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Objectives. HIV preexposure prophylaxis (PrEP) use has increased since its US Food and Drug Administration approval in 2012. Our objective was to describe trends in PrEP use by US women.
Methods. Using national pharmacy and HIV surveillance data, we calculated the PrEP-to-diagnosis ratio (PDR), a measure of PrEP prescriptions each year compared with HIV diagnoses the previous year, for women from 2017 to 2023. We also calculated PDRs in 2023 for the 20 counties with the highest numbers of diagnosed HIV infections among women and reviewed reports of public health activities conducted by recipients of Centers for Disease Control and Prevention HIV prevention funding.
Results. The PDR for women was 1.5 in 2017, and it increased to 5.8 by 2023. In the 20 counties with the highest number of diagnosed HIV infections among women, PDRs ranged from 2.2 to 16.9. Counties With the highest PDRs conducted PrEP activities designed for women.
Conclusions. PrEP is a highly effective HIV prevention intervention that can empower women to protect their health, but its use has been low. Public health and clinical interventions designed for women can increase their PrEP use and support ending the US HIV epidemic. (Am J Public Health. 2025;115(6):920-923.
ignificant progress has been made S in reducing HIV transmission in the United States, but systemic factors and long-standing inequities have contributed to ongoing racial and ethnic disparities.' In 2022, Black women were 13% of the US female population but accounted for 50% of HIV diagnoses among women. HIV preexposure prophylaxis (РГЕР) has been recommended by the Centers for Disease Control and Prevention (CDC) since 2014.7 PrEP can reduce the risk of sexual HIV acquisition by up to 99% 3 Although PrEP use has increased among men, its use remains low among women, with only 8% of PrEP prescriptions for women in 2023 The Ending the HIV Epidemic in the US (EHE) initiative includes a goal to increase РгЕР implementation and aims to decrease new HIV infections 90% by 2030." It also has an overarching goal to achieve HIV-related health equity with increased implementation of prevention services for disproportionately affected US populations.
The PrEP-to-diagnosis ratio (PDR) is the number of persons prescribed PrEP in a given year for each new HIV diagnosis in the previous...