This week, French President Emmanuel Macron said condoms would be made available free of charge in pharmacies for 18 to 25 year olds, starting in January 2023. The main aim of this new policy is to fight the spread of disease. sexually transmitted diseases (STDs). Health authorities estimate that the number of STDs in France increased by 30% in 2020 and 2021. The government will also provide free STD tests to the same age group.
Condoms are already partially reimbursed by the national health system if prescribed by a doctor or other health professional. In concrete terms, the health insurance reimburses 60% of the costs. People with additional insurance can be fully reimbursed.
Last week, the French parliament also passed a law that allows young women to get a free morning after pill from the pharmacy after unprotected sex.
For several years, the French legislator has been pushing for better access to hormonal contraception and condoms, to curb unwanted pregnancies and target the spread of STDs.
The United States is also seeing a sharp increase in STD cases, including a 26% increase in new syphilis infections in 2021. And HIV cases increased by 16% in 2021.
The emerging STD crisis is prompting public health officials in the United States to call for new prevention efforts. The Centers for Disease Control and Prevention (CDC), for example, suggests expanding condom distribution programs as a “cost-effective structural intervention that provides communities with the resources needed to prevent the spread of HIV.” Here, the CDC recommends testing for STDs, as it does for HIV, and has a link that includes clinics and other sites where testing is free.
But, as is often the case in the United States, what happens in practice at the local level is a patchwork of politics. Some clinics offer free condoms and STD tests. But the availability of clinics can be a problem, especially in rural areas.
Public health officials have promoted the idea of home testing kits for STDs, to make testing easier to access. But the tests tend to be quite expensive for consumers and are generally not reimbursed. This year, California became the first state to require health insurers to cover home STD testing. Other states may follow.
Similarly, the situation in the UK and Europe is varied. In the UK, for most people under 25, STD tests are free. However, free tests are not (yet) available in pharmacies. Condoms can be obtained free of charge from family planning clinics and from the local GP. However, the British Medical Association is calling on the government to provide free condoms in all pharmacies, as this would reduce barriers to access.
Most European Union (EU) countries offer free condoms and STD testing at sexual health clinics. However, condoms and STD tests are not widely available free – for any age group – in pharmacies or primary care practices.
The use of hormonal contraceptives still requires a prescription in most European countries as it does in the United States. Nevertheless, an increasing number of European countries have over-the-counter (OTC) availability. This also includes the UK. In addition, emergency contraception (morning after pill) is available over the counter in almost all EU countries. Throughout Europe, out-of-pocket costs for all types of hormonal contraceptives are generally minimal, or even free if obtained from birth control clinics and most sexual health clinics.
The increase in STD infections led France to decide to facilitate free access to condoms and STD screening tests in pharmacies for the 18 to 25 age group. And, the French are expanding free access to hormonal contraceptives for women. The UK and a number of other countries in Europe appear to be adopting similar measures to address public health needs, although policies are unlikely to be harmonised. In the United States, public health officials have advocated expanding access to free STD testing and condoms. However, it is likely that considerable variation will persist at the local and state level, and for most people these items will not be freely available.
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