JOHN YANG: Tonight on PBS News Weekend, the potential barriers to accessing drugs that prevent HIV infection, including an ongoing legal challenge.

Then, a new study digs deeper into California's homeless population and why black and brown communities in cities like Chicago bear the brunt of automated speed cameras.

MAN: If we're going to generate revenue, it needs to be off the backs of the entire city of Chicago and not targeted towards the black and brown communities where the people are hurting the most.

(BREAK) JOHN YANG: Good evening.

I'm John Yang.

On this, the 500th day of the war in Ukraine, more Russian shelling took more Ukrainian lives.

The attack on the eastern Ukrainian town of Lyman killed at least eight civilians and wounded 13 others.

Ukrainian President Volodymyr Zelenskyy marked the day with a video showing him on Snake Island in the Black Sea, which has become a symbol of Ukraine's resistance.

Russian forces captured the island in the early days of the war, only to be forced to withdraw a few months later.

Zelenskyy is in Turkey, where President Recep Tayyip Erdogan endorsed Ukraine's membership in NATO, a bid that's a big flashpoint between Ukraine and Russia.

But President Biden told CNN's Fareed Zakaria that Ukraine shouldn't be admitted into NATO just yet.

JOE BIDEN, U.S. President: I don't think there is unanimity in NATO about whether or not to bring Ukraine into the NATO family now at this moment in the middle of a war.

And so I think we can work it out, but I think it's premature to say to call for a vote in now.

JOHN YANG: Ukraine's membership in NATO will likely be discussed next week, when President Biden and the leaders of other NATO nations gather in Lithuania.

Sudanese health officials say at least 22 people died in one of the deadliest airstrikes in three months of fighting.

It happened in Omdurman which is across the Nile River from Khartoum.

Paramilitary forces blame the attack on the Sudanese military.

There are no signs of let up in the fighting between the two sides.

In Southern California, six people are dead in this morning's crash of a small business jet.

The FAA says the Cessna Citation took off from Las Vegas and crashed about 300 miles away in a field in Murrieta, California, between Los Angeles and san Diego.

No word yet on the identities of the dead.

And the heat just keeps on coming.

More dangerous temperatures in the forecast for much of the south and Southwest.

Highs are expected to be over 110 in places like West Texas, Arizona and California.

Forecasters say this heat wave, stretching from Florida to California could last several weeks.

And meteorologists say weather patterns in the coming week could bring more smoke from Canadian wildfires to the upper Midwest.

Still to come on PBS News Weekend, a new study has fresh insights on California's homeless population.

And why speed cameras are disproportionately, affecting Chicago's minority residents.

(BREAK) JOHN YANG: The latest legal battle over the Affordable Care Act centers on its requirement that private health insurance fully cover preventive services like cancer screenings, vaccine nations in birth control.

Also on that list, drugs that prevent HIV infection called pre-exposure prophylaxis, or PrEP.

The retail price of PrEP can be as much as $6,000 for a 90 day supply.

That puts it out of reach for many of those who benefit from it but don't have insurance.

Shefali Luthra is a health reporter at the 19th News.

She focuses on the intersection of gender and health.

Shefali, first of all, tell me about PrEP.

How effective is prep?

SHEFALI LUTHRA, The 19th: PrEP is incredibly effective.

Studies put it at more than 90 percent effective in preventing HIV.

Some would call it a wonder drug, and it's not entirely wrong.

It has really transformed what it means to sort of live in our society, especially if you are in a group that is high risk for contracting HIV.

Taking PrEP largely in a daily pill, although there is a new injectable form as well, can really allow you to live a life that is much safer, much freer of risk, and just without the fear of contracting a disease that in the past has been incredibly dangerous.

JOHN YANG: Given those benefits.

Given what you just said, PrEP, the pills have been around for about a decade now, but the CDC estimated in 2020 that only about a quarter of the people who would benefit from PrEP are actually on PrEP.

Why that gap?

SHEFALI LUTHRA: There has been a historic number of reasons as to why PrEP uptake wasn't as high and still isn't as high, frankly, as how public health experts would like a large one.

In the past, as you mentioned, was the price tag.

The pills taken for PrEP have been very expensive.

There are new generics on the market that bring down the price, but without insurance that covers the medication, it can be prohibitive for many people, especially those who are with lower incomes.

The other sort of challenge that we don't always talk about, but that is really important is outreach.

And there is a lot of really effective outreach in making sure that certain demographics know about PrEP.

This is largely seen as a drug that has been very good at making its way to men who are white and who are gay.

And it often doesn't reach out in the same way to many people who are also at higher risk but aren't considered in that archetype.

And there are large efforts in particular to expand outreach to trans Americans and to black Americans who are at higher risk of HIV and may not be told about Prep by their doctors or may, for other reasons, not consider it as the right drug for them.

JOHN YANG: The other thing that some people talk about is the fact you've got to take a pill every day.

Does the fact this injectable PrEP, which you only get a shot every other month after initial two shots in two months, do you think that would help spread use of this drug?

SHEFALI LUTHRA: I think that's an open question right now.

And we do know that even with the injectable PrEP, you need to have regular visits to a doctor to get the injection, which can be a barrier for folks who aren't that plugged into the healthcare system, who don't have a regular medical professional they see who don't have health insurance.

We also know that the injectable PrEP is still fairly new.

It isn't always covered at no cost by health insurance, unless for some reason you've shown that you cannot take the daily pill.

It seems like a really viable possibility to expand options for people who want to prevent themselves from getting HIV, but I think it's too early to say just how meaningful an impact it could have.

JOHN YANG: As we say, this is the center of a new legal battle over the ACA.

There's a lawsuit that's before the Fifth Circuit Court of Appeals right now, a group wants to knock out the preventive care mandate.

Who's bringing this suit and why do they want it out?

SHEFALI LUTHRA: This group of employers from Texas has challenged the preventive services mandate in court.

They filed it in a court in Texas where the judge is known to be quite hostile to the Affordable Care Act.

It goes to an appeals court that is known for being quite conservative.

And their argument is twofold.

In part, they say the federal government has overstepped its authority in determining certain preventive services that must be covered at no cost by the ACA.

They also claim that they have a religious exemption.

They say that providing insurance to their employees that covers PrEP violates their religious beliefs.

And frankly, the arguments, many legal authorities have told me, are quite steeped in bias against largely gay men in what many have described as homophobic claims that covering PrEP would facilitate or encourage people to have sex outside of a marriage between a man and a woman.

And what was troubling to some is that there is some interest in those legal arguments, although at this point, those are not the main claims as to why PrEP shouldn't be covered.

But right now, what is happening is that the Fifth Circuit Court of Appeals based in Louisiana, is hearing arguments in this case.

They'll issue a decision relatively soon.

But for now, they have said that health insurers must keep covering PrEP and other preventive services at no out of pocket cost to consumers.

JOHN YANG: And if that were to go away, what would it do to not only HIV prevention, but to birth control, to cancer screening and all sorts of other things that fall under that category?

SHEFALI LUTHRA: The contraception question is a little bit tricky because the guarantee for birth control with no out-of-pocket cost comes from multiple variations or multiple facets of the ACA.

But we do know that there could be new costs for consumers, for PrEP, for mental health screenings, for cancer screenings, for all sorts of sort of reproductive health care services that we now take for granted.

And that could suddenly become very expensive for people if they are no longer able to have this preventive services mandate.

That, to be clear, has been in effect for a very long time.

The ACA was passed in 2010, which was more than a decade ago.

JOHN YANG: Shefali Luthra of the 19th News.

Thank you very much.

SHEFALI LUTHRA: Thank you for having me.

JOHN YANG: Across the country this weekend, many Americans are sweltering in the heat and humidity.

A good time to be indoors with the air conditioning on.

But for thousands of Californians, that's not an option.

They're unsheltered and living outside.

As Ali Rogin reports, a new study from the University of California, San Francisco, offers new insights into this population.

ALI ROGIN: 30 percent of Americans without a home are in California.

Over 3,000 were surveyed as part of the largest representative study of homelessness in the United States since the 1990s.

Among the findings nearly half of all unhoused adults in California are older than 50.

Two-thirds reported mental health symptoms, and a majority said that the cost of housing was the main barrier to finding a home.

People of color are disproportionately affected.

6 percent of California residents are black, but they make up 26 percent of the unhoused population.

1.3 percent of California identify as Native American, compared to 12 percent of the unhoused population.

Dr. Margot Kushel is the principal investigator of the study.

She heads the Benioff Homelessness and Housing Initiative at UCSF.

Dr. Kushel, thank you so much for joining us.

You've been researching homelessness for quite a long time.

What in the findings surprised you?

DR. MARGOT KUSHEL, Benioff Homelessness and Housing Initiative: I think a few things that are worth pointing out.

First, nine in 10 people in the study lost their stable housing in California.

There's a lot of mythology around people coming to California because of the warm weather or whatnot.

We didn't find that at all.

And I think the next thing that really stuck out was how much homelessness was being driven by economic factors.

The median household income of our participants in the months before becoming homeless was only $960 a month.

For context, in California, the median cost of a one bedroom apartment is $1,700 a month.

When we asked what was happening in people's lives before they became homeless, they often had an income shock.

They had their hours cut, someone in the household lost their job, and then they became homeless because they just couldn't pay the rent.

Once they became homeless, everything else fell apart.

ALI ROGIN: I want to ask you also about the racial disparity that we noticed that the homelessness numbers seem to be particularly high among black and Native American communities.

How do you explain those disparities?

MARGOT KUSHEL: These are communities that have been disparately impacted by structural racism throughout the generations.

They are communities that were really shut out of building wealth through home buying.

They have not only faced discrimination in their daily activities, but have huge deficits in household wealth.

Much of it because of the ways that they've been shut out of housing markets, which are the main way that Americans built wealth.

I think you add to that the other forms of oppression, discrimination in our criminal justice system, discrimination in employment system, and all the other forms that racism has leads to this hugely disparate impact.

ALI ROGIN: The study also noted that more than half of unhoused people are over the age of 50.

Why does there seem to be that commonality?

MARGOT KUSHEL: This is really, I think, the story of homelessness in the last few decades, the proportion of people over 50 has skyrocketed.

We found that nearly half, 41 percent of those over 50 had never been homeless before the age of 50.

These are seniors who worked physically demanding difficult, low paid jobs their whole life.

As the cost of housing skyrocketed, their incomes didn't keep up and they simply became displaced into homelessness.

ALI ROGIN: You spoke to many people who are currently experiencing homelessness.

What are their living conditions like?

MARGOT KUSHEL: You know we found that about three quarters were primarily unsheltered, either living in their cars or living outside.

One thing that really stood out to us was the amount of violence.

Just for context, 10 percent of everyone experiencing homelessness reported that they had been sexually assaulted during this episode.

Well over a third had been physically assaulted.

Fewer than half had anyone from any agency or other governmental or nonprofit body try to help them get back into housing.

Since they became homeless, people's health declined.

Their well-being declined, their sense of safety decline.

They became more and more disconnected from work, from labor.

Someone said to us, being homeless, it's a full time job.

What was really striking to us, though, was that basically everyone we encountered wanted desperately to be housed again.

ALI ROGIN: And what are some of your recommendations for achieving that goal?

MARGOT KUSHEL: All routes to ending this crisis really run through housing.

But there isn't going to be a way out of this crisis unless we can address the brutal and dramatic shortage of affordable housing.

So our first recommendations were really about increasing that supply, using things like rental vouchers from the federal government, more support for creating and preserving affordable housing.

A lot of people said that small amounts of money would have stopped their downward slide into homelessness.

We really need to increase access to behavioral health treatment, both to keep people safe when they're homeless, but really importantly to support them when they get housed again.

We need to help people's incomes rise.

Almost half were looking for work.

We need to help them get back into the labor market.

And we really need to take a racial equity approach to everything that we do.

The top line story has to be these are older people of color who have been displaced from housing that is too expensive for them, and we really need to rectify that really fascinating study.

ALI ROGIN: The lead investigator of it, Dr. Margot Kushel with UCSF.

Thank you so much for joining us.

MARGOT KUSHEL: Thank you for having me.

JOHN YANG: For many of us, the daily commute includes slowing down to go by automated speed cameras.

Cities across the country have used them for decades, and today nearly 200 communities have them in place.

But critics say that in places like Chicago, the tickets and fines they generate disproportionately fall on black and brown residents.

Economics correspondent Paul Solman has our report.

PAUL SOLMAN: An open road in Black, South Chicago.

This is another example of an arterial street with terrible infrastructure that encourages people to speed and at the same time has cameras that send out tickets automatically, points out Oboi Reed, Chicago traffic reform.

activist.

OBOI REED, CEO, Equiticity Ventures: The infrastructure is horrible in our neighborhoods.

Potholes, multilane streets, highways, interest in exit ramps, arterial streets like Stony Island, Ashland.

PAUL SOLMAN: And speaking of Ashland, the speeds on this avenue, says garage owner Shay Sumter are sometimes -- SHEA SUMPTER, Owner, Star Bright Hand Carwash: At least 60 to 70 miles an hour.

PAUL SOLMAN: Really.

SHEA SUMPTER: It's like a highway.

PAUL SOLMAN: Truth be told, if I weren't here for a story on speeding fines, I'd probably be cruising at around 40 myself.

Good thing I wasn't.

Hairdresser Daira Brooks, who runs a salon next to Shea Sumpton's garage, had no such reminder.

DAIRA BROOKS, Hairdresser: I got a speed ticket.

I was going like 35, 36 in.

PAUL SOLMAN: A 30 miles an hour zone, and then -- DAIRA BROOKS: I never received any tickets in the mail.

That next Friday, I had a boot on my truck.

PAUL SOLMAN: Chicago introduced automated speed cameras in 2013.

The fine $35 for going 10 miles an hour over the limit.

But in 2021, the threshold was cut to 6 miles an hour over.

Chicago has since raked in an extra $120 million paid mostly according to ProPublica by drivers of color.

ALD.

ANTHONY BEALE, 9th Ward, Chicago: The program was rolled out under the auspices that it was all about public safety.

PAUL SOLMAN: City council member Anthony Beale represents the city's largely black 9th Ward.

ANTHONY BEALE: We've learned that it's not about public safety, that the entire system is about generating revenue.

PAUL SOLMAN: You're an alderman.

The city does need money, right?

ANTHONY BEALE: The city does need money, but if we're going to generate revenue, it needs to be off the backs of the entire city of Chicago and not targeted towards the black and brown communities where the people are hurting the most.

I've had residents go to the grocery store.

They got a ticket going to the grocery store, and they got a ticket going home from the grocery store.

STACEY SUTTON, University of Illinois Chicago: Those are the same neighborhoods that are food deserts.

PAUL SOLMAN: Stacey Sutton has studied literally millions of tickets given in Chicago from 2016 to 201, who got them disproportionately?

STACEY SUTTON: Majority black neighborhoods or majority Latinx neighborhoods.

Those are the same neighborhoods that have less access to public transportation.

PAUL SOLMAN: And more tickets they can't afford.

Daira Brooks paid the first just to unboot her car.

DAIRA BROOKS: Then when I paid that, then I had to get on a payment plan for the rest of them.

PAUL SOLMAN: Because the tickets, eight or nine in total, had doubled in price due to late fees.

DAIRA BROOKS: I'm happy that we're talking about it because my payment plan is due tomorrow.

So -- PAUL SOLMAN: It reminds you.

DAIRA BROOKS: It reminds me.

PAUL SOLMAN: That's what these interviews are useful for.

DAIRA BROOKS: So I appreciate you.

PAUL SOLMAN: Please.

STACEY SUTTON: There was a case of a firefighter in Chicago, a black man who lived on the South Side.

He had purchased a car for his son that was sitting on a lot.

That car sitting on a lot accumulated.

tickets.

PAUL SOLMAN: 17 of them, with late fees, $30,000.

STACEY SUTTON: He can file for bankruptcy or lose his job.

That's when I learned that Chicago has the highest rate of personal bankruptcy cases related to fines and fees.

PAUL SOLMAN: In the country.

STACEY SUTTON: In the country.

PAUL SOLMAN: Flat fines and fees of this sort have become a notorious way for cities to make money, as in Ferguson, Missouri, which helped trigger the uprising of 2015.

The Justice Department concluded that, quote, Ferguson's strategy of revenue generation through policing has fostered practices that are themselves unconstitutional.

These practices disproportionately harm African Americans.

STACEY SUTTON: Ferguson is the big case, but there's so many cases.

PAUL SOLMAN: There is, however, it turns out, an alternative.

MATTHEW SCHILKE, Journalist: In the U.S., you pay maybe $200 for a fine.

In Finland, you pay maybe 1 percent.

It's in direct proportion to your income.

PAUL SOLMAN: Of your total income, says U.S. born Helsinki journalist Matt Schilke which, if your wealthy NHL hockey player Rasmus Ristolainen meant a fine of $135,000 for going 50 in a 25 miles per hour zone just a few years.

ago.

MATTHEW SCHILKE: This is something that's been in Finnish society for decades and probably will be for the next decades to come.

PAUL SOLMAN: Good old Egalitarian Finland, whose policy Chicago Alderman Daniel La Spata admires.

ALD.

DANIEL LA SPATA, 1st Ward, Chicago: I think that's a great idea.

I honestly know colleagues who are working on ordinances geared around that very idea right now on the City Council.

PAUL SOLMAN: But La Spata recently rejected a move to switch the speed at which tickets are issued back to 10 miles over the limit from six.

DANIEL LA SPATA: We've kept it at six because we know that is more likely to keep you alive in the case of a crash.

We know that at 30 miles per hour likelihood of a pedestrian, a cyclist, even a driver dying in that crash is about 20, 30 percent.

At 40 mph, that goes up to 90 percent likelihood of you dying in that crash.

PAUL SOLMAN: As some of his constituents have.

DANIEL LA SPATA: I've met with the fathers and mothers of seven and eight year olds who were killed because of the speeds that were being driven by motorists.

PAUL SOLMAN: But says Ashland garage owner Shea Sumpter.

SHEA SUMPTER: It was three deaths last year.

PAUL SOLMAN: Three deaths on right here.

SHEA SUMPTER: Right on Ashland.

PAUL SOLMAN: Don't the speed cameras discourage that kind of speed?

SHEA SUMPTER: No, it needs to be a physical person instead of a camera.

PAUL SOLMAN: So what about physical patrol cars?

STACEY SUTTON: Police related ticketing can lead to horrendous outcomes, and we've seen that for black and Latinx communities, especially.

But especially for black communities.

PAUL SOLMAN: The real goal, says activist Oboi Reed, to make Chicago's most speed inviting streets less so, more bus lanes, pedestrian islands, crosswalks because as things stand - - OBOI REED: We're putting a financial burden on communities that's already poor instead of the city investing in engineering to solve the problem of traffic violence here.

PAUL SOLMAN: Alderman La Spata's response.

We're working on it.

With millions of dollars set aside in the city budget, including, he predicts, upgrading Ashland Avenue.

I've been a journalist for a very long time.

I drove down Ashland, I stood at Ashland, I watched cars go by.

If I'm a betting man, I'm betting that there's no significant improvement of the infrastructure on Ashland Avenue by the time I come back to Chicago in, say, five years.

Am I crazy?

DANIEL LA SPATA: I would love to take you up on that bet.

I don't think you win that bet, Paul.

PAUL SOLMAN: For PBS News Weekend, Paul Solman in Chicago, hoping not for the first time that mine will be a losing bet.

JOHN YANG: And now online, a look at why domestic violence experts are worried about new abortion restrictions in post row America.

All that and more is on our website, pbs.org/NewsHour.

And that is PBS News Weekend for this Saturday.

On Sunday, we take a look at the use of artificial intelligence on the battlefield and the challenges the U.S. Military faces as it adopts this fast moving technology.

I'm John Yang.

For all of my colleagues, thanks for joining us.

See you tomorrow.