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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.2

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

Increasing PrEP utilization may help payers avoid significant future costs associated with HIV5

For illustrative purposes only. Model portrayal.

In a 2025 retrospective claims analysis, mean lifetime healthcare costs were more than $2.4 million higher*† (undiscounted) for people living with HIV vs people without HIV in the US5

*Annual costs were evaluated from 2018 to 2023, and cumulative costs of HIV were projected from age 18 to 75 years.

†Net present value using a 3% discount rate is $1.1 million in 2023 US dollars.

Study Details
The analysis used a large, representative sample of primarily 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.

However, PrEP uptake remains low in the US and 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

Opportunities exist to increase PrEP uptake in the communities that need it7

These groups account for a disproportionate share of new HIV diagnoses

38%

Black/African American people

34%

Hispanic/Latino people

28%

All others

(CDC, 2023. Estimated HIV diagnoses in the US and 6 territories and free states for individuals aged ≥ 13 years.)

Share of new US HIV diagnoses in 2023

Open access for all PrEP options, including long-acting modalities, is important to minimize barriers that may stand in the way of PrEP utilization and to accommodate diverse individual needs and risk profiles.

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References:
  1. Centers for Disease Control and Prevention. Ending the HIV epidemic in the U.S. (EHE). Accessed September 8, 2025. https://www.cdc.gov/ehe/php/about/goals.html?CDC_AAref_Val=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 September 8, 2025. https://www.cdc.gov/nchhstp/newsroom/releases/2023/2021-hiv-incidence.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. Cohen JP, Beaubrun A, Ding Y, Wade RL, Hines DM. Estimation of lifetime costs among insured persons with HIV in the United States. Pharmacoecon Open. 2025;9(2):163-172. doi:10.1007/s41669-025-00584-0
  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 September 8, 2025. https://stacks.cdc.gov/view/cdc/156513
  7. Centers for Disease Control and Prevention. HIV diagnoses, deaths, and prevalence: 2025 update. Published April 29, 2025. Accessed September 8, 2025. https://www.cdc.gov/hiv-data/nhss/releases/hiv-diagnoses-deaths-and-prevalence-2025.html