The judge ruled that providing the anti-HIV drugs via the healthcare system was unlawful after siding with Conservative lawyers who challenged the measure on religious grounds.

The legal challenge was mounted in 2020 by eight Texan individuals and two Texan businesses. It was argued that the free PrEP requirement, as well as free coverage requirements for contraceptives and the human papillomavirus (HPV) vaccine, requires business owners to pay for services that “encourage homosexual behavior, prostitution, sexual promiscuity and intravenous drug use” despite their religious beliefs.


Perry N. Halkitis, Dean of the Rutgers School of Public Health, slammed the Texas ruling that the U.S. Affordable Care Act’s requirement that private insurance plans cover HIV pre-exposure prophylaxis (PrEP) at no cost to patients as unconstitutional as “egregious lack of separation between church and state.”

Speaking about the ruling, Dr Halkitis said,

“The use of antivirals in the form of pre-exposure prophylaxis, which has been approved since 2012, has been a game changer in our fight against HIV and AIDS as the application of PrEP allows individuals to have one more tool to prevent them from acquiring HIV. The result has been dramatic decreases in the HIV infection rate in the United States.


By decreasing the incidence of HIV, the number of people who require lifelong treatment also goes down, which puts less of a burden on our society economically and in terms of the health of populations. The ruling by U.S. District Judge Reed O’Connor is extremely shortsighted. It is reminiscent of decisions in the 1990s to prevent the distribution of condoms in schools.

Without covering PrEP, highly at-risk populations — mostly gay and bisexual men and Black women — will continue to become infected with HIV, perpetuating this ongoing epidemic in our society. The decision of the judge is ultimately one that will spread further disease and cause harm to the people of Texas. In the end, this will lead to an increase in the number of infections in people living with HIV in Texas and across the United States, creating a larger number of individuals who require lifelong treatment and creating burdens on their lives and creating burdens on our economy.

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This misinformed or misguided decision based solely on the individual’s religious beliefs is another example of the egregious lack of separation between church and state which is undermining the health of all of us.”

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