Health insurer UnitedHealthCare apologises for rejection letter citing ‘high risk homosexual behaviour’

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A US heath insurance giant has apologised for telling a man he cannot have HIV-preventing drugs because of “homosexual behaviour”.

UnitedHealthCare had faced online outrage after a letter to a gay man was made public in which the insurer refuses to provide Pre-Exposure Prophylaxis (PrEP) drug Truvada, which drastically lowers the chance of being infected with HIV.

The letter to Thomas Ciganko had said: “The request for coverage is denied. This decision is based on health plan criteria for Truvada. The information sent in shows you are using this medicine for High risk homosexual behaviour.”

The baffling letter goes on to detail the conditions for prescribing Truvada, suggesting that the man did not meet the criteria for “pre-exposure prophylaxis to reduce the risk of sexually acquired HIV infection in adults at high risk”.

HIV activists said it was clear that men who have sex with men do meet the criteria, questioning United’s procedures and branding the letter a “malicious attempt to discourage PrEP uptake by people who need it most”.

Health insurer UnitedHealthCare apologises for rejection letter citing ‘high risk homosexual behaviour’

Following a high-profile campaign, the insurer said in a statement that it “regrets” the wording used in the letter.

A statement said: “We apologize for the insensitive language appearing in the letter and regret any difficulty it caused.”

UnitedHealthCare said it would make a number of changes to procedure following the row.

It explained: ” We have corrected our letters, removed the prior authorization requirement for Truvada and members can fill their prescription at the network pharmacy of their choice.”

Removing the prior authorization requirement means people will not be forced to seek permission through the bureaucratic process in order to fill their prescription.

Activist James Krellenstein, who had penned a petition against the change, said: “Activism works.


“After only five days of pretty intense pressure from AIDS activists, we got one of the largest health insurers in the nation — UnitedHealthcare — to completely cave.

“If you are on United, you will no longer be required to do **any** prior authorization or use a mail order pharmacy to procure Truvada. Thanks to the nearly 3,000 people who signed our petition to the health commissioner.”

The World Health Organisation has recommended PrEP for men who have sex with men, in order to lower the risk of HIV infection.

In the United Kingdom, PrEP is set to be made available for free on the National Health Service as part of a three-year trial.

The trial in England will provide PrEP to 10,000 people, while PrEP will also be made available under devolved healthcare administrations in Wales an Scotland.

What is PrEP and how can I get it? Everything you need to know about HIV-preventing drugs