Beyond the LGBTQIA+ Community: Why Equitable PrEP Access Is a Public Health Victory for All

PrEP has transformed HIV prevention in the United States. When taken as prescribed, PrEP significantly reduces the risk of acquiring HIV. Yet more than a decade after its approval, access remains uneven, shaped by stigma, misinformation and systemic barriers that disproportionately affect Black communities and LGBTQIA+ people. Expanding and normalizing PrEP access for everyone regardless of sexual orientation, gender identity or perceived risk is not just an LGBTQIA+ issue. It is a public health imperative.

PrEP Narrow Framing and Expansive Future

PrEP has often been framed narrowly as a medication for gay and bisexual men. While men who have sex with men remain among those most affected by HIV, this limited narrative obscures a broader reality. Heterosexual women, transgender people, nonbinary individuals, and even people who regularly use certain drugs also face HIV risk. Black Americans, in particular, continue to experience higher rates of HIV compared with other racial groups, driven structural inequities rather than individual behavior.

Stigma remains one of the most persistent barriers to PrEP uptake. Patients report concerns about being judged by providers, family members, or partners. Others avoid seeking PrEP altogether because they fear being labeled promiscuous or assumed to be part of a specific community. These perceptions discourage preventive care and allow HIV transmission to persist.

Normalizing Care, Diminishing Obstacles

Normalizing PrEP as routine health care helps dismantle these barriers. When PrEP is treated like birth control or cholesterol medication more people are willing to access it. Public health research has consistently shown that stigma reduction improves engagement in care and health outcomes across populations.

Telehealth platforms such as MISTR and SISTR are playing a growing role in reshaping how PrEP is accessed. These services provide at-home HIV testing, virtual medical consultations and discreet delivery of medication. By removing the need for in-person clinic visits, they address common obstacles including transportation challenges, limited clinic hours and fear of discrimination in medical settings.

MISTR primarily serves cisgender men, while SISTR was created to meet the needs of cisgender women, transgender women, and nonbinary people. Together, they reflect a broader shift toward inclusive prevention strategies that acknowledge diverse bodies and experiences. Their models also highlight how technology can expand access in underserved areas, including the South, where HIV rates remain high and health care infrastructure is often limited.

The Wide Impact of Prevention

Equitable PrEP access has benefits that extend far beyond individual users. Widespread use of PrEP reduces community-level HIV transmission, lowering overall health care costs, and easing strain on public health systems. It also complements other prevention tools, such as condoms, routine testing, and treatment as prevention for people living with HIV.

For Black LGBTQIA+ communities, expanded PrEP access intersects with larger conversations about bodily autonomy, medical trust, and health justice. Historically marginalized groups have often been excluded from preventive care or subjected to biased treatment. Ensuring that PrEP is accessible, affordable, and culturally competent helps address these long-standing disparities.

Public health victories are rarely achieved through targeted interventions alone. They require broad adoption, shared responsibility, and systemic change. Normalizing PrEP for everyone, not just those society deems “at risk,” moves the country closer to ending the HIV epidemic.

When prevention is inclusive, stigma loses its power. And when stigma fades, communities become healthier, safer and more resilient.

Have you seen more inclusive messaging around HIV prevention recently?

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