HIV Care • PrEP

PrEP — State by State

The national picture

Black Americans account for 42% of new HIV diagnoses but only about 14% of PrEP users — the single highest-leverage prevention gap in HIV care today.

PrEP — pre-exposure prophylaxis — is a daily pill or every-two-months injection that prevents HIV in people who don't have HIV. CDC data show daily oral PrEP reduces the risk of sexually transmitted HIV by about 99% and the risk from injection-drug sharing by about 74% when taken as prescribed. Injectable PrEP (Apretude, cabotegravir) shows similar efficacy with the convenience of six dosing visits per year instead of 365.

You qualify for PrEP if you're HIV-negative and at ongoing risk. The CDC explicitly recommends PrEP for anyone sexually active who has had a bacterial STI in the last six months, anyone in a serodifferent relationship with a partner with HIV, and anyone who has shared injection-drug equipment in the last year. In practice, most providers will prescribe PrEP to anyone who asks and is HIV-negative — the benefit-to-risk ratio is overwhelming.

Cost: PrEP is covered with zero out-of-pocket on every ACA-compliant insurance plan, every state Medicaid plan, and Medicare. Uninsured patients qualify for the federal Ready, Set, PrEP program (getyourprep.com) for medications and the manufacturer patient-assistance programs (Gilead Advancing Access, ViiV Connect) for visits and labs. Twenty-two states plus DC also operate their own PrEP Drug Assistance Programs — the state pages below show which.

For Black communities

AIDSVu's 2023 PrEP-to-Need ratio analysis shows Black Americans account for 42% of new HIV diagnoses but only about 14% of PrEP users. The gap is not about awareness — surveys find Black respondents are as likely as white respondents to say they'd take PrEP if their provider offered it. The gap is about which providers offer it. Fewer than 1 in 4 U.S. primary-care clinicians report routinely prescribing PrEP, and PrEP-prescribing rates are lowest in the ZIP codes with the highest Black HIV burden.

Black-led HIV organizations in Getting-to-Zero cities operate PrEP-specific navigation programs — peer-led intake, same-week prescriber appointments, benefits coordination, three-month follow-up support — that close the gap where their local health system won't.

PrEP in every state

Alabama

Alabama Department of Public Health, Division of HIV Pr…

Alaska

Alaska Section of HIV/STD Program

Arizona

Arizona Department of Health Services, Office of HIV Se…

Arkansas

Arkansas Department of Health, HIV/STD/Hepatitis C Sect…

California

PrEP Assistance Program (PrEP-AP)