Bill Overview
Title: Ryan White PrEP Availability Act
Description: This bill expands the use of Ryan White HIV/AIDS Program grants for providing medical care and services to low-income individuals with HIV/AIDS. Recipients may use the grants to provide pre-exposure prophylaxis (PrEP) and related preventive services for individuals who are at risk of contracting HIV.
Sponsors: Sen. Scott, Rick [R-FL]
Target Audience
Population: Individuals at risk of HIV globally (focusing on low-income)
Estimated Size: 1200000
- The bill targets individuals at risk of HIV, focusing on prevention through PrEP.
- Globally, millions are at risk of contracting HIV due to various factors like lack of information, medical services, unsafe practices, or high prevalence areas.
- PrEP is a highly effective prevention method when used properly, reducing the risk of HIV from sex by about 99% and from intravenous drug use by at least 74% when taken daily.
- Low-income individuals often lack access to comprehensive healthcare services, making them vulnerable.
- The global population at risk for HIV, including low-income individuals who would benefit from PrEP and related services, is substantial.
Reasoning
- The policy aims to help low-income individuals at risk of HIV by expanding PrEP access, effectively reducing new HIV infections.
- PrEP is expensive, and without insurance or assistance, at-risk individuals may not afford it. This policy addresses this barrier by making PrEP more accessible.
- While the policy targets a significant number of at-risk individuals, the U.S. has a varied population. Many might not be impacted, either because they do not fall under the risk categories or already have access to PrEP through other means.
- The policy has a significant budget, but it must cover both PrEP provision and related services, like counseling and regular health check-ups, to be effective.
- To keep within the budget while maximizing effect, the distribution of resources must be strategic, focusing on high-need areas and populations first.
Simulated Interviews
Receptionist (Atlanta, GA)
Age: 34 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 7/20
Statement of Opinion:
- I'm worried about my health and can't afford medications like PrEP on my current salary.
- It's comforting to know this policy could help people like me protect ourselves better and keep healthy.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 9 | 5 |
| Year 20 | 9 | 5 |
Freelance Graphic Designer (San Francisco, CA)
Age: 28 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 5/20
Statement of Opinion:
- I'm glad to see more support for PrEP, though in San Francisco, access isn't as much of an issue as it might be elsewhere.
- Broader education and prevention programs are also essential in tackling HIV spread.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 8 | 7 |
| Year 20 | 8 | 7 |
College Student (Miami, FL)
Age: 22 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 6/20
Statement of Opinion:
- As someone who knows peers who struggle with HIV risk, this policy is a significant positive step.
- I hope the policy also includes education so more people understand and trust using PrEP.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 9 | 6 |
| Year 10 | 9 | 6 |
| Year 20 | 9 | 6 |
Teacher (New York, NY)
Age: 45 | Gender: female
Wellbeing Before Policy: 8
Duration of Impact: 0.0 years
Commonness: 10/20
Statement of Opinion:
- Although I'm not the target audience, it's crucial that such policies exist to support those without means.
- It seems like a responsible use of funds to invest in prevention rather than treat.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 8 | 8 |
| Year 10 | 8 | 8 |
| Year 20 | 8 | 8 |
Bartender (Los Angeles, CA)
Age: 31 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 8/20
Statement of Opinion:
- I'm happy about increased accessibility, though I worry about awareness. Already using PrEP, so not directly impacted but it's good more will benefit.
- The management of funds and implementation of such services are vital.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 8 | 6 |
Unemployed (Dallas, TX)
Age: 39 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 20.0 years
Commonness: 2/20
Statement of Opinion:
- Having access to things like PrEP could be a lifeline for people in unstable situations like mine.
- I hope it also means better general healthcare access, though my focus is on staying healthy in precarious conditions.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 7 | 4 |
| Year 5 | 7 | 4 |
| Year 10 | 8 | 4 |
| Year 20 | 8 | 4 |
Retired (Charlotte, NC)
Age: 50 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 0.0 years
Commonness: 10/20
Statement of Opinion:
- Programs like this are crucial, though I don't personally benefit.
- I support the community benefits, and it's a wise direction for public health policy.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 7 | 7 |
| Year 20 | 7 | 7 |
Pharmacy Technician (New Orleans, LA)
Age: 26 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 5/20
Statement of Opinion:
- It's reassuring to see more preventive actions being taken, although my own risk is lower being in a stable relationship.
- I hope the policy brings education so people understand the protection PrEP offers.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 8 | 6 |
Musician (Chicago, IL)
Age: 30 | Gender: other
Wellbeing Before Policy: 5
Duration of Impact: 15.0 years
Commonness: 3/20
Statement of Opinion:
- We often advocate for more inclusivity in health policies, and this seems like a proper step forward.
- I hope it becomes a step to better inclusion of diverse communities vulnerable to HIV.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 8 | 5 |
Social Worker (Jackson, MS)
Age: 40 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 20.0 years
Commonness: 4/20
Statement of Opinion:
- A policy like this could really support my work and offer more tools to protect my clients.
- Implementation needs thorough planning to reach those most in need effectively.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 9 | 6 |
| Year 5 | 9 | 6 |
| Year 10 | 9 | 6 |
| Year 20 | 9 | 6 |
Cost Estimates
Year 1: $1000000000 (Low: $800000000, High: $1200000000)
Year 2: $1050000000 (Low: $850000000, High: $1250000000)
Year 3: $1100000000 (Low: $900000000, High: $1300000000)
Year 5: $1150000000 (Low: $950000000, High: $1350000000)
Year 10: $1300000000 (Low: $1100000000, High: $1500000000)
Year 100: $2000000000 (Low: $1700000000, High: $2300000000)
Key Considerations
- The cost-effectiveness of PrEP relies heavily on adherence rates and the ability to reach the high-risk population effectively.
- There are potential disparities in access that could limit the effectiveness of the program if not adequately addressed.
- Long-term benefits hinge on maintaining funding levels and ensuring the sustainable provision of services.