The federal government is, for the first time, funding a pilot program that will provide generic pre-exposure prophylaxis (PrEP) medications to prevent HIV. Specifically, the Centers for Disease Control and Prevention (CDC) has made about $7 million available for PrEP programs in jurisdictions already receiving funding for the Ending the HIV Epidemic in the United States initiative.

The initiative targets counties, cities and other jurisdictions that make up a disproportionate number of new HIV cases and are prime recipients of PrEP efforts. As the federal government explains it in its funding description:

“Jurisdictions with greater need for PrEP and lower uptake among priority populations disproportionately affected by HIV and low PrEP prescriptions (i.e., Black and Latino gay, bisexual, and other men who have sex with men…and Black cisgender and transgender women) need these additional resources and flexibility to accelerate PrEP uptake through patient navigation/case management services and improve access to and utilization of existing PrEP services not covered by other financial resources.”

In addition to supporting PrEP access and uptake, the CDC funding available to health departments will support efforts to increase awareness of and access to post-exposure prophylaxis (PEP), which refers to the antiretroviral medications taken soon after a potential exposure to HIV in order to prevent transmissions, as well as doxycycline post-exposure prophylaxis (doxyPEP) to prevent sexually transmitted infections (STIs), such as syphilis and gonorrhea.  

The CDC funding was announced August 1, and applications are due by August 31. The formal title of the funding opportunity is High-Impact HIV Prevention and Surveillance Programs for Health Departments: Accelerating Pre-Exposure Prophylaxis (PrEP) Uptake for Ending the HIV Epidemic in the United States. Click Grants.gov for more info.

For several years, PrEP advocates have pressured the government to fund a national PrEP program to make the prevention tool available to those who need it most. They praise this new funding opportunity by the CDC.

“This is a real opportunity to make an impact in our national efforts to scale up PrEP and end HIV as an epidemic,” said John Meade, MPH, senior program manager for policy at AVAC and co–founding member of PrEP in Black America, in a press release from PrEP4All. “The entire advocacy community, after years of building an evidence base for this sort of approach to equitable uptake, is ready to take the successes and lessons learned from this initiative to Congress to advocate for a national program.”

“We think it’s important for any department thinking of applying to note that the notification of funding opportunity (NOFO) specifically includes selection criteria prioritizing jurisdictions in the Deep South and states that have not expanded Medicaid—meaning that it’s well worth it for those priority jurisdictions to get an application in. Also, there is flexibility on the timeline for grant implementation through 2026, so the short window shouldn’t discourage anyone,” added Michael Chancley, MSW, communications and mobilization manager for PrEP4All and co–founding member of PrEP in Black America.

“This initiative aligns squarely with what the PrEP advocacy community has identified as what’s needed. Our organizations are ready to work with health departments to help provide context on how this grant opportunity came to be and why it is so important in advancing our movement for a National PrEP Program. We look forward to doing everything we can to support the innovative public health leaders who are ready to take full advantage of this opportunity,” said Jeremiah Johnson, MPH, PrEP4All executive director.

In related news, PrEP4All’s Johnson coauthored an op-ed in Health Affairs last month titled “A New Drug Could Change the HIV Prevention Landscape, but Only With a Fair Price Tag.” Written with Amy Killelea, the article calls on pharma giant Gilead Sciences to commit to reasonable pricing for lenacapavir, an injectable given every six months that has shown to be 100% effective as PrEP in sub-Saharan African women. The long-acting injectable is currently available in the United States as HIV treatment at a cost of $42,500 a year, according to PrEP4All. Clinical trials are underway to explore its use as PrEP in other populations, including men who have sex with men.