Preventing HIV just got easier

The ideas and innovators shaping health care

Aug 22, 2023 View in browser   By Evan Peng, Carmen Paun, Erin Schumaker and Daniel Payne PROGRAMMING NOTE: Future Pulse won’t publish from Monday, Aug. 28, to Monday, Sept. 4. We’ll be back in your inbox on Tuesday, Sept. 5. THE NEXT CURES An injectable HIV preventative could drive down transmission. | Getty Images The U.S. Preventive Services Task Force’s decision on Tuesday to expand the list of PrEP drugs it recommends to reduce the risk of HIV transmission has public health advocates feeling optimistic. Increased uptake of PrEP medicines could significantly reduce transmission, but many of those at risk aren’t taking them. The newly recommended Apretude from British drugmaker ViiV Healthcare is an injectable that patients only need to take every other month. The other option, which the task force recommended in 2019, is a daily pill: Descovy from Gilead Sciences. There’s evidence that long-acting injectable PrEP is more effective than the daily pill, because of spotty adherence. The task force's recommendation triggers Obamacare's coverage mandate, so patients with insurance can get the drugs without a copay or deductible. “You may not want to take a drug every single day,” said Carl Schmid, executive director of the HIV+Hepatitis Policy Institute. “I think the future of PrEP is going to be long-acting.” The task force’s decision to approve the injectable “offers clinicians more opportunities to give people options that will work with their own lifestyle,” added Dr. Jim Stevermer, a task force member and professor of family and community medicine at the University of Missouri. Why it matters: While PrEP uptake has improved in recent years, growing from 13 percent of those that could benefit in 2017 to 30 percent in 2021, according to the CDC, progress has been uneven: 78 percent of eligible white people are taking PrEP, compared to only 21 percent of eligible Latino people, 11 percent of eligible Black people and 12 percent of eligible women. Even so: A federal district court in Texas in March tossed out Obamacare’s preventive care insurance requirement, siding with a group of Texas employers and individuals that claim the mandate is unconstitutional because the task force is made up of independent experts who are neither Senate-confirmed nor chosen by a Senate-confirmed agency head. The plaintiffs also singled out PrEP, arguing that requiring coverage of it violates their religious rights. The 5th U.S. Circuit Court of Appeals has stayed the ruling while it considers the Biden administration’s appeal. What’s next? If the preventive care insurance mandate stands, insurers will have to cover the newly recommended PrEP option in the plan year starting on or after Aug. 31, 2024.   A NEW PODCAST FROM POLITICO: Our new POLITICO Tech podcast is your daily download on the disruption that technology is bringing to politics and policy around the world. From AI and the metaverse to disinformation and cybersecurity, POLITICO Tech explores how today’s technology is shaping our world — and driving the policy decisions, innovations and industries that will matter tomorrow. SUBSCRIBE AND START LISTENING TODAY.     WELCOME TO FUTURE PULSE Seoul, South Korea | Evan Peng This is where we explore the ideas and innovators shaping health care. A blood test in development in the U.K. could one day quickly diagnose the underlying disease causing a child’s fever, the BBC reports. Share any thoughts, news, tips and feedback with Carmen Paun at cpaun@politico.com, Daniel Payne at dpayne@politico.com, Evan Peng at epeng@politico.com or Erin Schumaker at eschumaker@politico.com. Send tips securely through SecureDrop, Signal, Telegram or WhatsApp. Today on our Pulse Check podcast, host Ben Leonard talks with POLITICO's Mia McCarthy about her reporting on the first locally transmitted malaria cases reported in the U.S. in 20 years — a mysterious reemergence that's puzzling public health experts. Listen to today’s Pulse Check podcast FUTURE THREATS More people are smoking up than ever before. Pot is hot among young adults, POLITICO’s Natalie Fertig reports. The number of those ages 19 to 30 who reported using marijuana in the last 12 months reached the highest level ever in 2022, according to the National Institute on Drug Abuse’s Monitoring the Future survey, which has tracked cannabis consumption since 1988. Nearly half of young adults (43.6 percent) used marijuana at some time in 2022 — with the highest rates for people in their mid- to late-20s. That’s up from a low of 23.3 percent in 1991. Within the 19- to 30-year-old group, adults ages 27 to 28 recorded the highest percentage of use at 46.6 percent. Those enrolled in college full-time used marijuana at a much lower rate (4.7 percent) than those of college age not enrolled (14.5 percent). Don’t Bogart that joint: Young adults (ages 19 to 30) who used marijuana daily (defined as 20-plus times in the last 30 days) also reached its highest rate ever, 11.3 percent. By comparison, the rate of daily users fluctuated between 3.3 percent and 5 percent from 1988 to 2010. Marijuana vaping also reached the highest level recorded since it was added to the survey in 2017, with a 12-month prevalence among young adults of 21.3 percent. Not just for the young: People in the 35- to 50-year-old group also use pot more, with 12-month prevalence hitting 27.9 percent in 2022. That’s more than double the 13.1 percent rate 10 years earlier.   DON’T MISS POLITICO’S TECH & AI SUMMIT: America’s ability to lead and champion emerging innovations in technology like generative AI will shape our industries, manufacturing base and future economy. Do we have the right policies in place to secure that future? How will the U.S. retain its status as the global tech leader? Join POLITICO on Sept. 27 for our Tech & AI Summit to hear what the public and private sectors need to do to sharpen our competitive edge amidst rising global competitors and rapidly evolving disruptive technologies. REGISTER HERE.     WORLD VIEW A new EU law aims to break kids' smartphone addictions. | Getty Images Concern about social media’s impact on mental health, especially among the young, has gone global. Beginning later this month, the EU’s Digital Services Act will require the biggest online platforms — those with more than 45 million European users, such as TikTok, Facebook and YouTube — to open up their systems to scrutiny by the European Commission and prove they’re doing their best to ensure their products aren’t harming kids, POLITICO’s Carlo Martuscelli reports. The particulars: The law requires the tech giants to submit to the commission an assessment of product design, algorithms, advertising and terms of services on a range of societal issues such as the protection of minors and mental well-being. They’ll then have to propose and implement measures to mitigate negative impacts. Measures could include ensuring that algorithms don’t recommend videos about dieting to teenage girls or turning off autoplay by default so minors don’t get hooked. The law bans the companies from tracking kids’ online activity to show them personalized advertisements. Penalties: A fine of up to 6 percent of companies’ global annual revenue could be assessed if firms don’t comply.   Follow us on Twitter Carmen Paun @carmenpaun Daniel Payne @_daniel_payne Ruth Reader @RuthReader Erin Schumaker @erinlschumaker Evan Peng @thepngfile   Follow us

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