Two bills are moving through the Massachusetts legislature with a focus on magnifying access to medication for HIV preventive care, as well as to free menstrual hygiene products, particularly for those from historically underrepresented and marginalized populations. If passed, the first measure would enable pharmacists to administer pre-exposure prophylaxis (PrEP) and require the state’s Department of Health to provide pharmacists with training to do so effectively. The second measure would offer free menstrual products in easily accessible locations, such as in homeless shelters, public schools, and correctional facilities across Massachusetts.
How can PrEP help enhance health equity? The bill gained significant momentum on the heels of the publication of survey results from the Centers for Disease Control and Prevention (CDC) showing that roughly 23,000 individuals in Massachusetts had an HIV infection, which represented a rise of over 15% since 2011. Moreover, not only was there an additional 25,000 individuals thought to be at high risk for HIV, but approximately only one-third of that cohort had been prescribed PrEP. This data is notable in that the survey also illustrated that those lacking access to prescriptions are disproportionately comprised of minorities and injection drug users. As a result, health equity proponents see PrEP access as a key pathway to materially reducing disparities among those with HIV infections and, ideally, towards a zero HIV infection rate.
Similarly, the dissemination of free and accessible feminine hygiene products also is seen as a substantial conduit towards reducing health inequities. Specifically, with the cost of menstruation products averaging over $20 per month, many women cannot afford these products or, to do so, they need to miss time in class, take on additional jobs, or experience other negative impacts. Research also has shown that for incarcerated or unhoused women, they can also suffer from circumstances in which menstrual products are withheld from them, and even used as coercive tools. This Massachusetts bill, referred to informally as the “I AM” legislation, has the potential to help destigmatize menstruation and disproportionately assist resource-constrained women.
The health equity policies comprised in these bills are similar to the pending legislation in some other states that also are gaining momentum. These developments bode well for efforts to reduce health disparities and enhance health equity in the months and years to come.
