The cost to cover HIV prevention drugs may be causing employers to hire fewer gay men, study finds

When preventive HIV medications are offered through employer-sponsored health insurance, the annual income of gay men in the U.S. declines and part-time employment rates go up, an Aug. 17 study from researchers at Troy, N.Y.-based Rensselaer Polytechnic Institute found.

The study analyzed 10 years of Census Bureau data. Researchers found that  young white men are most affected because they are the most likely to be taking HIV prevention drugs, which must be covered under the ACA.

The study specifically looked at Truvada, a drug released in 2012 that prevents HIV infection with a price tag of about $20,000 annually. Researchers found that since the release of the drug and its availability from employers, American men in same-sex relationships saw their incomes decrease $2,650 (3.9 percent) compared to men in opposite-sex relationships. For gay men working full-time, the decrease was $3,013.

In addition, during the same period the proportion of men in same-sex relationships working part-time increased 10.7 percent.

Similar numbers were not observed among women in same-sex relationships.

The researchers wrote that because new and more expensive medications increase employers' healthcare expenditures, there is an incentive to hire applicants that don't use them.

"Employer-sponsored insurance clearly affects workers by sexual orientation which could also help to explain some of the historical wage penalty for gay and bisexual men," Conor Lennon, PhD, an associate professor of economics at Rensselaer, wrote. "Moreover, given recent FDA approvals of increasingly expensive pharmaceuticals – such as Aduhelm for Alzheimer's – future work should try to estimate how the costs of new medications impact the earnings and employment of those workers likely to need access to such expensive drugs."


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