PrEP in North Dakota, 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 North Dakota, 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.

North Dakota 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 1-701-328-2378 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 Sanford Health Infectious Disease Clinic and Family HealthCare FQHC (Fargo) as the local institutions that show up consistently, both are listed below.

Sanford Health Infectious Disease Clinic. Sanford Health's ID Clinic in Fargo is North Dakota's only HIV specialty clinic and the state's Ryan White Part C grantee, covering the entire state through a combination of in-person and telehealth appointments; Sanford partners with Family HealthCare's Fargo FQHC for PrEP initiation.

Family HealthCare FQHC (Fargo). Family HealthCare in Fargo is North Dakota's largest FQHC and operates the state's only walk-in rapid-testing program with evening hours, serving new North American refugee communities along with the long-time Fargo-Moorhead Black community.