Financing and Delivering Pre-Exposure Prophylaxis (PrEP) to End the HIV Epidemic in the United States

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Johns Hopkins faculty and colleagues, including NASTAD's Tim Horn, released a proposal for a national program to finance and distribute medications that prevent HIV infection, known as pre-exposure prophylaxis, or PrEP.

The goal of the proposal is to scale up access to PrEP substantially in order to help end the HIV epidemic.

The recently updated National HIV/AIDS Strategy for 2022-2025 recognizes the need for much greater use of PrEP. In 2019, less than 25% of people eligible for PrEP received a prescription. And disparities based on race/ethnicity, gender, and geography are enormous. 

However, many people who need PrEP cannot get it, nearly 10 years after the medications first became available in the United States. The reasons for poor access include high prices, expensive laboratory tests, excessive requirements for free services, and limited availability in many parts of the country. 

With funding from Arnold Ventures, authors of the proposal consulted with more than 30 experts in HIV, pharmaceutical, and laboratory policy, federal partners, governmental public health leaders, and PrEP consumers. 

The proposal recommends a national prep program guided by these principles: accessibility, equity, simplicity, affordability, sustainability, and adaptability.

View the Proposal