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While pre-exposure prophylaxis (PrEP) remains a key component of national prevention goals to reduce or eliminate new HIV infections in the US, PrEP is alarmingly underutilized.1-4

 
Donut graph showing 36%36%

Of the 1.2 million people in the United States indicated for PrEP, only 36% were prescribed PrEP in 2022.*

According to the Centers for Disease Control and Prevention (CDC), efforts must be further strengthened and expanded to reach all populations equitably and reach our national goals.5

*Based on CDC estimates for 2022 for individuals aged ≥ 16 years in the US.

PrEP uptake in the US varies by state6

Click on the regions below to view CDC data by state for 2022

PrEP uptake among persons aged  16 years*

5% - 24%
25% - 29%
30% - 35%
36% and above
StatePrEP uptake among persons aged  16 years*
Connecticut41.9%
Maine28.5%
Massachusetts52.3%
New Hampshire34.3%
New Jersey35.4%
New York63.4%
Pennsylvania44.1%
Rhode Island47.1%
Vermont54.1%
StatePrEP uptake among persons aged  16 years*
Illinois39.3%
Indiana24.6%
Iowa46.2%
Kansas31.7%
Michigan24.1%
Minnesota30.3%
Missouri28.0%
Nebraska58.3%
North Dakota22.2%
Ohio25.7%
South Dakota35.3%
Wisconsin25.8%
StatePrEP uptake among persons aged  16 years*
Alabama31.2%
Arkansas32.7%
Delaware19.1%
District of Columbia59.7%
Florida37.1%
Georgia35.2%
Kentucky23.3%
Louisiana29.8%
Maryland25.2%
Mississippi38.3%
North Carolina30.7%
Oklahoma25.2%
Puerto Rico8.5%
South Carolina35.2%
Tennessee39.5%
Texas32.9%
Virginia24.1%
West Virginia17.4%
StatePrEP uptake among persons aged  16 years*
Alaska22.5%
Arizona32.3%
California37.4%
Colorado30.3%
Hawaii34.6%
Idaho22.4%
Montana23.3%
Nevada49.9%
New Mexico29.9%
Oregon30.7%
Utah58.6%
Washington34.4%
Wyoming20.6%

*PrEP uptake (or coverage), reported as a percentage, was calculated as the number of persons who have been prescribed PrEP divided by the estimated number of persons who had indications for PrEP.6

Significant disparities persist in PrEP uptake among Black and Latino/x populations in the US7

PrEP eligibility and uptake by race/ethnicity

Chart showing disparities in PrEP usage
Chart showing disparities in PrEP usage

For all PrEP options, maintaining open access is important to minimize barriers that may stand in the way of PrEP utilization and to accommodate diverse individual needs and risk profiles.

Increasing PrEP utilization may help payers avoid significant future costs associated with HIV8

For illustrative purposes only. Model portrayal.

In a retrospective claims analysis, mean lifetime healthcare costs were more than $1.5 million higher* for people living with HIV vs people without HIV in the US8

* Annual costs were evaluated from 2013 to 2017, and cumulative costs of HIV were projected from age 25 to 69 years.

Net present value using a 3% discount rate is ~$851K in 2017 US dollars.

Study Details
The analysis used a large, representative sample of commercially insured US adults with HIV to evaluate and project cumulative costs of HIV.
IQVIA claims were used to identify people with HIV and match them with people without HIV.

Explore local data on HIV/AIDS statistics

Visit AIDSVu.org
References:
  1. Centers for Disease Control and Prevention. Ending the HIV epidemic in the U.S. (EHE). Accessed January 2, 2024. https://www.cdc.gov/endhiv/prevent.html
  2. Centers for Disease Control and Prevention. The state of the HIV epidemic in the U.S. Accessed January 2, 2024. https://www.cdc.gov/nchhstp/newsroom/fact-sheets/hiv/state-of-the-hiv-epidemic-factsheet.html
  3. Streed CG, Morgan JR, Gai MJ, et al. Prevalence of HIV preexposure prophylaxis prescribing among persons with commercial insurance and likely injection drug use. JAMA Network Open. 2022;5(7): e2221346. doi:10.1001/jamanetworkopen.2022.21346.
  4. Goldstein RH, Streed CG, Cahill SR. Being PrEPared — preexposure prophylaxis and HIV disparities. N Engl J Med 2018; 379:1293-1295; doi: 10.1056/NEJMp1804306.
  5. Centers for Disease Control and Prevention. Expanding PrEP coverage in the United States to achieve EHE goals. Published October 17, 2023. Accessed January 2, 2024. https://www.cdc.gov/nchhstp/dear_colleague/2023/dcl-101723-prep-coverage.html
  6. Centers for Disease Control and Prevention. Core indicators for monitoring the ending the HIV Epidemic Initiative (preliminary data): National HIV Surveillance System data reported through June 2023; and preexposure prophylaxis (PrEP) data reported through March 2023. HIV Surveillance Data Tables 2023;4(3). Published October 2023. Accessed January 2, 2024. https://www.cdc.gov/hiv/library/reports/surveillance-data-tables/vol-4-no-3/index.html
  7. Centers for Disease Control and Prevention. Core indicators for monitoring the Ending the HIV Epidemic initiative (preliminary data): National HIV Surveillance System data reported through March 2023; and preexposure prophylaxis (PrEP) data reported through December 2022. HIV Surveillance Data Tables 2023;4(2). Published June 2023. Accessed January 2, 2024. https://www.cdc.gov/hiv/library/reports/surveillance-data-tables/vol-4-no-2/index.html
  8. Cohen JP, Beaubrun A, Ding Y, Wade RL, Hines DM. Estimation of the incremental cumulative cost of HIV compared with a non-HIV population. Pharmacoecon Open. 2020;4(4):687-696. doi:10.1007/s41669-020-00209-8.

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