More than a third of eligible beneficiaries on PrEP for HIV, but disparities persist

New preliminary data from the Centers for Disease Control and Prevention (CDC) indicates more than a third of people who could benefit from preexposure prophylaxis (PrEP) for HIV received a prescription for it in 2022.

Expanding PrEP use is a key part of the CDC’s Ending the HIV Epidemic in the U.S. (EHE) initiative, which aims to cut down HIV infections in the country by 90 percent by 2030.

PrEP has been available in the U.S. since 2012, and coverage of it has continued to rise in recent years. According to the preliminary CDC data, 36 percent of people who could benefit from PrEP were prescribed it last year.

This signifies a jump of 12 percent in coverage since 2019, when the CDC’s initiative was launched.

Roughly 1.2 million people in the U.S. could benefit from taking PrEP, which reduces the risk of contracting HIV by about 99 percent when taken as prescribed.

Groups who could benefit most include those severely impacted by HIV: gay and bisexual men; transgender women; Black and Hispanic/Latino people; Black cisgender women; and people who inject drugs.

“Today’s data also show progress in increasing PrEP uptake in virtually all EHE jurisdictions, despite the unprecedented public health challenges funding recipients faced during this period with the COVID-19 pandemic and outbreaks of mpox, which consumed considerable resources as EHE efforts were just getting underway,” the CDC said in a statement.

Jonathan Mermin, director of CDC’s National Center for HIV, Viral Hepatitis, STD, and TB Prevention, credited ongoing outreach efforts for the latest coverage rates.

“There’s been a lot of effort from community based organizations, from health departments, from CDC and other federal agencies to expand PrEP use for the people who would benefit and in 2021 we updated our guidance for providers to discuss PrEP with sexually active adolescents and adults and to provide prep to anyone who does request it,” Mermin said.

Between 2017 and 2021, annual new HIV infections fell by 12 percent. Expanded use of PrEP and HIV testing are thought to be behind this trend.

Mermin noted, however, that the data also suggested the disparities are widening when it comes to these crucial preventive medications. The groups who stand to most benefit are accessing these drugs the least.

Disparities were observed across gender and race. Among white people, 94 percent who could benefit from PrEP received a prescription compared to 24 percent of Hispanic/Latino people and 13 percent of Black people.

Between men and women, 41 percent of men who could benefit from PrEP received a prescription while only 15 percent of women who could benefit could say the same.

In 2022, people also had access to a third option for PrEP for the first time: Apretude. This injected form of PrEP is equally as effective as the two daily oral forms that are available — Truvada and Descovy — while involving one injection every two months. According to a Mermin, it is unclear if having this additional option made a difference in last year’s coverage rates.

He added that these efforts in combating the spread of HIV require resources and funding, which is allocated by Congress. Since 2020, Congress has continually provided less than what the White House has requested for the EHE initiative.

For 2024, the Biden administration has requested $850 million. The White House requested the same amount last year, and only $573 million was allocated.

“For several years, the president has requested hundreds of millions of dollars more for the ending HIV initiative and a national PrEP program. And that’s several hundred million dollars more than what Congress did end up providing,” Mermin said. “So we need to maximize innovation.”

“We need increased investments if we’re going to continue to increase PrEP use and reduce some of the disparities that we’re seeing,” he added.