Over 100 HIV organizations cosigned a letter to Congress requesting that members fund a program to expand access to pre-exposure prophylaxis, or PrEP, the daily pills and long-acting injections that prevent HIV.


The letter was addressed to leaders of the Appropriations Committee, which oversees federal spending and is currently working on the budget for fiscal year (FY) 2023, which starts October 1 and runs to September 30, 2023.


“We specifically urge you to fund a new national PrEP program within the Centers for Disease Control and Prevention (CDC) Division of HIV Prevention at $400 million in FY 2023,” the letter reads. “The funding would be a necessary first step toward achieving the PrEP for All to End the HIV Epidemic program proposed in President Biden’s FY 2023 Budget Request. Following significant disruptions during the COVID pandemic, it is also an essential investment to reach the ambitious targets put forth in President Trump’s Ending the HIV Epidemic initiative.”



The letter was spearheaded by national advocacy group PrEP4All along with Federal AIDS Policy Partnership, AIDS Budget and Appropriations Coalition and the HIV Prevention Action Coalition.


“Queer, Black, and Brown communities—who bear the brunt of tens of thousands of new HIV infections each year—cannot afford to let any more time go by before we fully scale up PrEP access. And due to many issues involving cost, lack of insurance coverage and knowledge of PrEP, we’ve seen PrEP mostly benefit white Americans (and primarily white gay men in large cities) in the past decade since the first drug was approved for PrEP. To ensure equity, we need House and Senate appropriators to immediately fund a national PrEP program and leverage the cost savings power brought about by generic competition,” said Jeremiah Johnson, PrEP policy manager for PrEP4All, in a press release from the group.


Last summer, the U.S. government clarified that insurers must cover PrEP and related services to prevent HIV, but many people lack insurance. With the arrival of generic PrEP, the cost has decreased to as little as $20 a month, the letter notes, adding that lifetime health care for a single HIV diagnosis costs nearly $500,000. With about 35,000 people diagnosed with HIV each year in the United States, a PrEP program would save the government money.


According to the letter, the envisioned national program “will support the expansion and creation of PrEP programs by providing grants for the purchase of medications, costs of labs, essential support services (e.g., counseling, linkage and adherence services), PrEP outreach and education activities, and the expansion of PrEP provider capacity. We believe that this grant should be available to a wide range of provider networks, including traditional and nontraditional clinical providers (including ob/gyns and providers serving young adults) and community-based organizations, establishing provider eligibility to directly and easily connect patients to the benefits of the program. The end result must be a simple and streamlined pathway to access for communities who most need PrEP.”


To read more about Biden’s proposed budget, which includes funding for a 10-year PrEP program, see “Biden’s 2023 Budget Invests $9.8B in PrEP and Boosts Other HIV Funding.”


In related news, both the National HIV/AIDS Strategy, recently updated for 2022–2025, and the Ending the HIV Epidemic: A Plan for America initiative aim to reduce new HIV infections by 75% by 2025 and by 90% by 2030 but lay out different objectives and strategies for reaching those targets.

To learn more about PrEP, PEP (post-exposure prophylaxis) and other prevention methods, see the POZ Basics on HIV Prevention. And for a collection of related articles, click #PrEP. You’ll find headlines such as “Illinois Pharmacists Can Now Prescribe HIV Prevention Meds” and “High Drug Copays Leave PrEP Prescriptions Unclaimed.”