Investing in National HIV PrEP Preparedness

This Perspective article argues that the U.S. has failed to develop public health infrastructure capable of equitably reaching vulnerable communities during crises. Despite progress in HIV prevention, annual new infections remain at 35,000, with widening racial disparities. The authors propose a federally supported national PrEP program that secures affordable medication and lab pricing for uninsured populations, expands nonclinical provider networks, and funds community outreach. Backed by major advocacy coalitions and highlighted in the FY2023 budget process, the plan emphasizes hub-and-spoke delivery models and health equity. The authors assert that such a program could not only reduce HIV incidence but also serve as a template for future public health crises involving marginalized communities.

This Perspective article argues that the U.S. has failed to develop public health infrastructure capable of equitably reaching vulnerable communities during crises. Despite progress in HIV prevention, annual new infections remain at 35,000, with widening racial disparities. The authors propose a federally supported national PrEP program that secures affordable medication and lab pricing for uninsured populations, expands nonclinical provider networks, and funds community outreach. Backed by major advocacy coalitions and highlighted in the FY2023 budget process, the plan emphasizes hub-and-spoke delivery models and health equity. The authors assert that such a program could not only reduce HIV incidence but also serve as a template for future public health crises involving marginalized communities.