National HIV Testing Day Highlights Expanding PrEP, PEP Access, Persistent Barriers

National HIV Testing Awareness Day, observed annually on June 27, underscores the importance of knowing one’s HIV status, but knowing is only the first step in preventing or actively living with this disease.

An estimated 1.2 million people are living with HIV in the US, and approximately 1 in 8 people living with HIV are unaware of their infection, according to the CDC.¹ These data should encourage individuals with certain risk factors to get regularly tested for HIV, in addition to provider advocacy for pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) for HIV. Individuals with potential HIV exposure or ongoing risk factors should undergo routine HIV testing in accordance with the CDC’s recommendations, especially gay and bisexual men who reported male-to-male sexual contact and/or injection drug use, which make up more than 50% of new HIV cases.¹

Among these men, the majority identify as either Hispanic/Latino or Black/African American. Yet, despite the highly effective preventive therapy, only 36% of people who could benefit from PrEP received a prescription, and even fewer for those who identify as Black or Hispanic.²

“What we need are trusted messengers that can infiltrate work within those populations and do tailored messaging,” Perry N. Halkitis, PhD, MS, MPH, dean of the Rutgers School of Public Health, said in an interview with The American Journal of Managed Care^® (AJMC^®).

Halkitis also alluded to the stigma surrounding PrEP medications, especially in underserved communities where the population may be primarily Black or Hispanic. Reducing this stigma is pivotal to reducing HIV infections and requires collaborative efforts from public health organizations, officials, and community members.

“We’ve got to continue to normalize HIV,” he said. “HIV is just another chronic disease… and the stigma that is associated with it is so reminiscent of the early days of AIDS that we have to chip away at that too.”

State Policies Are Expanding Access to HIV PrEP and PEP

Another barrier to access, aside from external scrutiny and perceptions, is how the therapy is delivered and, in turn, patient adherence. Many states, health organizations, and hospitals have partnered to expand and restore access to treatment and options for patients.

Florida lawmakers approved funding for Florida’s AIDS Drug Assistance Program (ADAP) as of May 25, 2026, restoring coverage for more than 12,000 Floridians who lost coverage after the state’s health department cut the program. The program was cut on March 1st, but lawmakers worked quickly, appropriating emergency bridge funding through June 30, 2026.³

Lawmakers ultimately approved their budget negotiations and provided ADAP with $75 million for the 2026-2027 fiscal year, restoring ADAP income eligibility back to 400% of the federal poverty level, reinstating health insurance premium assistance, and reversing drug restrictions imposed by the state’s Department of Health.

Moreover, the state of Georgia moved to distribute PrEP and PEP at pharmacies as of July 1, 2026. The Senate Bill 195 grants pharmacists the ability to dispense these medications after they’ve completed the mandatory training for distribution.⁴

“This will be a really good thing for people in urban centers who don't have transportation necessarily to go to places,” Halkitis said. “[And for] people in rural centers, also where pharmacies could be the center point of all of their care.”

Pharmacy-focused legislation like that in Georgia, in conjunction with programs like ADAP, addresses 2 major barriers to adherence in patients: cost and location, Halkitis said.

“I think those 2 elements together will be extremely important, and this requires legislation to make that happen,” he said.

Georgia and Florida are also not the only states aiming to bridge these gaps in HIV care. More recently, Mount Sinai Health System partnered with Wisp, the largest women’s telehealth company, to offer the first fully remote HIV prevention program by a New York City medical system. The program aims to reduce barriers to PrEP initiation and adherence by eliminating multiple barriers patients face, including coverage, traveling to see a provider, picking up medication, and getting tested in-person.²

Long-Acting PrEP Expands Options, but Access Challenges Remain

The medication type also impacts patient adherence, Kelsea Aragon, PharmD, an associate professor of pharmacy practice at the University of New Mexico College of Pharmacy, said in an interview with AJMC.

“The long-acting injectables just give more flexibility and more options for patients to prevent HIV, which I think is our biggest priority as clinicians,” she said. “It really is about what fits best for the patient. It just gives us a lot more options in a space where we are so grateful to have any at all.”

Several FDA-approved long-acting antiretroviral therapies are now available as of April 2026, including 3 long-acting treatment regimens for people living with HIV and 2 long-acting PrEPs for HIV prevention.⁵ These medications may be preferred by patients as they stay in the body and work longer when compared with oral pills taken daily.

As of 2024, Medicare, under Part B, now covers the administration of long-acting injectables for HIV PrEP and FDA-approved antiretroviral drugs to prevent HIV.⁶ Medicaid programs cover HIV testing nationwide, and nearly every state Medicaid program covers PrEP, although coverage policies vary.⁷

These injectables have the potential to significantly increase adherence among patients, Aragon said. Especially those who live in rural areas with no local access to a provider, or those who are unhoused and can’t carry a daily oral pill.

“If we reimbursed and covered those cognitive services and delivery of long-acting injectables at community-based pharmacists, that could really expand and help improve access and hopefully close some of those health disparities and make them a little bit narrower,” she said.

Where Do We Go From Here?

Community-based pharmacists and wider adoption of coverage for PrEP, PEP, and HIV screening are only the beginning to bridging health care accessibility, which has plagued underserved communities. Leaving disease stigmatization, although a significantly bigger hurdle to tackle, is up to developing meaningful patient-provider relationships, Aragon said.

“Collaboration with community-based organizations is super important because usually those are the individuals and organizations that have meaningful relationships with the patients we're trying to reach,” she said.

On National HIV Testing Day, getting tested remains a gateway to prevention and treatment, but improving access alone is not enough. Expanding access to PrEP, PEP, pharmacists, long-acting therapies, and trusted community partnerships will be equally important for reducing HIV transmission and narrowing longstanding disparities.

“Having someone you trust in a community-based organization that can help do a warm handoff to a pharmacist or to a clinic, where they say, ‘This is a known, safe person; they're going to take care of you,’ is essential,” Aragon said.

References

1. About HIV. Centers for Disease Control and Prevention. January 14, 2025. Accessed June 23, 2026. https://www.cdc.gov/hiv/about/index.html

2. Wisp Collaborates with Mount Sinai to Expand Access to PrEP and HIV Prevention Across New York State. Mount Sinai. June 9, 2026. Accessed June 23, 2026. https://www.hivma.org/policy--advocacy/professional-practice-advocacy/national-prep-program/

3. Kenslea G. Florida Lawmakers Reach Deal to Reverse HIV drug cuts. Aids Healthcare Foundation. May 25, 2026. Accessed June 24, 2026. https://www.aidshealth.org/2026/05/florida-lawmakers-reach-deal-to-reverse-hiv-drug-cuts

4. Gratas S. Stakeholders prepare for greater access to medication that prevents HIV. GPB. June 1, 2026. Accessed June 24, 2026. https://www.gpb.org/news/2026/06/01/stakeholders-prepare-for-greater-access-medication-prevents-hiv

5. Long-acting HIV Medicine. HIV Info. April 17, 2026. Accessed June 23, 2026. https://hivinfo.nih.gov/understanding-hiv/fact-sheets/long-acting-hiv-medicine

6. PrEP. Centers for Medicare & Medicaid Services. June 5, 2026. Accessed June 23, 2026. https://www.cms.gov/medicare/coverage/prep

7. Medicaid Coverage of HIV Testing and PrEP. KFF. July 1, 2021. Accessed June 23, 2026. https://www.kff.org/hiv-aids/state-indicator/hiv-testing