Imagine a future where, with just a couple taps on your phone or a click on your laptop, you can get your weight loss medication, your multivitamins—and maybe even your HIV prevention. Discreet. Fast. No stigma. No gatekeeping. That future isn’t five years away. It’s already here—for some. Now, it’s time to make it work for HIV, too.
In recent years, the health tech sector has transformed how people access care. Platforms like Hims & Hers Health, Ro, and NURX have upended traditional models, using direct-to-consumer (DTC) telehealth to deliver treatments ranging from erectile dysfunction and skincare to birth control and GLP-1-based weight loss medications. Hims, in particular, has been a standout—reporting nearly $1.5 billion in revenue and its first annual profit.
If the private sector can move this quickly to meet demand for weight loss and wellness treatments, why is HIV prevention still mired in outdated systems?
Let’s break down what worked. Hims leveraged consumer demand for GLP-1 drugs, initially offering compounded versions of semaglutide—marketed by Novo Nordisk as Wegovy—at a fraction of the cost. Demand soared. Although the company faced regulatory setbacks when the FDA ruled those shortages resolved, Hims rebounded by partnering with Novo to sell the brand-name drug directly. Investors saw the value. Users saw results. No clinic visits, no waiting. Just access.
Ro followed a similar path, launching its own weight loss platform and aggressively marketing convenience and discretion. NURX has long pioneered at-home birth control and STI testing. These are not just niche services—they’ve redefined care for millions.
Now look at HIV prevention. PrEP has been available for over a decade, but uptake still lags—especially in the communities that need it most. Scientific progress hasn’t translated into real-world access. Stigma, insurance hurdles, and outdated care models continue to block the path. [I wrote last week about how the U.S. is still falling behind on HIV.]
To be clear, some of this innovation is already happening. Platforms like Mistr, Q Care+, and NURX are proving that telehealth can power discreet, judgment-free access to HIV prevention. Mistr, for example, offers free online access to oral PrEP in all 50 states, covering everything from virtual consults to lab work and home delivery. These services are working. But they remain the exception—not the norm. What’s still missing is the kind of strategic partnership we now see in the weight loss space—where U.S.-based telehealth platforms have partnered directly with drug manufacturers like Novo Nordisk. We need similar partnerships in HIV: originator companies working hand-in-hand with digital platforms to accelerate uptake, expand reach, and build the kind of convenience-first ecosystem today’s users expect.
What’s also missing are self-injection options. Today, injectable PrEP options like cabotegravir require in-clinic administration and aren’t designed for direct-to-consumer models—yet. If lenacapavir is approved by the FDA, it could offer another long-acting injectable option, but it too will require provider-administered dosing. But we can do better. Our innovations shouldn’t stop at the pharmacy shelf. Companies should be designing prevention options that reflect how people live and how they access care in 2025—including self-injectables that put control in the hands of the user.
Meanwhile, future oral formulations like MK-8527—currently in development—offer promising alternatives that could be more compatible with telehealth and DTC platforms.
While all of this sounds exciting, many state Medicaid programs don’t reimburse for telehealth platforms. Community health centers, overburdened and underfunded, often lack the digital infrastructure to innovate. Meanwhile, millions remain unprotected, and HIV transmissions continue.
What if we flipped the script?
Imagine an HIV prevention ecosystem where users can access oral PrEP with the same ease as ordering skincare or supplements. Where medical consultations happen online, prescriptions are delivered to your door, and digital follow-up supports adherence—all without judgment or bureaucracy.
But for this shift to happen, we need three things:
1. Regulatory flexibility. Just as regulators allowed compounded GLP-1 drugs during shortages, federal and state health agencies should expand access pathways for HIV prevention through telehealth—especially in underserved areas. This includes modernizing provider licensing laws, lab reimbursement policies, and teleprescribing rules.
2. Private-private collaboration. Pharma companies developing new HIV prevention products should partner with DTC platforms to enable real-world distribution. These platforms already understand how to engage consumers; let’s use that knowledge to bring prevention to scale.
3. Reframed financing. The U.S. health insurance system—including Medicaid, Medicare, and private payers—must adapt to the way people actually access care today. Too many insurance plans still don’t cover labs, telehealth consults, or shipping costs for PrEP and injectable prevention. Others impose unnecessary prior authorizations, step therapy requirements, or confusing co-pay structures. The Affordable Care Act made PrEP a covered preventive service, but implementation has been uneven—and legal threats to that mandate persist. If we want more people protected, the system needs to pay for prevention the way consumers access it: online, conveniently, and without red tape. And that means not cutting investments in HIV prevention—it means modernizing how those dollars are spent to match how people seek care today.
Let me be clear: I’m not suggesting that federal programs that support HIV should go away. Far from it. Federal funding for HIV services remains essential, especially for uninsured and low-income populations. But this is 2025. Consumers should be empowered to have real choices. Those with the ability to pay should be able to access HIV prevention directly—at transparent, affordable prices—through the same kinds of platforms they already use for other health needs. Meanwhile, our federal programming should be focused on reaching those most in need.
Of course, HIV prevention isn’t identical to weight loss. Both issues come with layers of stigma, structural inequality, and social marginalization. But that makes the case for disruption stronger, not weaker. We cannot treat people’s lives as less deserving of innovation than aesthetics or wellness trends.
So yes—imagine that future. One where your health essentials, including HIV prevention, are just a few clicks away. That’s the future I want. Sign me up.
In some ways, HIV prevention is like weight loss: 1. Populations who can benefit the most have the most difficulty receiving it. 2. We continue to focus on the outcome and not address the structural issues like poverty, racism, etc. 3. Even knowing that someone like myself who could benefit from Ozempic for diabetes management, insurance has declined it until I try a series of other drugs and prove that I'm impacted by the side effects and unable to take it before this drug will be approved. In HIV insurance or lack thereof, and the ability to pay for the medication, regardless of which platform you can access it, is still a barrier. These are the issues that need to be addressed.