A stark racial disparity exists in access to HIV prevention medication, with Black and brown communities bearing a disproportionate burden of new infections while being severely underrepresented among those receiving preventive treatment.
Black Americans accounted for 42% of new HIV diagnoses in 2021 but only 14% of PrEP users, according to data from AIDSVu. Hispanic and Latino individuals represented 27% of new HIV diagnoses and 17% of PrEP users, while white individuals comprised 26% of new diagnoses and 64% of PrEP users.
Geographic disparities compound the problem. In the South, Black individuals made up 48% of new HIV diagnoses but only 21% of PrEP users. In the Midwest, Black individuals represented 48% of new diagnoses and only 12% of PrEP users. In the Western U.S., Hispanic and Latinx people accounted for 46% of new HIV diagnoses but only 23% of all PrEP users.
Jamal Keyton Perry experienced these barriers firsthand. As a Black gay man, he didn’t learn about Truvada—a once-daily pill that is 99% effective in preventing HIV—until five years after the FDA approved it in 2012.
Barriers to PrEP access include limited access to early testing and treatment, high medication costs for those without insurance, mistrust of the medical system, stigma related to homophobia in Black communities, generalized HIV stigma, health care providers not discussing PrEP during medical visits, and a lack of targeted educational campaigns.
While Black gay and bisexual men experience higher rates of HIV, studies indicate they do not necessarily engage in riskier behaviors than other groups, underscoring how systemic barriers drive the disparity.
See: “Access gap to HIV PrEP in Black and brown communities” (February 13, 2026)
