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Rapid PrEP: Reducing Friction, Smoothing the Path

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Released: August 19, 2026

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Receiving both a PrEP prescription and the medication on the same day as the initial screening or intake appointment addresses a straightforward problem: Even when people are interested in PrEP, that initial interest can quickly wane if starting treatment is difficult. Read on to learn why rapid PrEP is so important.

Jim Pickett
Jim Pickett
Low Friction Rapid PrEP

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Rapid pre-exposure prophylaxis (PrEP) (receiving a PrEP prescription and medication on the same day as the initial screening or intake appointment) addresses a straightforward problem: Even when people come to a healthcare professional interested in PrEP, that initial interest can quickly wane if starting the medication becomes difficult.

With standard methods of PrEP provision, people may receive their prescription but still need to find a pharmacy and fill it. They may have to wait for laboratory testing or return for another appointment. If that process takes days or even up to a week, we can lose people along the way. This can be particularly consequential for people from vulnerable or underserved populations who may already face substantial barriers to accessing healthcare.

That is why, as a patient advocate, I believe pushing for rapid PrEP is a critical endeavor. We should continually ask ourselves how we can streamline PrEP delivery, reduce friction with the healthcare system, and make the process of protecting themselves from HIV easier for each individual.

Rapid Does Not Mean Rushed
However, there is an important caveat: Choice is critical. Not everyone wants or needs a rapid start. Rapid PrEP works well when someone is ready to go and confident with their decision to start PrEP. In those situations, we should avoid creating unnecessary barriers.

On the other hand, many people may be hearing about PrEP for the first time during their appointment. They may have questions or concerns, or they may simply need some time to decide whether PrEP is the right decision for them. If people are unsure, we can share information, but we should never press someone into a decision before they are ready. If we do, we may undermine their persistence in care.

Maintaining Choice as PrEP Options Expand
Just as freedom of choice is crucial for people starting PrEP, accounting for individual needs and preferences in choosing a regimen is critical. There are different options to accommodate personal needs and preferences, but the “best” option is the one that a person will take.

As the prevention landscape continues to evolve, we should be thinking about how rapid-start models might apply across PrEP modalities. Oral PrEP lends itself well to rapid-start approaches and is the best-studied same-day modality. Many people are interested in injectable options, which also have some evidence for working well as rapid PrEP if the right systems are in place. A clinic offering these options must also consider procurement and cost.

The underlying question remains the same: How do we make it easier for people to receive the prevention option they want when they are ready to receive it?

Build PrEP Around the Patient, Not the Clinic
Improving PrEP delivery also gives us an opportunity to reconsider where and how prevention services happen. We can think about incorporating self-testing, expanding clinic hours, partnering with community organizations, and bringing PrEP provision outside traditional clinic settings.

For healthcare professionals and organizations considering same-day PrEP, resources such as the National HIV PrEP Curriculum developed by the University of Washington and partners offer guidance on same-day oral PrEP initiation. Programs can also use PrEP uptake data to understand where gaps remain. In addition, HIV Bluprint, a community-research collaboration, has excellent templates and tools for building or improving prevention programs.

The broader principle is that our systems should adapt to people rather than continually asking people to adapt to our systems.

PrEP as Health and Empowerment
I believe PrEP should empower patients to feel more comfortable in their sexual lives, support pleasure and intimacy, and provide a sense of control over one’s health.

When conversations focus primarily on risk and danger, we may unintentionally reinforce stigma or make it sound like the person is not a candidate if they do not have risk factors. Instead, we can talk about staying healthy, feeling empowered, and making choices that support someone’s well-being.

Changing how we talk about PrEP can be just as important for increasing uptake as removing logistical barriers.

In all, rapid PrEP is a practical way to reduce the gap between interest in HIV prevention and the ability to act on that interest. At the same time, rapid PrEP must remain patient centered. Speed is key, but it should never replace communication, informed choice, or trust. Our goal is not simply to get more people on PrEP quickly, but it is to build prevention systems that are accessible, flexible, empowering, and responsive to the needs of the people we serve.

Your Thoughts
Where does friction remain in your PrEP delivery process? Which steps could be redesigned to make PrEP easier to access? Leave a comment to join the discussion!

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