The United States would erase all of the reductions in new HIV infections achieved over the last decade if PrEP coverage were to decline by only 3.3% per year over the next decade.
Atlanta, GA, September 11, 2025 – A new study published today in JAMA Network Open highlights the serious public health and economic consequences of rolling back access to HIV prevention services in the United States. Led by AIDSVu Principal Scientist, Dr. Patrick Sullivan of Emory University, the study finds that even modest reductions in the use of pre-exposure prophylaxis (PrEP) could result in thousands of avoidable HIV infections and billions in additional healthcare costs over the next decade.
The study finds that a 3.3% annual drop in PrEP coverage over the next decade could lead to over 8,600 additional preventable HIV infections and $3.6 billion in additional medical costs. PrEP coverage is the number of persons prescribed PrEP divided by the estimated number of persons who had indications for PrEP.
“Excess HIV Infections and Costs Associated with Reductions in HIV Prevention Services in the United States: Projection Using Real-World Data,” evaluates the potential consequences of limiting access to HIV prevention services—particularly pre-exposure prophylaxis (PrEP). Using population-based, real-world data, the researchers applied a previously validated ecological model to estimate how reductions in PrEP access could influence future trends in HIV diagnoses. This model maps the relationship between PrEP usage rates and HIV infection rates, allowing the authors to project the number of excess HIV cases and the additional healthcare costs that would result from such reductions.
These findings come as the House appropriations bill proposes deep cuts to federal HIV prevention funding—reductions that, if enacted, would risk reversing decades of progress, leading to thousands of preventable HIV infections and billions in additional healthcare costs.
These findings emphasize the importance of continued investment in PrEP and HIV prevention services to protect public health and prevent new HIV infections across the United States.
Key Findings:
- A 3% annual decline in PrEP coverage over the next 10 years could result in 8,618 additional preventable HIV infections and $3.6 billion in lifetime medical costs.
- A 10% annual decline in PrEP coverage over the next 10 years could result in nearly 27,000 additional new infections and over $11.3 billion in lifetime medical costs.
- A more modest 2% annual decline in PrEP coverage over the next 10 years could result in 5,226 additional preventable HIV infections and $2.2 billion in lifetime medical costs.
“This study demonstrates that even small setbacks in PrEP utilization—whether due to policy changes that restrict healthcare coverage, increased out-of-pocket costs, or reduce funding for HIV prevention programs—have the potential to reverse all of the progress we’ve made over the past decade in reducing new HIV infections,” said Dr. Patrick Sullivan, lead author and professor at Emory University.
“PrEP is one of the most effective tools we have to end the HIV epidemic, but its impact depends on sustained and equitable access for everyone who can benefit from it. Any erosion in PrEP coverage risks not only the health of individuals and communities, but also places an unnecessary financial burden on our healthcare system. Investing in PrEP access is not just sound public health policy—it’s a fiscally responsible strategy that will save lives and reduce long-term medical costs,” continued Sullivan.
PrEP is a highly effective biomedical intervention for preventing HIV infection. As of 2022, only 36% of the 1.2 million Americans with indications for PrEP were prescribed it, up from just 13% in 2017. This remains short of the federal Ending the HIV Epidemic (EHE) goal of 50% PrEP coverage by 2025.
Healthcare and policy decisions that make PrEP harder to access have far-reaching consequences. The study underscores the urgency of maintaining robust federal and state-level funding and support for HIV prevention and PrEP services, and for programs that facilitate access to healthcare. Failing to do so risks backsliding on national goals to reduce new HIV infections and end the HIV epidemic.
AIDSVu to Launch Innovative HIV Modeling Tool
AIDSVu will soon launch an interactive HIV Modeling Tool that will allow users to explore how changes in PrEP coverage and viral suppression rates can affect new HIV infections and overall healthcare costs. The tool will highlight the potential impact of policy changes—such as reducing funding for HIV programs, restricting coverage, or increasing out-of-pocket costs—that could lead to thousands of avoidable HIV infections and billions in added healthcare expenses over the next decade. Conversely, policies that maintain or increase funding for HIV prevention and treatment, expand coverage, or eliminate patient out-of-pocket costs can lead to significant reductions in HIV infections and lower healthcare costs.
More Groundbreaking PrEP Analyses from the AIDSVu Team
A study recently published in The Lancet HIV reveals that U.S. states with the highest pre-exposure prophylaxis (PrEP) coverage experienced a 38% drop in new HIV diagnoses from 2012 to 2022, while states with the lowest coverage saw a 27% increase. This is the first comprehensive, decade-long analysis to show the population-level impact of PrEP, a medication proven to prevent HIV infection. The findings underscore PrEP’s critical role in the federal Ending the HIV Epidemic initiative, demonstrating its effectiveness not only for individuals but also for reducing new infections and healthcare costs across entire communities.
More Data on PrEP:
AIDSVu, a leading HIV/AIDS data platform dedicated to making HIV data widely available, easily accessible, and locally relevant, recently released 2024 PrEP use data showing that since 2012, the number of PrEP users in the U.S. has grown significantly. Between 2023 and 2024, PrEP use increased by 17% to 591,475 people—mirroring the rise seen from 2022 to 2023. These new data offer critical insight into the populations and areas of the country that are accessing PrEP, where gaps remain, and how trends have evolved over time. The data reveals both progress and persistent disparities, especially among Black, Hispanic/Latino, young, female, and Southern populations.
AIDSVu is presented by Emory University’s Rollins School of Public Health in partnership with Gilead Sciences, Inc. and the Center for AIDS Research at Emory University (CFAR). AIDSVu’s maps and data demonstrate the need for further investments in health equity including mitigating effects of various social determinants of health such as lack of health insurance and poverty. There is still much work to be done to achieve health equity, improve the quality of life for people living with HIV, and end the HIV epidemic in communities across the U.S.
PrEPVu.org Additional Resources
Through data incubation, analysis and visualization, PrEPVu offers an understanding of PrEP use across the country and the people and communities with the greatest unmet need for PrEP.
- Interactive maps of PrEP use and PrEP-to-Need Ratios by age, sex, race/ethnicity, and geography.
- Data dashboards and policy tools tailored for public health officials, researchers, and advocates.
- A monthly newsletter, PrEPVu Monthly, offering insights, expert commentary, and community spotlights.
Additional PrEP resources on AIDSVu include a Deeper Look: PrEP page providing further insights on AIDSVu’s PrEP use and PnR data, downloadable infographics and data sets, national, regional, state, and county profiles, and blogs by HIV experts.
AIDSVu also features a PrEP Locator, a national directory of public and private practice providers of PrEP across the U.S. AIDSVu users can find local PrEP providers near them with this tool or overlay service locations on top of AIDSVu’s PrEP use maps.
