The Efficacy of State-Level PrEP Access Programs: A Tale of Two States

By Noah Zwiefel, Macalester College

Pre-exposure prophylaxis (PrEP) reinvents what we know about HIV prevention by nearly eliminating the risk that an individual will seroconvert after exposure to HIV. Uptake, however, has been slow in many areas where it would be most beneficial. In recent years, several states have introduced programs designed to increase PrEP uptake. Some, as in Washington, focus only on decreasing price; others, such as in New York, focus on addressing other factors, such as a lack of awareness of PrEP among potential patients, and lack of buy-in from providers. In this paper, I use synth and difference-in-differences to examine the efficacy, in terms of increased PrEP prescriptions, of New York and Washington’s PrEP access programs. I find relatively weak evidence that Washington’s less comprehensive program was associated with at most 700-900 new prescriptions between 2014-2016, and stronger evidence that New York’s more sweeping program is associated with an increase of between 5,000-6,000 prescriptions.

Read the full paper here.

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