Deeper Look: PrEP

The PrEP utilization data on AIDSVu reveal that the number of PrEP users in the U.S. increased by 20% from 2021 to 2022, continuing a trend of consistent growth in PrEP use since 2012. In addition, AIDSVu’s PrEP use data by race/ethnicity reveal that in 2021, Black people represented 40% of all new HIV diagnoses, but only accounted for 14% of PrEP users in 2022. Hispanic/Latinx people represented 17% of PrEP users in 2022 and 29% of new HIV diagnoses in 2021.

These data reveal the importance of looking at PrEP use through a health equity lens. In order to be effective, programs should be driven by the goal of increasing PrEP use among populations with the greatest unmet need for PrEP. The data available on AIDSVu can help inform policies and programs to ensure that communities that are disproportionately impacted by HIV are aware of and able to access PrEP.

PrEP, or pre-exposure prophylaxis, is when people at risk for HIV take or receive HIV medicine regularly to lower their chances of getting infected with HIV.  The Centers for Disease Control and Prevention (CDC) has estimated that approximately 1.2 million people are at high risk for HIV exposure and could benefit from comprehensive HIV prevention strategies, including PrEP.

What is Pre-exposure prophylaxis (PrEP)?

• Pre = before
• Exposure = coming into contact with HIV
• Prophylaxis = treatment to prevent an infection from happening

The PrEP utilization data on AIDSVu reveal a 52% average annual increase in persons using PrEP across the U.S. — including a 20% increase from 2021 to 2022. While these data point to significant growth in PrEP use nationwide, they also highlight important disparities in PrEP use across different sexes, races/ethnicities, age groups, geographic location, socioeconomic status, and access to care. In the United States, 36,126 people were diagnosed with HIV in 2021, underscoring the need to continue expanding the use of PrEP and other comprehensive HIV prevention strategies.

AIDSVu’s PrEP data, which provide a reliable and consistent metric for PrEP users in each county and state in the U.S. by year from 2012 to 2022, can be stratified by age and sex. State-level maps from 2021-2022 can additionally be stratified by race/ethnicity for Hispanic, Black, and white individuals. These data and maps offer important, comparative information and tools to public health officials, policymakers, and researchers to inform efforts to increase PrEP awareness and access where it is needed most. Please see the Data Methods page for additional information on the data set and its limitations.

What These Data Tell Us

(PrEP use data is from 2022, and new diagnoses data is from 2021, unless otherwise noted.)

Overall PrEP Use

• The number of PrEP users in the U.S. increased by 20% from 2021 to 2022, continuing a trend of consistent growth in PrEP use since 2012.
• The South accounted for 52% of HIV diagnoses but only accounted for 38% of PrEP users.
• In 2022, states that had expanded Medicaid programs had an average PrEP use rate that was 1.4X higher compared with states that have not expanded Medicaid.

PrEP Use by Sex

• Among all PrEP users in the U.S., 92% were male and only 8% were female, despite the fact that women comprised 18% of new HIV diagnoses.

PrEP Use by Age

• Teenagers and young adults (aged 13-24 years) had the greatest unmet need for PrEP among all age groups, with a PNR of 9. That means that for every person in that age group diagnosed with HIV, there were only 9 people using PrEP.
• 64% of all PrEP users were between 25 and 44 years old.
• The rate of PrEP use per 100,000 people was highest in the 25-34 age group (378) and lowest in the 55+ age group (46).

PrEP Use by Race/Ethnicity

• Black people represented 14% of PrEP users, but 42% of new HIV diagnoses.
• Hispanic/Latinx people represented 17% of PrEP users and 27% of new HIV diagnoses
• White people represented 64% of PrEP users and 26% of new HIV diagnoses.
• Regionally, Black people made up 52% of new HIV diagnoses in the South, but only 21% of PrEP users in the South; in the Midwest, Black people made up 48% of new HIV diagnoses, but only 12% of PrEP users.

• In the South, there were 27 white PrEP users for every new HIV diagnosis among white people. In comparison, there were only 4 Black PrEP users for every new HIV diagnosis among Black people.
• Of the 5 states with the greatest unmet need for PrEP (Puerto Rico, Mississippi, South Carolina, Alabama, and West Virginia), 4 were in the Southern region of the United States.
• In the West, Hispanic/Latinx people represented 46% of new HIV diagnoses but only represented 23% of all PrEP users.

* PrEP-to-Need Ratio (PNR) is the ratio of the number of PrEP users in 2022 to the number of people newly diagnosed with HIV in 2021. It is a measurement for whether PrEP use appropriately reflects the need for HIV prevention. A lower PNR indicates more unmet need.