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Grad Student Groups Call on HUHS to Reform HIV Medication Policy

Seven Harvard graduate student organizations submitted a letter to Harvard University Health Services calling on Harvard to increase the refill quantity limit for medications used to treat and prevent HIV infection.
Seven Harvard graduate student organizations submitted a letter to Harvard University Health Services calling on Harvard to increase the refill quantity limit for medications used to treat and prevent HIV infection. By Kai R. McNamee
By Isabella B. Cho, Crimson Staff Writer

Seven Harvard graduate student organizations submitted a letter to Harvard University Health Services Wednesday calling on Harvard to increase the refill quantity limit for medications used to treat and prevent HIV infection.

Sent on World AIDS Day on Dec. 1, the letter — addressed to HUHS Executive Director Giang T. Nguyen — urges the University to increase the quantity limit of an HIV medication refill from 30 days to 90 days. Under the Harvard University Student Health Program, prominent medications used to treat and prevent HIV fall under medications that are limited to 30-day supplies, per refill, at network pharmacies.

The letter requests that HUHS formally review and alter the 30-day medication list with its insurance partner Blue Cross Blue Shield at the beginning of the new calendar year.

University spokesperson Jason A. Newton wrote in an email that Nguyen plans to respond directly to the undersigned organizations, which include LGBTQ@GSAS, Harvard Law School Lamda, and the Harvard Graduate Students Union-United Auto Workers.

In the letter, the student groups argued the current quantity limit puts patients at risk. The current 30-day supply limit increases the potential for discontinuity of care, according to the letter.

The letter also states that the 30-day quantity limit “runs counter” to the 90-day dosage recommendation for HIV medication offered by the United States Department of Health and Human Services and Centers for Disease Control and Prevention.

“On May 15, 2020, the CDC issued a ‘Dear Colleague’ letter to providers, recommending that clinicians ‘consider providing a prescription for a 90-day supply of PrEP medication (rather than a 30-day supply with two refills) to minimize trips to the pharmacy and to facilitate PrEP adherence,’” the letter reads.

The letter addresses the stigma faced by patients seeking HIV treatment or preventative medication.

Lamda co-president Courtney G. Dougherty, a third-year student at the Law School, said she believes the 30-day supply limit exacerbates prejudice surrounding people vulnerable to HIV.

“Specializing it [HIV medication] for what is essentially no reason — at least that I can think of — only adds to that level of stigma,” Dougherty said. “The stigma around it really is so nefarious and unnecessary, and just incorrect. And then from there, it just makes people’s lives easier.”

Dougherty, who works at on issues surrounding trans and BGLTQ+ healthcare discrimination at the Law School, called the 30-day supply limit “arbitrary.”

“We know that PrEP [pre-exposure prophylaxis] is this amazing drug, and we know it’s so helpful — it basically makes your viral load of HIV non-existence, it prevents the spread of this disease, it does all of these things,” she said. “There’s no reason why we should just put one more straw on the camel’s back.”

LGBTQ@GSAS co-president Daniel A. Arias, who helped draft the letter, said 30-day supply limits place an additional onus on patients.

“It puts additional barriers in place for patients already facing significant challenges in accessing equitable, high-quality healthcare,” he wrote in a Wednesday press release.

Arias, who is a graduate student in Population Health Sciences, recognized efforts made by HUHS to support the health of BGLTQ+ students at Harvard. He said he hopes HUHS builds on its commitment by implementing the letter’s recommendations.

“We are hopeful that HUHS will be responsive to the concerns we raise,” he said. “And we have reason to be hopeful: HUHS has done excellent work to promote LGBTQ+ health at Harvard, and we know they remain dedicated to ensuring equitable health care that meets student needs.”

—Staff writer Isabella B. Cho can be reached at isabella.cho@thecrimson.com. Follow her on Twitter @izbcho.

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