September 9, 2022 (WASHINGTON, DC) – A federal judge in the US District Court for the Northern District of Texas ruled earlier this week that the Affordable Care Act’s (ACA) provision requiring employers’ health insurance plans to provide access to pre-exposure prophylaxis (PrEP) for the prevention of HIV acquisition violates the religious rights and freedoms of employers afforded under the Religious Freedom Restoration Act (RFRA).


The International Association of Providers of AIDS Care (IAPAC) and its clinician-members in the United States condemn this egregiously odious ruling, which only serves to permit blatantly homophobic discrimination in the guise of “religious freedom.” In violation of nondiscrimination law, and contrary to scientific evidence about HIV prevention, the employer who brought the challenge falsely claimed that providing PrEP access violates its religious freedom because such access would “encourage homosexual behavior, prostitution, sexual promiscuity, and intravenous drug use.” Moreover, the ruling jeopardizes the United States’ efforts to decrease new HIV infections by 75% by 2025. When taken as prescribed, PrEP can reduce by up to 98% the possibility of HIV-negative individuals acquiring HIV. Access to all US Food and Drug Administration (FDA)-approved medications, including those approved for HIV prevention and treatment, must remain free from partisan judicial activism.


Additionally, Judge O’Connor’s ruling in Braidwood Management v. Becerra that the US Prevention Services Task Force (USPSTF) was unconstitutionally delegated Congressional power(s) threatens to upend preventive medicine in the United States. Pre-exposure prophylaxis for HIV is only one of nearly 100 preventive services recommended by the USPSTF. Health plans are required to provide coverage of these preventive services without copays or other similar cost-sharing burdens placed on the insured. If this ruling is allowed to stand, it subjects crucial health screening services such as testing for sexually transmitted infections and HIV, diabetes screening, and cancer risk assessments to unlawful discrimination and makes Americans vulnerable to the whims of employers seeking to skirt the patient rights afforded by the ACA – all in the name of “religious freedom.”


“We stand united with like-minded medical and patient advocacy allies across the United States in declaring that the ruling in Braidwood Management v. Becerra is a threat to the health of all Americans and an unacceptable interference in efforts to prevent new HIV infections in the United States,” said Dr. José M. Zuniga, IAPAC President/CEO. “Access to PrEP in no way bridges religious freedoms but instead honors the right of every person to dignity, health, and wellbeing. We call upon the ruling’s reversal on appeal. Additionally, we call for leadership in Congress to pursue legislative remedies to RFRA – up to and including repeal – to ensure individuals and institutions wishing to blatantly discriminate cannot hide behind a false shield of religious freedom.”