What Is The Future Of PrEP Under Trump 2.0? Alarm Bells Are Ringing.
PrEP (pre-exposure prophylaxis) has been at the forefront of HIV prevention for over a decade. But with the political landscape in the US shifting dramatically, its future could be endangered. Advocates are growing increasingly concerned about the challenges that could lie ahead with a potential Trump return and Republican-led policies. So, what’s happening, and why does it matter now? Let’s break it down.
An Eight-Year Break in Infectious Disease Research?
Robert F Kennedy Jr has a key role in Trump’s new administration as he’s been tapped to lead the Department Of Health And Human Services (HHS), which controls a $1.7 trillion budget and critical health agencies like the CDC, FDA and NIH. This has caused alarm across the medical community because of Kennedy’s controversial views about HIV and AIDS – as well as his anti-vax opinions.
Kennedy has notoriously questioned the well-established fact that HIV causes AIDS, aligning himself with denialists like Peter Duesberg. He even wrote a glowing endorsement for Rebecca V Culshaw’s book, The Real AIDS Epidemic, which dismisses HIV medications as “toxic drugs” targeting Black and gay communities. Culshaw’s claims go so far as to compare HIV healthcare measures to the historic Tuskegee Syphilis Experiment, a deeply unethical study that exploited Black men under the guise of medical research.
But that’s not all. Kennedy has pushed for what he calls an eight-year “break” in infectious disease research. For advocates, this is more than troubling, it’s terrifying.
For advocates, these positions represent a dangerous step backward. Jeremiah Johnson, executive director of PrEP4All, highlighted the stakes: “If we lose funding across various programs, we’re not going to get anything done with continuing to advance PrEP access.”
SCOTUS, PrEP, and Preventive Care
The Supreme Court’s upcoming review of the Affordable Care Act’s preventive care mandate adds another layer of uncertainty. At issue is the requirement for insurers to fully cover preventive treatments like PrEP. If struck down, patients could face significant out-of-pocket costs, limiting access for those who need it most.
This comes amid existing disparities in PrEP access. A 2022 CDC analysis found that while 94% of eligible white individuals are prescribed PrEP, only 13% of Black Americans and 24% of Hispanic Americans receive it. These disparities are particularly troubling as these groups continue to experience the highest rates of new HIV diagnoses.
A Doctor Speaks Out
Dr Eric John Burnett, a Columbia University-based physician, recently took to Instagram about Trump’s order for the CDC to retract manuscripts to scrub the papers of any “banned words”. In his post, he cautioned, “This is not normal, I’m not being an alarmist here. Few things rattle me. This is very disturbing.”
Burnett’s concerns are that if certain words are no longer allowed to be used, how can research and policy effectively reach those who most need the medications? See his post in full below…
As advocates push for state-level and federal support, uncertainty looms. Still, activists remain resolute. As Johnson poignantly stated, “The sexual health needs of marginalised communities are always under attack. We can’t afford to let up now.”
