I've been on PrEP for 11 years. Access to the HIV prevention drug is in danger.

Accessing PrEP is a struggle that persists well beyond the initial prescription. For over a decade, I have used PrEP to protect my health, yet the path to consistent care remains riddled with administrative hurdles and significant cost barriers. Even with the introduction of generic daily pills and advanced injectables, many people find themselves fighting insurance companies for coverage or paying thousands of dollars for necessary medical care.

Data from AIDSVu underscores a harsh reality regarding these disparities. While the South accounts for a massive portion of new HIV diagnoses, it also faces some of the lowest rates of PrEP utilization. This gap hits Black and Latino communities, women, and youth the hardest. When we combine high out-of-pocket costs with systemic issues like the lack of Medicaid expansion in many states, it becomes clear why so many remain left behind by the current healthcare model.

Federal funding serves as the backbone of HIV prevention, yet we now face serious threats to this infrastructure. Proposed cuts to Medicaid and the expiration of subsidies jeopardize testing, outreach, and education. We cannot treat prevention as a luxury. Advocacy groups like PrEP4All have spent years pushing for a National PrEP Program to standardize access and eliminate the financial burden for the uninsured. This is a matter of public health stability that has historically enjoyed bipartisan support.

Protecting HIV funding is not just about keeping current programs afloat. It is about committing to an end to the HIV epidemic by 2030. We have successfully fought off billions in proposed cuts, but maintenance is not sufficient. True progress requires a dedicated federal investment to reach those who currently lack access to a provider or a nearby sexual health clinic. As we observe National HIV Prevention Day, the message is plain. We need a permanent, robust commitment to equitable care that serves everyone, regardless of their zip code or their insurance status.