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Gay-rights group backs use of HIV-prevention pill

DAVID CRARY
AP National Writer

NEW YORK (AP) — The largest U.S. gay-rights organization Saturday endorsed efforts to promote the use of a once-a-day pill to prevent HIV infection and called on insurers to provide more generous coverage of the drug.

Some doctors have been reluctant to prescribe the drug, Truvada, on the premise that it might encourage high-risk, unprotected sexual behavior. However, its preventive use has been endorsed by the Centers for Disease Control and Prevention, the World Health Organization, and many HIV/AIDS advocacy groups

The Human Rights Campaign, which recently has been focusing its gay-rights advocacy on same-sex marriage and anti-discrimination issues, joined those ranks with the release of a policy paper strongly supporting the preventive use of Truvada. It depicted the drug as “a critically important tool” in combatting HIV, the virus that causes AIDS.

“HRC does not take this position lightly,” the policy paper said. “We recognize there is still ongoing debate … and that there are those out there who will disagree with our stance.”

Truvada has been around for a decade, serving as one of the key drugs used in combination with others as the basic treatment for people with HIV. In 2012, the Food and Drug Administration approved it for pre-exposure prophylaxis, or PrEP — in other words, for use to prevent people from getting sexually transmitted HIV in the first place.

“Today, there is an unprecedented chance to end the HIV/AIDS epidemic, in part through PrEP’s aggressive prevention of new HIV infections,” said Chad Griffin, president of the Human Rights Campaign. “There is no reason — medical or otherwise — to discourage individuals from taking control of their sexual health and talking to their doctor about PrEP.”

The CDC says studies have shown that Truvada, when taken diligently, can reduce the risk of getting HIV by 90 percent or more. Research discussed at the International AIDS Conference in July found that use of the drug does not encourage risky sex and is effective even if people skip some doses.

As part of its announcement, the Human Rights Campaign called on insurers, regulators and Truvada’s manufacturer to take steps to reduce costs, raise public awareness, and make the option available to all medically qualified individuals who could benefit from it, regardless of ability to pay.

The cost of Truvada varies widely; a New York State Health Department fact sheet gives a range of $8,000 to $14,000 per year. The manufacturer, California-based Gilead Sciences Inc., has a program that provides assistance to some people who are eligible to use Truvada but cannot afford it.

The Human Rights Campaign urged all states to emulate Washington state, which implemented a program earlier this year offering assistance in paying for PrEP. The preventive option also was endorsed by New York Gov. Andrew Cuomo when he announced initiatives in June aimed at ending the state’s AIDS epidemic by 2020.

The HRC called on state insurance regulators to take action against any insurers who deny legitimate claims from patients who’ve been prescribed PrEP by their doctors.

A prominent provider of services to HIV-positive people, the Los Angeles-based AIDS Healthcare Foundation, remains a vocal critic of the preventive use of Truvada. In an ad campaign launched in August, the foundation says many gay men fail to adhere to Truvada’s once-a-day regimen and describes government promotion of the drug as “a public health disaster in the making.”

On Oct. 10, an alliance of about two-dozen HIV/AIDS organizations in New York released an open letter to the Healthcare Foundation, asking it not to extend the ad campaign to their state.

“We believe your campaign could prevent people at risk for HIV from using this potential lifesaving medication,” the letter said.

The Healthcare Foundation’s president, Michael Weinstein, said his organization did plan to run ads soon in New York City asserting there is data casting doubts on Truvada’s effectiveness.

“Censoring the discussion is not the answer,” he said.

Weinstein also noted that — according to figures from Gilead — only a few thousand people thus far have filled prescriptions for Truvada.

“If people really felt it was the answer, it’s hard to imagine it wouldn’t have spread like wildfire,” Weinstein said. “It’s obvious there is enormous ambivalence in the medical community.”

According to the CDC, there are about 50,000 new HIV infections annually, with gay and bisexual men accounting for nearly 63 percent of them.

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Human Rights Campaign: http://www.hrc.org/

AIDS Healthcare Foundation: http://www.aidshealth.org/#/

CDC factsheet: http://www.cdc.gov/hiv/pdf/PrEP_GL_Patient_Factsheet_PrEP_English.pdf

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Follow David Crary on Twitter at http://twitter.com/CraryAP

Copyright 2014 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Don’t Settle for Student Loans to Pay for Online Education

Online college programs are becoming a more popular choice for prospective students, with one study finding that more than 6 million students enrolled in at least one online course in fall 2015. The popularity of these courses can be attributed in part to their flexibility with working adults' schedules, students' ability to progress more quickly through online programs and, oftentimes, cheaper tuition. [See 10 low-cost online bachelor's programs for out-of-state students.]Online degrees can be beneficial to many college students, but some studies have shown online learners complete their programs at lower rates than students at traditional brick-and-mortar campuses. Individuals with student loans but no degree comprise two-thirds of defaulted borrowers. Though these numbers are not encouraging, just like for traditional programs, there are ways to reduce how much you'll need to borrow for an online program to ensure you won't become one of these statistics. Don't just settle on borrowing student loans to cover the whole cost of your program and living expenses. Instead, start thinking about how to cut costs and cover your balance in different ways, such as the following. -- Grants and scholarships: Even though you are taking an online course, you can still apply and receive grants and scholarships. But your first step should be to complete the Free Application for Federal Student Aid, commonly referred to as the FAFSA, which will allow you to receive a Pell Grant if your expected family contribution is low enough. The EFC criteria and award amounts are adjusted annually, but the 2017-2018 academic year awards range from $606 to $5,920, which could significantly lower the amount you borrow annually. Your next step is to apply for scholarships. You can start by checking online scholarship search engines, such as the Salt Scholarship Search, College Board's BigFuture and Peterson's. But don't forget to take advantage of local organizations and your school's financial aid office. Both may offer scholarships that you can't find with a national scholarship search. [Review these 10 sites to kick off your scholarship search.]For instance, organizations like the Elks Club, Knights of Columbus or the Rotary Club typically offer scholarships annually to local students. Just because you're going to school online doesn't mean you're ineligible. Visit your local library for scholarship listings, and ask around town. You might be surprised how many local organizations offer scholarships. While these scholarships typically aren't large, every little bit counts. Each dollar you receive in a scholarship is a dollar you don't have to borrow and pay interest on. -- Work-study: Another option for online students may be work-study awards. Not all students enrolled in online programs are eligible, but students at some schools -- including, for example, SUNY Empire State College and Liberty University -- are. Work-study awards are not given upfront like scholarships and grants. In most cases, they are an offer to earn up to the awarded amount if you secure an eligible work-study job. While there is a misconception that all work-study jobs must be on campus, students can work for off-campus, nonprofit or public employers as long as the work is in the public's interest. You may be able to work for a for-profit employer if the job is relevant to your course of study. No matter who the outside employer is, it will need to have an established agreement with your college for you to receive work-study funds. Remember, to be eligible for federal financial aid, you must be enrolled and pursuing a degree or certificate. If you're not working toward a credential, Pell Grants and work-study won't be option, but you may still be able to take advantage of private scholarships -- just be sure to read the eligibility criteria carefully. [Explore what to know about financial aid in online programs.]-- Pay as you go: One of the great benefits to enrolling online is the flexible schedule, which can allow you to complete your college coursework around your responsibilities. But prospective students often overlook using their part- or full-time job earnings as an option for paying for college. Almost 80 percent of college students in 2015 worked at least part time while attending classes, according to the National Center for Education Statistics. By budgeting and thinking strategically about your college costs, you can likely reduce your dependence on student loans by paying a portion out of pocket. Many -- but not all -- online programs are less expensive than traditional programs and often have shorter payment periods. Six, eight or 10 weeks are common course durations. Because of the frequency of payments in an online setting, you may be well-placed to pay as you go and possibly avoid borrowing altogether. Attending college online and avoiding student loans may be challenging, but if you are willing to put in the effort, you can limit the amount you need to borrow. More from U.S. News Q&A: Understanding Student Loan Discharge Eligibility Student Loan Refinancing Isn't Right for All Borrowers
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