The decision by the company — which operates across the southeast — is leading some to wonder if the company has "moral" objections to PrEP.

Publix, a large supermarket chain in the southeastern U.S., has reportedly refused to cover HIV prevention medication through its employee insurance plans.

Publix has excluded coverage for medication used in the prevention strategy known as PrEP, or pre-exposure prophylaxis, reports The Body, a site devoted to news about HIV and AIDS. Truvada is the only drug so far approved for use as PrEP, which involves taking the medication daily to prevent the user from acquiring HIV if exposed. Studies have indicated it is nearly 100 percent effective in preventing HIV transmission if taken as directed.

David Holland, director of the Fulton County PrEP Clinic in Atlanta and an assistant professor of medicine at Emory University, told The Body he had tried to obtain PrEP coverage for a patient who works for Publix, and the company rejected it, even after an appeal. “We’ve started over 400 people on PrEP at our clinic alone, and this is the only person that we weren’t able to get PrEP for,” he said.

Publix gave boilerplate answers to the site’s inquiries about the denial of coverage. “Annually, we evaluate benefits covered under our health plans,” Publix spokeswoman Brenda Reid said in a written statement. “There are numerous medications covered by the plan used in the treatment of HIV. … There are some medications that have coverage limitations or require prior authorization. Any Publix associate with questions regarding his or her coverage can contact our benefits department directly.” She also said Publix’s health insurance plans “provide generous medical and prescription coverage.”

HIV activists said the denial is probably not related to cost, as few employees would seek PrEP, and they pointed out that HIV prevention is much less costly in the long run than HIV treatment. That led some to wonder if the denial came on supposedly “moral” grounds.

Florida-based Publix is a closely held private company, controlled largely by the heirs of founder George W. Jenkins, while employees own 30 percent of its stock. Its political action committee and members of the board of directors have donated largely to Republican politicians, The Body reports.. It has a zero rating on the Human Rights Campaign’s Corporate Equality Index, apparently because, unlike most large companies, it doesn’t participate in HRC’s survey on policies affecting LGBT employees.

Over the past few years, several employees have complained of anti-LGBT discrimination at Publix stores, The Body reports, citing the activist group Equality Florida and Miami’s New Times newspaper. A cake decorator at a Publix store who said he was fired for being gay filed a complaint with the Broward County, Fla., Human Rights Board a few years ago, resulting in the board ordering Publix to pay him $100,000, but the decision was subsequently reversed, New Times reports. The company also lagged its competitors in making domestic-partner benefits available to employees’ same-sex partners, according to the paper. Yet many employees have said Publix is an excellent place to work.

The denial of PrEP coverage is not illegal under federal or state law, but activists can help change the situation by speaking out, Anne Tucker, associate professor at the Georgia State University College of Law, told The Body. “I'm not sure it’s legally actionable, but that doesn't mean it’s not reprehensible,” she said. “That doesn't mean that it’s not a bad public relations story; that doesn’t mean it can’t be the focus of other campaigns to try to change it.”