On July 22, 2021, PrEP4All, Inc., along with 66 other public health and advocacy organizations submitted a letter to Dr. Rochelle Walensky, Director of the Centers for Disease Control and Prevention (CDC), requesting the CDC change it’s policy for HIV grantees to pay for pre-exposure prophylaxis (PrEP) ancillary services. The CDC responded to this request via email on Wednesday, October 27, 2021.

In the response, the CDC reiterates prioritizing PrEP as a critical tool for ending the HIV epidemic and announces plans to make covering clinical services an allowable expense for health departments receiving CDC funding under Integrated Human Immunodeficiency Virus (HIV) Surveillance and Prevention Programs for Health Departments (PS18-1802).   CDC would require grantees to ensure that CDC is the payer of last resort for these ancillary services.   Allowing PS18-1802 grantees to use funds to cover clinical services is one step towards making PrEP more accessible to those at risk for acquiring HIV, especially in non-Medicaid expansion states.  

            Unfortunately, this change in CDC policy does not go far enough to address financial barriers to accessing PrEP.   This proposed change is only available to PS18-1802 funded health departments and does not include other PrEP healthcare sources such as community health centers or community-based organizations. Increasing PrEP access is critical to ending the HIV epidemic in the U.S. 

A National HIV Prevention Program is still needed to ensure PrEP is accessible to everyone who needs it, especially individuals who are uninsured or most vulnerable to HIV.   A National HIV Prevention Program would not only ensure PrEP medication is paid for, but would also cover necessary clinical and support services to further address barriers to PrEP access, including labs, provider visits, housing, and transportation.  Until a National HIV Program is established, it is imperative that CDC expand PrEP access by  allowing all HIV prevention grant recipients, not just health departments under PS18-1802, to use funds to cover necessary clinical services.  

National HIV Prevention Program