Radically different
Figure 2 from the PURPOSE-1 trial changed the world.
Between gray and red bars representing the study’s background HIV incidence and the arms randomized to receive oral pre-exposure prophylaxis (PrEP) was white space filled only by a previously unimaginable number: zero. Zero infections over one year among the 2,134 cisgender adolescent girls and young women who received the novel long-acting injectable antiretroviral lenacapavir.
A patient came to my office recently and told me she had stopped her statin. She’d been on it for two years. Her coronary artery calcium score was 280 and LDL was 168, up almost 100 points since she had stopped taking her statin. Her father had died from a heart attack at 58.
When I asked about the decision, she crossed her arms and furrowed her brow.
The U.S. Supreme Court ruling this week against Colorado’s ban on licensed mental health providers engaging in gender and sexuality “conversion therapy” could narrow the authority of state medical boards to regulate aspects of health providers’ care that involves speech, according to legal experts. The implications could extend far beyond matters related to LGBTQ+ rights to other forms of talk therapy, telehealth, and physician advice on Covid-19, vaccines, or reproductive care.
Because the therapist who challenged the law, Kaley Chiles, engages in talk therapy — without prescribing medications or having any physical contact with patients — the majority decided that the Colorado law constitutes a restriction on her speech due to her particular viewpoint, or opinion. In an 8-1 decision, the judges sent the case back to a lower court for a higher level of judicial scrutiny, which will likely result in the ban being overturned.