Barriers such as discrimination, HIV stigma, anti-LGBTQ+ attitudes and poverty make it harder for people to access HIV prevention tools, to learn their status and to get the care they need. In 2022, only 36% of the 1.2 million people in the U.S. eligible for pre-exposure prophylaxis (PrEP) were prescribed it. Additionally, approximately 13% of people living with HIV in the U.S. are unaware of their status.
Although progress has been made in reducing new HIV cases, certain communities are still disproportionately impacted. The South, for example, accounts for 53% of HIV diagnoses but only 39% of PrEP users. This shows the ongoing gap in access to prevention services.
“When examining disparities in PrEP uptake in the South among race and ethnicity, it’s clear that social, structural, and political barriers further restrict access to these essential services. For example, for every new HIV diagnosis among LatinX populations, only six people were on PrEP, compared to nearly twenty among their White counterparts. The numbers are even lower for Black populations, with just four PrEP users for every new diagnosis. This data highlights why the South leads the nation in new HIV diagnoses and demonstrates how inequities continue to fuel disparities in health outcomes,” said Will Ramirez, Director of Public Policy & Advocacy, Southern AIDS Coalition.
“Furthermore, restrictive state policies in the South, like the lack of expansion of Medicaid, limitations on funding for HIV prevention programs, and the absence of comprehensive sex education impact the landscape and contribute to disparities in the region.”
We have the opportunity to improve equitable access to HIV prevention services and ensure people receive the care they need by unlocking the power of over 70,000 community pharmacies.
The National HIV AIDS Strategy released by the White House highlights the ways pharmacists can help us reach our national HIV goals. The document and the President of the United States calls for us to leverage the knowledge and accessibility of pharmacists in every urban and rural community as part of a comprehensive HIV prevention and care strategy to expand access and improve population health. – Harold J. Phillips, MRP, Deputy Director for Programs, NMAC
This is what RxEACH aims to do.
How RxEACH is working to expand access to HIV prevention services for underserved communities
At the Elton John AIDS Foundation, we’re proud to fund pioneering initiatives like RxEACH, a national coalition working to transform access to PrEP and PEP by making it easier to get directly from pharmacies. By empowering community pharmacies to play a key role in HIV prevention, we’re leveraging existing healthcare infrastructure and collaborating with public health systems in underserved areas.
Collaboration across care disciplines is crucial, ensuring pharmacies can serve as entry points that connect individuals to medical providers for ongoing care and treatment.
Bridging gaps
In areas where access to HIV prevention services may be limited, community pharmacies can bridge the gap in geographic inequity. If we enabled pharmacies in the U.S. South to provide PrEP, we could increase access to PrEP by 80 times.
Boosting accessibility
Over 50% of pharmacies in the United States are located in medically underserved areas. Community pharmacies could become crucial access points for HIV prevention services.
Empowering choice
By improving ease of access to HIV prevention services, individuals can choose to receive PrEP and PEP in a location that best suits their needs.
Save lives and money
Integrating PrEP as an early intervention practice can decrease HIV rates and reduce lifetime healthcare costs associated with HIV treatment.
To increase access to HIV prevention in pharmacies, policy changes are needed at both federal and state levels. Currently, a pharmacist’s ability to offer HIV screening, PrEP, and PEP varies across states, and even where allowed, they often can’t get reimbursed for their time.
The RxEACH initiative is empowering local advocates to push for these policy changes by providing resources like the State Action Playbook and state-specific profiles.
But to make this work, changes in federal and state policies are needed so pharmacies can provide HIV testing and prevention services.
To end the HIV epidemic in the U.S., we need to reach those not currently in care by meeting people where they are. This means doing things differently. Community pharmacies offer convenient locations, extended hours, and can be a less stigmatizing environment for accessing HIV prevention. We are grateful for the dedication of RxEACH partners in pushing for the necessary policy changes to make this a reality. – Noelle Esquire, US Portfolio Lead, Elton John AIDS Foundation
Interested in learning more about RxEACH?
Explore the RxEACH website to learn about the important role that community pharmacies can play in improving HIV prevention and care uptake.
faq: hiv prevention
HIV can be passed on through particular bodily fluids like semen and blood, if a person with HIV has a detectable viral load. But prevention has advanced significantly.
What is PrEP?
Pre-exposure prophylaxis (PrEP) is like a shield that you can take daily to prevent HIV. It helps to block the virus from taking hold when you are exposed to it. When taken as prescribed, PrEP reduces the risk of getting HIV from sex by 99% and from injection drug use by 74%.
What is PEP?
Post-exposure prophylaxis (PEP) is a short course of HIV medicines that you can take if you think you have been exposed to HIV to prevent the virus from taking hold in your body.
The sooner you start PEP the better. PEP must be started within 72 hours of possible exposure to HIV to reduce the risk of infection