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The US has failed to build public health infrastructure that can reach vulnerable communities during public health crises. Advocates have called for a national preexposure prophylaxis (PrEP) program to address this, which would empower the federal government to secure fair public health prices for PrEP medications and related laboratory tests for uninsured persons. A national PrEP program would also invest in community education efforts, expansion of PrEP-provider networks and telehealth, and creating demand and building awareness in key populations. Advocates recommend funding "hub-and-spoke" delivery models to expand the number of PrEP touchpoints for marginalized communities. While the limited funding allocated to the "Ending the HIV Epidemic in the US" initiative in the FY 2023 budget could be a first step, advocates call for a $400 million investment to create a nationwide program that could be scaled up over time.
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