National PrEP Program Not Yet a Reality in United States

A national preexposure prophylaxis (PrEP) program in the United States is something of interest for Jeremiah Johnson, executive director, PrEP4All. However, the funding for such a program remains limited.

“What we have wanted to do is pull together a coordinated, simultaneous program that addresses the major barriers to PrEP access that we hear about repeatedly from community members, one being the complexity of cost and coverage,” Johnson said in an interview with Managed Healthcare Executive. “We did see the Biden administration call for such a program three years in a row and their budget request to Congress. We've not seen that request continue with the Trump administration.”

Jeremiah Johnson

Johnson said that his organization was successful in getting the Centers for Disease Control and Prevention (CDC) to study HIV prevention strategies at five pilot sites across the United States. This was the first time CDC funds were allowed to go directly toward paying for antiretrovirals of any kind.

“The big challenge we're seeing right now is that the Trump administration and its budget request to Congress for FY 26 have all but eliminated the division of HIV prevention at CDC, while they have maintained in their proposal some funding for the Ending the HIV Epidemic Initiative,” Johnson said.

The initiative was started by President Trump in 2019, during his first term.

Johnson likened the defunding to removing the house foundation but leaving the roof.

“You're not going to be able to build any sort of 'ending the epidemic' response if you don't have basic surveillance testing, not to mention all of the essential PrEP services that you see there,” Johnson said.