Big Idea in Brief: Sustaining Momentum and Increasing Access to PrEP in Uncertain Times

Policy Action is Needed to Make It Easier to Start and Stay on PrEP

Helping individuals start and stay on pre-exposure prophylaxis (PrEP) is a critical part of efforts to end the HIV epidemic in the United States. Investments in PrEP and HIV prevention not only help protect lives, but lower costs, save taxpayer dollars, and alleviate pressure on healthcare delivery systems. While other effective HIV prevention tools exist, including condoms and various risk reduction strategies, none are as effective or offer the same durability of protection as PrEP. At this time there is uncertainty and significant disruption to HIV prevention in the United States. A June 2025 decision by the U.S. Supreme Court maintains the current requirement that PrEP be provided without cost-sharing in most private insurance plans and Medicaid expansion plans, but cuts and staff reductions at the Department of Health and Human Services (HHS) including essentially decimating the Division of HIV Prevention (DHP) at the Centers for Disease Control and Prevention (CDC) have created chaos. Preventing HIV is a necessity and not a luxury. Sustaining access to effective prevention must remain a national priority.

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