New data released by the Centers for Disease Control and Prevention (CDC) reveals that over one-third of individuals who could benefit from preexposure prophylaxis (PrEP) for HIV were prescribed it in 2022.
PrEP expansion is a critical component of the CDC’s Ending the HIV Epidemic in the U.S. (EHE) initiative, which aims to reduce HIV infections in the country by 90 percent by 2030.
Since its availability in the U.S. in 2012, PrEP coverage has consistently increased. According to the preliminary CDC data, 36 percent of eligible individuals were prescribed PrEP last year.
This marks a 12 percent increase in coverage since the launch of the CDC’s initiative in 2019.
Approximately 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 directed.
The groups that could benefit the most include those most affected by HIV: gay and bisexual men; transgender women; Black and Hispanic/Latino individuals; Black cisgender women; and people who inject drugs.
“Today’s data also demonstrate progress in increasing PrEP adoption in nearly all EHE jurisdictions, despite significant public health challenges faced by funding recipients during this period, such as the COVID-19 pandemic and outbreaks of other diseases, which required considerable resources as EHE efforts were just beginning,” stated the CDC.
Jonathan Mermin, director of CDC’s National Center for HIV, Viral Hepatitis, STD, and TB Prevention, attributes the latest coverage rates to ongoing outreach efforts.
“There has been extensive effort from community-based organizations, health departments, CDC, and other federal agencies to expand PrEP usage for those who would benefit. In 2021, we updated our guidance for providers to discuss PrEP with sexually active adolescents and adults and to provide PrEP to anyone who requests it,” said Mermin.
Between 2017 and 2021, annual new HIV infections decreased by 12 percent. Expanded use of PrEP and increased HIV testing are believed to have contributed to this trend.
However, Mermin highlighted that the data also indicate widening disparities regarding access to these vital preventive medications. The groups that stand to benefit the most have the lowest access rates.
Disparities were observed across gender and race. Among white individuals, 94 percent who could benefit from PrEP received a prescription, compared to 24 percent of Hispanic/Latino individuals and 13 percent of Black individuals.
Regarding gender, 41 percent of eligible men were prescribed PrEP, while only 15 percent of eligible women received the medication.
In 2022, a third option for PrEP became available for the first time: Apretude. This injectable form of PrEP is equally effective as the two currently available daily oral forms, Truvada and Descovy, and requires an injection every two months. It is unclear if this additional option influenced last year’s coverage rates, according to Mermin.
Mermin emphasized that these efforts to combat HIV transmission require resources and funding, which are allocated by Congress. Since 2020, Congress has consistently provided less funding than what the White House has requested for the EHE initiative.
For 2024, the Biden administration has requested $850 million, the same amount as last year, where 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. This is several hundred million dollars more than what Congress ultimately provided,” stated Mermin. “We must maximize innovation.”
“We need increased investment if we want to continue expanding PrEP use and reducing the disparities that we are witnessing,” he added.
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