House Adopts Lewis Amendment Increasing Access To Teen HIV Prevention

FRAMINGHAM, MA - As part of the Massachusetts House’s budget debate last week, an amendment filed by Rep. Jack Lewis (D-Framingham) was adopted to increase access to HIV prevention services for youth across the Commonwealth.

The amendment is based on legislation championed by Lewis, Rep. Chynah Tyler (D-Boston) and Senator Julian Cyr (D-Truro).

“Our Commonwealth must do everything possible to empower young adults to make informed choices relating to HIV prevention,” said Lewis. “Ensuring equitable accessibility to life-saving, life-enhancing HIV-prevention medication is instrumental to efforts to achieve zero new cases and zero stigma around HIV.

"It is a great honor to partner with Rep. Chynah Tyler, Senator Julian Cyr, and so many public health advocates on this vital change to Massachusetts law," he continued. "I will be forever grateful to Speaker Ron Mariano, Chair Aaron Michlewitz, and Chair Marjorie Decker for their leadership in making this vital change a reality."

Lewis served as the founding executive director of OUT MetroWest, a Framingham-based non-profit committed to helping the region’s LGBTQ+ youth thrive. It was in this capacity that he first learned of the barriers to access for our Commonwealth’s young people.

“When the original statute was passed,” added Lewis, “the idea of HIV prevention medication was not yet fully realized, so our current laws were drafted too narrowly, creating unnecessary and unintentional barriers to HIV prevention services.”

Preexposure prophylaxis (PrEP) is an FDA-approved prescription medication that, when taken daily, reduces the risk of getting HIV from sex by more than 90%. Under the current statute, the “mature minor” rule, minors may give their consent for many sensitive services, including treatment of sexually transmitted diseases, but prevention services such as PrEP are not explicitly permitted by law.

“The physicians of the Massachusetts Medical Society applaud passage by the Massachusetts House of policy that expands access to critical pre-exposure prophylaxis (PrEP) HIV medication for adolescents,” said Dr. Carole E. Allen, President of the Massachusetts Medical Society. “Young people, especially LGBTQ youth and LGBTQ youth of color, are disproportionately impacted by HIV, and the pandemic has exacerbated barriers to HIV testing, prevention, and care.

"Minors are currently permitted to consent to a myriad of sensitive health services, including the treatment of sexually transmitted infections, HIV among them," she added. "This policy will enable young people to obtain PrEP medication, a critical preventive tool that will decrease the rate of new HIV infections among young people, lessen disparities in infection rates, reduce life-long disease burden, and ultimately save lives.”

"The health and well being of our youth is one of the most important issues that we face,” noted Tanya Neslusan, Executive Director of MassEquality. “We are extremely grateful to Representative Lewis and the cosponsors of this budget amendment for fighting to ensure that youth in the Commonwealth have access to PrEP to prevent further spread of HIV and taking us one step closer to eliminating HIV transmissions for future generations.”

Fourteen percent of new HIV diagnoses are young people, ages 14-24 years old, and are disproportionately Black and Latino, according to the Massachusetts Department of Public Health, which estimates that only a fraction of those at risk of HIV infection who are candidates for PrEP have accessed this new tool.

“We know that LGTBOIA+ youth face major barriers in obtaining adequate access to healthcare, particularly Black and Brown,” said Tyler. “Healthcare is a right that should be available to all citizens, and today we made that a reality for many. I am honored to collaborate with Rep. Lewis to champion this important piece of legislation for the LGBTQIA+ community."

“The commission commends the Massachusetts legislature for this significant stride towards increasing access to HIV prevention medication for our most vulnerable youth,” noted Shaplaie Brooks, Executive Director of the MA Commission on LGBTQ+ Youth. “This bill speaks to the intersectional nature of HIV prevention for all people in Massachusetts.

"The BIPOC community’s access to preventative care is at the cornerstone of the health equity crisis," Brooks continued. "We understand that we miss an entire population of youth who are afraid to identify as LGBTQ+ because they fear rejection from their families, and that BIPOC youth are far more likely to face familial rejection. With nearly 14% of reporting school aged youth in Massachusetts identifying as LGBTQ+, 18.1% of reporting LGBTQ+ youth having received STI testing, and reporting trans-identified students being four times as likely to have experienced sexual violence, the need for all youth - especially unreported youth - to have access to harm reducing remedies is urgent.”

"Barriers to care are more frequently faced by the most vulnerable in our communities--particularly LGBTQIA+ and BIPOC young people,” added Carl Sciortino, Vice President of External Relations at Fenway Health. “They are also among the most at risk for HIV, making this preventative measure even more crucial. This effort removes a barrier to access necessary healthcare, and we applaud Representative Lewis, House leadership, and members of the House for supporting this commonsense public health policy."

“GLAD congratulates Representative Lewis and the Massachusetts House of Representatives,” said Ben Klein, AIDS Law Project Director at GLAD, "for their leadership in acting to ensure that all young people in Massachusetts have access to the most effective means of preventing HIV transmission. This legislation is a huge step forward in ending the HIV epidemic in the Commonwealth.”

Lewis said he connected this victory in the Massachusetts House to larger international efforts to combat stigma around HIV/AIDS and expand awareness and access to HIV prevention services. He currently serves on the Steering Committee of the Global Equality Caucus, an international caucus of pro-equality legislators and parliamentarians.

“Successful passage of this bill demonstrates the meaningful effect that legislators can have on tackling the inequities that afflict marginalised communities,” said Alan Wardle, Director of the Global Equality Caucus. “Extending the provision of PrEP means that HIV prevention strategies will now reach more people at disproportionate risk of being exposed to the virus, namely LGBTQ+ youth and people of color. This is a win for the people of Massachusetts, and we thank the legislative champions that made it happen.”

This language was included in Consolidated Amendment “D” of the House budget, along with other amendments relating to public health, mental health, and disabilities.

Lewis was first elected in 2016 and represents the communities of Ashland and Framingham.