PrEP in Missouri — 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 Missouri, 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.

Missouri 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 1-800-533-2437 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 Washington University Infectious Diseases Clinic (the Center for Positive Health) and Kansas City CARE Health Center as the local institutions that show up consistently — both are listed below.

Washington University Infectious Diseases Clinic (the Center for Positive Health). The Center for Positive Health at Washington University in St. Louis is Missouri's largest Ryan White Part C grantee, serving about 2,400 people living with HIV; Wash U co-sponsors the EHE Blueprint for St. Louis with the city Department of Health.

Kansas City CARE Health Center. Kansas City CARE Health Center (formerly the Kansas City Free Health Clinic) is the Ryan White Part B case-management contractor for western Missouri, operating the state's highest-volume Black-community-focused rapid-testing program out of the East 31st Street clinic.