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One of the most effective factors in containing the spread of HIV has been the widespread availability of preexposure prophylaxis (PrEP). A PrEP regimenwhich has grown to include daily pills or injections every few monthscan decrease the chances of HIV infection by up to 99%. To build on those gains, in 2021, the federal government, under the Affordable Care Act, mandated that health insurers fully cover PrEP, as well as clinical visits and the labs required every three months. But an upcoming hearing before the Supreme Court could upend that mandate. The casebrought by six individuals and two companiesis focused on whether mandating coverage of PrEP violates the religious freedom of certain business owners. Braidwood Management, one of the companies, is arguing PrEP coverage facilitates and encourages homosexual behavior, intravenous drug use, and sexual activity outside of marriage between one man and one woman,” according to the organization’s petition to the Supreme Court. HIV doesnt just impact the LGBTQ community, says Kate Steinle, chief clinical cfficer at Folx Health, a healthcare provider focused on the queer community. Removing this coverage [would] affect so many people. There are currently 1.2 million people in the United States with HIV. While HIV infection rates have decreased over 75% since the mid-1980s, in 2022 there were at over 31,000 new cases of HIV infection in the US. About 20% of the new cases are women, 83% of whom were infected during sex with men. Without insurance coverage, generic PrEP could cost up to $60 a month, not including lab-work and clinical visits. At Folx Health, cash prices for an initial visit to get PrEP costs $159, follow-up visits cost $79 each, and labs run $97 a year. If you have good insurance, the out-of-pocket costs might not prevent you from getting PrEP, says Edwin Corbin-Gutierrez, a senior program advisor at NASTAD, a nonprofit that represents public health officials focused on HIV and hepatitis. However, it can be a big burden for some people and the biggest impact will be on lower income people and the most marginalized. A 2024 study found that a small price increase from $0 to $10 a month for PrEP would double the rate of people who dont use PrEP. The study also found that the rate of new HIV infections among people who dont have a PrEP prescription was double or triple the rate of new HIV infections for people who use PrEP. Companies who sell PrEP are now scrambling to come up with a plan that protects public health should coverage fall through. Were in wait and see mode, says Daphne Chen, cofounder of TBD Health, a telehealth company that offers PrEP and sexual health services. Were hopeful that the government doesnt want an HIV epidemic on its hands. Both TBD Health and Nurx, another telehealth company that prescribes PrEP and treats other health conditions, have said that theyll work to keep costs as low as possible and to partner with nonprofits to help fund people who won’t be able to pay for PrEP without insurance. Nurx says approximately 15% to 20% of its patients are not using insurance to pay for PrEP. This comes at a really unfortunate time when were making great strides in the fight against HIV, says Neil Parikh, chief medical officer at Thirty Madison, Nurxs parent company. Well do whatever we can to make this affordable and connect patients to assistance programs. However, its not always as simple as wanting to make healthcare accessible. Blue Cross Blue Shield filed an amicus brief with the Supreme Court in which it argued that if some insurers drop PrEP and other preventative service coverage, other insurers will feel pressured to follow suit in the interest of keeping costs down and remaining competitive. Preventative care isnt just a health policy issue, its a business issue, says Elizabeth Kaplan, director of health care access at the Center for Health Law and Policy Innovation at Harvard Law School. According to a 2021 study, the cost of treating HIV can range from $400,000 to $1 million per person over the course of their life. Kaplan also points out theres a new treatment for PrEP on the horizon: an injection that can last for six months (some existing injections last for three months at a time). This could further reduce HIV transmission rates for had to reach people facing housing insecurity or addiction issues who may struggle with PrEP in the form of a daily pill, or with the three-month testing requirement. Kaplan adds that a ruling that ends required coverage of PrEP doesn’t have to spell the end of it. “Companies can still choose to cover PrEP without copays, she says. We urge them to do so. Its the right thing to do.
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This article is republished with permission from Wonder Tools, a newsletter that helps you discover the most useful sites and apps. Subscribe here. Books offer a compelling, slower alternative to the onslaught of negative news. With terrific new free tools, its increasingly easy to access print, digital, and audio books. Read on for my favorite book sites and apps. The heavy-hitters Libby lends out free e-books and audiobooks through libraries in 78 countries. It works for 90% of U.S. libraries. You can search for and check out nearly anything, instantly, for free, on any device. Audiobooks: Check out and listen to audiobooks at any speed. You may not need to pay for an Audible subscription. Definitions: Click on any word in an e-book youre reading in Libby for its definition or to see where else that name or phrase appears. Highlight: Save memorable passages for your notes. Multiple cards: You can use multiple library cards within a single Libby account. That helps you check which library has the shortest waiting list for a book in high demand. (See where you can get non-resident library cards). Limitation: Libby is digital-onlyyou cant use it for physical books. That requires a separate app or site, like the NYPL app in New York. Kanopy provides free access to top-notch feature films and documentaries. I log in with my library card. Watch on the Web, iOS or Android, or on a SmartTV app like Google TV, Roku, or Amazon Fire TV. Limitation: libraries limit the number of videos you can watch monthly. Hoopla is an alternative to Libby that works with 3,900 library systems in the U.S., Canada, Australia and New Zealand. Like Libby it hosts audiobooks and e-books, but also bundles in comics, movies, TV shows, magazines, and music. Use Hoopla to read, watch or listen from the Web or on a mobile device. I recently discovered its free Bingepasses, which allow instant access to a collection of magazines or videos for a week. World Cat tells you which of 10,000 global libraries near you have a particular book. It works in multiple languages. Search for books in print, e-book, braille, audio, or other formats. Find your next read Most Recommended Books shows you a list of smart people. Pick an expert or celeb you like and see which books they recommend, along with brief quotes on why they like each book. Check Goodbooks.io and ReadThisTwice for more expert/celeb book picks. Whichbooks World Map offers a creative way to find a book about any part of the world. Select a country and see books set in that region. Where to find book recs is a nice list from a Writing About Reading post. I also like the eclectic recommendations in the New York Times Read Like the Wind newsletter. BookClubs lets you find a book group near you or organize your own. Fable hosts book clubs & communities for sharing what youre reading. Find free and cheap books Project Gutenberg has more than 75,000 free e-books and audiobooks. No registration required. See the top 100 list for free reading inspiration. The Internet Archive has searchable e-books and a free library collection. Bookbub is handy for bargain hunters. It shows discounted and free e-books. Available as a newsletter or check the site for deals. Support Independent booksellers Alibris has 200 million titles from indy booksellers around the world. Powells is the worlds largest independent bookstore. Bookfinder lets you search online to find any book at the cheapest price. Indiebound helps you find a nearby real-world indy bookstore. Abebooks has great deals from independents. Check its bargain books + collections. Caveat: Amazon has owned it since 2008. Tertulia is a well-designed online co-op bookshop owned by readers. Make your own book list Listy is free. Its easy to look up & add books, and later export your list. (See my prior post about it). LibraryThing is free and easy for cataloging books & tracking reading. Free Notion book tracking template lets you customize a collection page. Free Airtable book list template & my Airtable exmple: 30 authors I like. Find great childrens books Sora is a digital library for kids. Schools make e-books and audiobooks available on the app. It works well with graphic novels, picture books, as well as comic books and textbooks. (We also use Libby for kids books). Epic is another popular kids e-book app. Its fun to use, but be aware that it leans into gamification and extrinsic motivationusing points and streaks to entice kids to repeatedly open the app. Kanopy has a great kids section with video versions of books by Eric Carle, Mo Willems and other great authors to spark an interest in reading. It also has math and science lessons. This article is republished with permission from Wonder Tools, a newsletter that helps you discover the most useful sites and apps. Subscribe here.
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Middle managers have had a hard go of it over the past five years. There was the upheaval of the pandemic, followed by ongoing changes in the workplace as companies adjusted to remote work and then, in many cases, eventually brought employees back into the office. Amid all these fluctuations, managers have been tasked with mitigating low morale, parrying employee discontent, and juggling their mounting responsibilities, especially as recurring layoffs thin their ranks. It doesnt seem like the challenges middle managers are facing will disappear anytime soon, which could lead to high rates of turnover in the very near future. And its also not clear whether a new generation of workers is readyor willingto take their place if managers leave their posts. In surveys, Gen Z workers have indicated they have little interest in middle management and that high rates of anxiety might keep them from taking on those jobs. As managers struggle, Gen Z sees the toll of the job and backs away, leaving fewer employees to rise into management roles, writes entrepreneur Jan Bruce. This puts more pressure on remaining managers. Bruce argues that many companies could be facing a manager crash this year that would have far-reaching effects, particularly if younger employees dont want to step into those roles. But there are some things employers can and should do to help support their current middle managers, as well as those who might take their place in the future. Invest in programs that support middle managers One thing leaders can do is evaluate psychosocial risk, according to Bruce, which can identify some of the biggest stressors facing managers at the company. That can include everything from tight deadlines to workplace conflict or excessive workloads. Managers are also often expected to oversee day-to-day tasks while also taking on more strategic, long-term projects. Being explicit about mental health resources and other workplace benefits can also be an important aspect of supporting middle managers, who often report feeling invisible and underappreciated. Mandatory vacations or disconnect periods can help alleviate some of the burnout and stress that managers are likely feeling. Beyond that, however, they also need adequate support from their higher-ups. Making sure managers have consistent, supportive check-ins with their own supervisors can help reduce isolation, Bruce writes. Train the next generation of managers In order to make middle management more appealing, companies also need to think about how to cultivate a new crop of workers who are equipped to step into those roles. Bruce notes that it is important to focus on some of the skills that are most valuable in managers and perhaps underdeveloped among Gen Z employees. We have found the employees most skilled in handling change and challengethe realities that managers deal with dailyhave the highest levels of those very skills: emotion control, stress management, engagement, and positivity, Bruce says. These are the specific, actionable areas to focus Gen Z training efforts on in order to improve their ability to handle management demands. What managers can do If youre a manager looking for guidance, there are also steps you can take to better manage your workload and schedule. To avoid toggling between different tasks, management expert Lia Garvin recommends scheduling similar meetings on the same day. When our calendar looks like Swiss cheese, we can get in the habit of slotting in meetings whenever we have a free moment, but this reinforces the overwhelm of having to operate at so many different levels in one day, she writes. Since managers are often hopping from meeting to meeting, it can be difficult to accommodate more strategic work or long-term projects. It can help to pencil that work into your schedule instead of assuming youll be able to carve out time in your day. Senior leaders can also help address this pain point by limiting meetings to certain days. Instead of fitting work in where you can, plan for it, Garvin says. Find and schedule one to two hours every week for project time, during working hours, that you dont schedule over. Perhaps the most important strategy managers can adopt, however, is to delegate more and spend less time involved in the details of projects that dont require close attention. Think of this as a way to give your employees new opportunities while also freeing up time in your dayand hopefully making your job the slightest bit easier. Ultimately, the middle managers role is to empower their teams to grow, Garvin adds. Its impossible to do this when were too stuck in all the details and barely able to come up for air.
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