Hall Evan
University of Michigan.
Undergrad J Public Health Univ Mich. 2022;6:98-108. doi: 10.3998/ujph.2316. Epub 2022 Apr 29.
Pre-exposure prophylaxis (PrEP) is a revolutionary medical advancement to prevent HIV infection upon exposure. However, since its introduction in 2012, PrEP largely remains inaccessible to adolescents who do not wish to disclose their PrEP usage through an explanation of benefits (EOBs) and who are covered under a parent/guardian insurance. This literature review uniquely documents the concept of insurance as a barrier to PrEP access because of EOBs and how non-governmental organizations (NGOs), including community-based organizations (CBOs), have addressed this insurance policy problem. Based on the results of this review, a new approach to resolving EOBs as a barrier to PrEP access for adolescents has the potential to be implemented at the state level across the country. The approach focuses on clarifying the definition of "endanger" under HIPAA to grant adolescents the privilege of medical disclosure as it relates to EOBs.
暴露前预防（PrEP）是一项预防暴露后感染艾滋病毒的革命性医学进展。然而，自2012年引入以来，对于那些不希望通过效益说明（EOBs）披露其PrEP使用情况且由父母/监护人保险承保的青少年来说，PrEP在很大程度上仍然难以获得。这篇文献综述独特地记录了由于EOBs导致保险成为PrEP获取障碍的概念，以及包括社区组织（CBOs）在内的非政府组织（NGOs）是如何解决这一保险政策问题的。基于这一综述的结果，一种将解决EOBs作为青少年获取PrEP障碍的新方法有可能在全国各州层面实施。该方法侧重于明确《健康保险流通与责任法案》（HIPAA）下“危及”的定义，以赋予青少年与EOBs相关的医疗信息披露特权。
