PrEP in Alabama — pre-exposure prophylaxis, who qualifies, how to start

Pre-exposure prophylaxis (PrEP) is a daily pill (Truvada, Descovy) or every-two-months injection (Apretude) that prevents HIV in people who don't have HIV. Taken as prescribed, daily-pill PrEP reduces the risk of sexually transmitted HIV by about 99% and the risk from injection-drug sharing by about 74%, per CDC. In Alabama, PrEP is available through primary-care providers, FQHCs, LGBTQ+ community health centers, and Ryan White Part C clinics — you do not need to see an HIV specialist to start.

To qualify for PrEP you need a recent negative HIV test (or one done the same day), a baseline labs panel (kidney function, hepatitis B, STIs), and a prescriber visit. Follow-up is every three months for a repeat HIV test and medication refill. Most insurance including Medicaid covers PrEP with zero out-of-pocket under the USPSTF Grade A preventive-services rule. The drug manufacturers (Gilead, ViiV) operate patient-assistance programs for anyone without insurance.

Alabama does not operate a state-funded PrEP Drug Assistance Program; residents rely on the federal Ready, Set, PrEP program (getyourprep.com) for medication coverage, Gilead Advancing Access or ViiV Connect for the drug copay, and the USPSTF Grade A preventive-services rule for clinic visits and labs (required zero-cost-share under the ACA). The state HIV program line is 1-800-228-0469 for a PrEP clinic referral.

Black PrEP uptake nationally lags sharply — a 2023 AIDSVu analysis found that Black Americans account for 42% of new HIV diagnoses but only 14% of PrEP users. Long-time Black residents name 1917 Clinic at UAB and Medical Advocacy and Outreach (MAO) — Montgomery as the local institutions that show up consistently — both are listed below.

1917 Clinic at UAB. The 1917 Clinic at UAB Hospital in Birmingham is the largest Ryan White Part C clinic in Alabama and one of the five largest in the Deep South; its CFAR-affiliated research center runs the state's HIV implementation science portfolio.

Medical Advocacy and Outreach (MAO) — Montgomery. Medical Advocacy and Outreach in Montgomery operates five Ryan White-funded clinics across south-central Alabama, including Selma AIR. MAO's mobile testing unit circulates through the Black Belt counties that anchor Alabama's HIV burden.