PrEP in Washington — 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 Washington, 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.

Washington operates Washington PrEP Drug Assistance Program (PrEP DAP), layered on top of the federal Ready, Set, PrEP program. Eligibility in Washington goes up to 500% of the federal poverty line, which covers clinician visits, lab work, and medication. Apply through the state HIV program line at 1-360-236-3460 or any community HIV organization that holds a state PrEP navigation contract.

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 Madison Clinic at Harborview Medical Center and Entre Hermanos as the local institutions that show up consistently — both are listed below.

Madison Clinic at Harborview Medical Center. The Madison Clinic at Harborview in Seattle is Washington's largest Ryan White Part C grantee, serving about 2,800 people living with HIV; Madison co-hosts the Fred Hutchinson AIDS Malignancy Consortium and the University of Washington CFAR implementation science core.

Entre Hermanos. Entre Hermanos in Seattle is Washington's Latino-LGBTQ+-led HIV service organization, operating the only Spanish-language-primary rapid-testing program in the Pacific Northwest and the Promotores de Salud peer-navigation network across King, Pierce, and Snohomish counties.