R Street Testimony in Support of GA SB 195, Authorizing pharmacists to dispense preexposure prophylaxis and postexposure prophylaxis under certain conditions
Testimony from:
Chelsea Boyd, Research Fellow, Integrated Harm Reduction, R Street Institute
In SUPPORT of Senate Bill 195, “Pharmacies; pharmacists are authorized to dispense preexposure prophylaxis and postexposure prophylaxis under certain conditions.”
January 28, 2026
House Health Committee
Chairman Hawkins and members of the committee:
My name is Chelsea Boyd, and I conduct health and harm reduction policy research at the R Street Institute (RSI), which is a nonprofit, nonpartisan, public policy research organization. Our mission at RSI is to engage in policy research and outreach to promote free markets and limited, effective government in many areas, including public health and harm reduction. That is why Senate Bill 195 is of interest to us.
Pharmacies play an integral role in health care delivery in the United States, one that has evolved considerably from medication dispensing. Today, pharmacies often fill a primary care access gap by providing specific primary care services, such as vaccinations and counseling patients on both medication adherence and risk reduction counseling.[1] It is perhaps no surprise that the general public is welcoming this shift. According to a national survey in 2022, the majority of Americans (72 percent) would be open to having medications prescribed by a specially-trained pharmacist instead of a doctor.[2]
An estimated 1.1 million Americans are living with HIV; and, although new HIV diagnoses decreased from 2008 to 2023, rates of new infections have plateaued more recently.[3] Furthermore, in 2023, about 39,000 people received new HIV diagnoses.[4] One of the key challenges in curbing the spread of HIV is that for every 100 people with HIV, only 87 people know they have HIV.[5] Launched by President Donald J. Trump in 2019, the Ending the HIV Epidemic in the U.S. (EHE) initiative aims to end the HIV epidemic in the United States by 2030. The innovative plan focuses the nation’s public health response on 57 prioritized jurisdictions where more than 50% of HIV diagnoses occur. Although Georgia is not a priority state, it does contain priority jurisdictions: Cobb, DeKalb, Fulton, and Gwinnett counties are all high priority areas.[6] The Atlanta metropolitan area is consistently among the U.S. metro areas with the highest rate of new HIV infections annually.[7] Given the high incidence of new HIV infections in Georgia and the increasing scope of (and support for) pharmacist-prescribing nationwide, there is a prime opportunity to increase access to proven medications that help stop the spread of HIV in Georgia.
Increasing access to HIV preventive medications by leveraging pharmacist-prescribing is becoming more common practice, especially in southern states. Arkansas, Louisiana, and Florida have all passed similar measures in the last three years.[8] Preliminary research indicates that such legislation is having a positive effect on public health.[9] Because many pharmacy-initiated HIV preventive medication policies were enacted recently, only a limited amount of studies evaluating these polices exist. However, in one study, about one-third of participants remained in treatment after 12 months with no new documented cases of HIV.[10] Additionally, a 2025 study that assessed whether pharmacist-prescribed PrEP policies can increase use found that allowing pharmacists to prescribe PrEP with no time limitation increased PrEP use by 25 users per 100,000 population. This figure equates to 14 percent of the mean rate of PrEP usage in 2023; suggesting that these policies could significantly increase PrEP use.[11]
While not the only solution to reducing HIV, preliminary findings of enacted policies similar to SB 195 suggest a demonstrable improvement in prevention and use of PrEP.[12] Coupled with the national expansion of pharmacists’ scope of responsibilities – and also crucially, American consumers’ support of it – this legislation will help to fill a primary care access gap by leveraging pharmacies across Georgia.[13] Expanding access to HIV prevention tools at the state level is also vital because federal funding for domestic HIV prevention efforts is unlikely to increase in 2026.[14] States must take an active role in HIV prevention by implementing policies that support evidence-based prevention efforts for their residents. Allowing pharmacists to prescribe medications that prevent HIV is one such policy. For these reasons, we appreciate Sen. Hufstetler’s leadership on this issue and urge your support for SB 195.
Respectfully,
Chelsea Boyd
Research Fellow, Integrated Harm Reduction
R Street Institute
(202) 922-6826
[1] Eric K. Farmer et al., “The Pharmacist’s Expanding Role in HIV Pre-Exposure Prophylaxis,” AIDS Patient Care and STDs 33:5 (May 6, 2019). https://www.liebertpub.com/doi/abs/10.1089/apc.2018.0294.
[2] “U.S. survey signals big shifts in primary care to pharmacy and clinic settings,” Wolters Kluwer, last accessed Feb. 18, 2025. https://www.wolterskluwer.com/en/news/us-survey-signals-big-shifts-in-primary-care-to-pharmacy-and-clinic-settings.
[3] “Deeper Look: Ending the HIV Epidemic,” AIDSvu, last accessed Jan. 22, 2026. https://aidsvu.org/resources/deeper-look/ending-the-hiv-epidemic/; “A Snapshot of HIV in the United States,” AIDSvu, last accessed Jan. 22, 2026. https://aidsvu.org/resources/#/toolsinfographics.
[4] A Snapshot of HIV in the United States,” AIDSvu, last accessed Jan. 22, 2026. https://aidsvu.org/resources/#/toolsinfographics.
[5] “Estimated HIV incidence and prevalence in the United States,” Centers for Disease Control and Prevention, last accessed Feb. 18, 2025. https://www.cdc.gov/hiv-data/nhss/estimated-hiv-incidence-and-prevalence.html.
[6] “EHE Priority Jurisdictions,” HIV.gov, last accessed Feb. 18, 2025. https://www.hiv.gov/federal-response/ending-the-hiv-epidemic/jurisdictions/phase-one.
[7] Ribhav Gupta, Rohan Bindlish, & Sten Vermund, “HIV Trends in Metropolitan US Cities from 2014-2022: Baseline For The Ending The Epidemic Initiative,” 5th HIV Research for Prevention Conference: Lima, Peru (Oct. 6-10, 2024). https://www.natap.org/2024/HIVR4P/HIVR4P_24.htm; Jim Gaines, “New HIV Case Rate in Metro Atlanta Third Highest in Nation,” The Atlanta Journal-Constitution (Apr. 1, 2024). https://www.ajc.com/news/atlanta-news/new-hiv-case-rate-in-metro-atlanta-third-highest-in-nation/6TDMS6CUTZG7RPVPRLE6O3JZCY/.
[8] Chelsea Boyd, “Pharmacist-Prescribed Medications to Prevent HIV: State Spotlight on Louisiana,” R Street Institute (Jul. 15, 2024). https://www.rstreet.org/research/pharmacist-prescribed-medications-to-prevent-hiv-state-spotlight-on-louisiana/; Chelsea Boyd, “Pharmacist-Prescribed Medications to Prevent HIV: State Spotlight on Florida,” R Street Institute (Jul. 9, 2024). https://www.rstreet.org/research/pharmacist-prescribed-medications-to-prevent-hiv-state-spotlight-on-florida/; Chelsea Boyd, “Pharmacist-Prescribed Medications to Prevent HIV: State Spotlight on Arkansas,” R Street Institute (May 29, 2024). https://www.rstreet.org/research/pharmacist-prescribed-medications-to-prevent-hiv-state-spotlight-on-arkansas/.
[9] Chelsea Boyd, “Preventing HIV with Pharmacist-Prescribed PrEP,” R Street Institute (May 14, 2024). https://www.rstreet.org/research/preventing-hiv-with-pharmacist-prescribed-prep/.
[10] Trisha A. Miller et al., “Implementation of pharmacist-led HIV pre-exposure prophylaxis management to increase access to care at an academic internal medicine practice,” Journal of the American College of Clinical Pharmacy 5:9 (September 2022), pp. 988-994. https://accpjournals.onlinelibrary.wiley.com/doi/abs/10.1002/jac5.1667.
[11] Taylor Le & Thomas Kelly, “State policies on pharmacist-initiated PrEP and PrEP usage,” Journal of the American Pharmacists Association 65:5 (Sep.-Oct. 2025). http://sciencedirect.com/science/article/abs/pii/S1544319125000949.
[12] Ibid.
[13] Kristin R. V. Harrington, Christina Chandra, & Daniel I. Alohan, “Examination of HIV Preexposure Prophylaxis Need, Availability, and Potential Pharmacy Integration in the Southeastern US,” JAMA Open Network 6:7 (Jul. 27, 2023). https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2807661; Bryan Gomez, et al., “Examining the potential of pharmacies to expand pre-exposure prophylaxis access along Georgia’s fixed-route public transit: A geospatial analysis,” Journal of the American Pharmacists Association 64:4 (Jul.-Aug. 2024). https://www.japha.org/article/S1544-3191(24)00107-9/abstract.
[14] “Congress must pass bipartisan FY 2026 bill without delay,” American Public Health Association, Jan. 21, 2026. https://www.apha.org/news-and-media/news-releases/apha-news-releases/congress-must-pass-bipartisan-fy-2026-bill-without-delay.