 103 PrEP-using gay and bisexual men and uncovered many insurance and medical provider-related barriers that gay and bisexual men face when attempting to remain on PrEP. These include prior-authorization and pharmacy mandates from insurance companies, as well as challenges related to attending quarterly PrEP-related medical appointments.

“To encourage PrEP adherence, it should be affordable, the insurance coverage should be reliable and without needless mandates, and it should be easy to make an appointment,” D’Angelo says. “If we can remove these barriers to PrEP adherence, we’re likely to see a rise in sustained use among gay and bisexual men. California Senate Bill 159 has already eliminated prior-authorization requirements on PrEP and PEP, and New York would be wise to follow in their footsteps.”

About the Institute for Implementation Science in Population Health at the City University of New York
The CUNY Institute for Implementation Science in Population Health (ISPH) was founded on the notion that substantial improvements in population health can be efficiently achieved through better implementation of existing strategies, policies, and interventions across multiple sectors. We study how to translate and scale-up evidence-based interventions and policies within clinical and community settings in order to improve population health and reduce health disparities. CUNY ISPH. Pursuing population health gains through better implementation. Follow us on Twitter: @CUNYISPH.

About the CUNY Graduate School of Public Health and Health Policy
The CUNY Graduate School of Public Health and Health Policy (CUNY SPH) is committed to teaching, research and service that creates a healthier New York City and helps promote equitable, efficient and evidence-based solutions to pressing health problems facing cities around the world. For more information, visit

For more information contact:
Christian Grov
[email protected]

Insurance- and medical provider-related barriers and facilitators to staying on PrEP: results from a qualitative study,” Alexa B D’Angelo, Javier Lopez-Rios, Anthony W P Flynn, Ian W Holloway, David W Pantalone, Christian Grov, Translational Behavioral Medicine, February 17, 2020, ibz191,

Reposted from the original with permission.