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This newly approved long-acting injectable PrEP offers 6 months of HIV protection, and represents a major scientific and policy breakthrough. However, its success will depend on ensuring equitable access, enforcing coverage requirements, and maintaining a robust, multi-faceted HIV prevention infrastructure amid political and systemic challenges.

The 15th anniversary of the Affordable Care Act is overshadowed by threats to HIV prevention efforts, including a looming Supreme Court case that could eliminate no-cost access to preexposure prophylaxis and other preventive services. Simultaneously, deep federal cuts and restructuring have destabilized critical public health infrastructure, jeopardizing decades of progress in the fight against HIV.