Routine PrEP Conversations and Access Are Needed to Cut HIV Risk
This opinion piece argues that HIV prevention efforts must reach people who could benefit from PrEP but are not getting it. It cites a study finding that only 1.6% of insured adolescents and young adults with an STI or high-risk behavior filled a PrEP prescription from 2018 to 2022, and notes disparities among Black, Hispanic, and female patients. The author calls for routine counseling and reducing privacy and access barriers.
An April JAMA Pediatrics analysis reviewed claims for 100,536 commercially insured patients aged 13–21 who had a bacterial STI or high-risk sexual behavior between 2018 and 2022. Although these patients had insurance and had seen a clinician, just 1.6% filled a PrEP prescription.
AIDSVu estimates cited in the piece show Black patients represented 15% of PrEP users in 2025 but 39% of new HIV diagnoses in 2024; Hispanic patients 18% and 34%, and women 10% and 20%. Federal guidance calls for telling every sexually active adult and teen about PrEP and prescribing it when requested and clinically suitable, even without disclosed risk factors.
Routine PrEP counseling and lower access barriers could affect adolescents, young adults, and groups with disproportionate HIV diagnoses, including Black, Hispanic, and female patients. If clinicians discuss prevention more consistently and address privacy and practical access obstacles, some patients who currently miss PrEP may gain a feasible option. Yet uptake may remain uneven if confidentiality concerns or stigma discourage disclosure. The story’s impact may therefore depend on whether health systems make prevention conversations routine without making patients feel exposed.