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PrEP Provision
An Exciting Time in HIV Prevention: PrEP Provision Is for Every Provider!

Released: November 20, 2025

Meredith E. Clement
Meredith E. Clement, MD
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Key Takeaways
  • HIV prevention and pre-exposure prophylaxis (PrEP) have followed a similar trajectory to methods of contraception: Expanded options for contraception and PrEP increase uptake.
  • PrEP should be considered a part of regular preventive medicine, like contraception, and all healthcare providers who can prescribe medications should be made eligible to prescribe PrEP

In many ways, the field of HIV prevention has paralleled the field of obstetrics and gynecology (OB/GYN), specifically in terms of methods of contraception. Pills, injections, rings, and more—many technologies for prevention of HIV are comparable to technologies for preventing pregnancy.

More Methods, More Access
One of the most exciting ways in which we, as HIV preventionists, hope our field will continue to align with the contraception field is in the idea that having more options available will enhance overall uptake. Indeed, a 2013 study by Ross and Stover demonstrated that for each additional contraception method made available to at least 50% of the population, overall uptake of contraception increased by 4% to 8%.

Our current HIV prevention toolbox includes daily and on-demand pills and, as of 2025, 2 injectables. In the not-so-distant future, we might have monthly pills and yearly injections, with even more methods in development, such as douches, patches, and other novel formulations. I anticipate that offering more choices means that pre-exposure prophylaxis (PrEP) users will be able to find a prevention option that optimally fits their lifestyle, ultimately leading to expansion of PrEP use, since more folks can find an option suitable for them.

Expansion of PrEP Provision
Another parallel to the OB/GYN field is the expansion of PrEP prescribing to “outside” practitioners. The distinction is a bit arbitrary, but PrEP has typically been viewed as falling into the purview of infectious diseases (ID) specialists. However, PrEP should ideally be considered part of regular preventive medicine, similar to contraception.

Indeed, PrEP can and should be prescribed by any healthcare provider licensed to prescribe medications, without the need to specialize in HIV or ID. Primary care providers, including internists or family medicine specialists, advanced practice providers, OB/GYNs, and those who work in sexually transmitted infection clinics or treat substance use disorders are all well suited to prescribe PrEP.

In some states, PrEP prescribing among pharmacists has been implemented. In New Orleans, where I work, we have heard great enthusiasm for PrEP prescribing among our psychiatry colleagues, especially for long-acting injectables that can potentially align with the administration of long-acting psychiatric medications, provided that proper training and education are in place.

We also have initiatives focused on PrEP implementation in emergency departments and urgent care facilities, thinking “outside of the box” to try to reach folks who could benefit from PrEP but are only accessing the healthcare system at limited touchpoints that may not include ID or even primary care clinics.

PrEP Uptake Is a Team Effort
As of 2022, the number of candidates for PrEP in the United States is estimated to be approximately 1.2 million, and that population has likely grown by leaps and bounds in the past 3 years. Among that 1.2 million, only 36% were prescribed PrEP, and uptake of long-acting injectable formulations, which have the potential to benefit so many, is still very low.

Among HIV/ID providers, there is clearly insufficient capacity to meet the needs of all PrEP candidates. Thus, an expanded base of providers prescribing PrEP is imperative if we want to ensure access. We need to help healthcare providers from various other specialties and in primary care understand that PrEP is within their scope and that they have an important role to play in ending the HIV epidemic in the United States.

It is an exciting time in HIV prevention, with novel options available and forthcoming, and continued expansion of our base of healthcare providers prescribing PrEP. Taking the lead from our OB/GYN colleagues, we have high hopes of being able to meet the needs of more and more PrEP candidates by offering greater choices for both product and provider.

We will discuss this topic in a series of free, live sessions at academic medical centers across the United States. To request one of these free, CME-certified, expert-led sessions at your academic medical center, click here.

Your Thoughts
If you do not currently prescribe PrEP, what support services do you feel are needed for you to implement PrEP in your practice? If you do currently prescribe PrEP, how do you think uptake of long-acting injectables could be improved? Leave a comment to join the discussion!

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