• Posted January 11, 2026

Overcoming Obstacles to HIV Prevention

Though an antiretroviral medication called PrEP provides near-perfect protection against HIV, patients must often surmount hurdles to obtain it.

From medical stigma to insurance denials and doctors who are unfamiliar with the regimen, a new report finds that many LGBTQ+ people have had negative experiences trying to protect themselves from the virus that causes AIDS.

Dr. Beth Oller, board member of GLMA, a nationwide organization of LGBTQ+ and allied health care professionals focused on health equity, has seen the fallout in her Kansas practice.

“I have a lot of patients who had not done preventive care for years because of the medical stigma,” she told KFF Health News, a program of the nonprofit KFF.

Taken as prescribed, PrEP — shorthand for preexposure prophylaxis — is 99% effective in protecting people against sexual transmission of the virus that causes AIDS.

Matthew Hurley — who lives in the San Francisco Bay Area, which has one of the nation’s highest concentrations of LGBTQ+ people — shared his experience with KFF Health News.

After having sex with someone who then tested positive for HIV, Hurley began taking PrEP. But when a change of insurance forced a change of doctors, he was surprised to discover that he knew more about the regimen than his new physician did.

"When I brought up PrEP to him, he said, 'What’s that?' " Hurley told KFF. "And I was like, oh boy."

He explained to his new doctor that he took a pill every day and had quarterly lab work to monitor for breakthrough infections or other health problems. After the physician did his own research, he agreed to prescribe PrEP.

That was just the first in a series of hurdles Hurley had to surmount. While most private insurance plans and Medicaid expansion programs are required under the Affordable Care Act to cover PrEP and related services like lab tests with no cost sharing, Hurley spent months contesting charges and past-due notices.

He finally found a provider that was better informed about PrEP — and hasn’t had an unexpected bill since.

Still, he wishes he didn’t have to separate his sexual health care from his primary care.

"I have multiple organizations that I have to deal with to get my holistic health dealt with," he said.

To head off some of the problems Hurley encountered, KFF recommends: 

Find out if PrEP is right for you. Under guidelines from the U.S. Centers for Disease Control and Prevention (CDC), it can be prescribed to anyone who is sexually active. In particular, the CDC recommends it for people who don’t use condoms consistently, IV drug users who share needles, men who have sex with men and people whose partners are living with HIV or whose HIV status is unclear.

Don’t assume your provider knows about PrEP. Check your state or local health department for a how-to guide you can share with your provider. The CDC also has PrEP guidelines, but some HIV/AIDS resources have been removed from federal websites.

Go in-network for labs. To avoid a bill you shouldn’t have to pay, ask your doctor’s office to be careful about coding required lab work and to send you to a lab that is in-network. If the office makes mistakes, share the PrEP billing and coding guide from NASTAD, a non-profit association representing public health officials who oversee HIV and hepatitis programs.

Seek savings. Truvada, the first approved PrEP drug, has several lower-cost, generic versions. Ask your doctor to prescribe meds your insurance will cover. Some drug makers have aid programs for qualifying patients.

Consider telehealth and seek out affirming care: Roughly 20% of patients on PrEP used telemedicine in 2024. Online pharmacies like Mistr and Q Care Plus offer PrEP without an in-person appointment and lab work can be done at home. The LGBTQ+ Healthcare Directory is a searchable nationwide database of health care providers who identify as queer-friendly.

More information

Learn more about using medication to reduce HIV risk.

SOURCE: KFF Health News, Jan. 5, 2026