August 12, 2026:

More than 38,000 people in the United States were diagnosed with new HIV infections in 2024, the most recent estimates available, and some 20 percent of them are women. The nation’s leading professional organization for OB-GYNs wants to get both those numbers down.

New medical recommendations from the American College of Obstetricians and Gynecologists, issued in August 2026, advise providers to “proactively initiate discussions” about HIV testing and prevention with their patients and prescribe preventive medications to any patient who requests it. Previous guidance emphasized discussing risk and prevention with patients identified as having high HIV risk.

Available as pills and injectables, pre-exposure prophylaxis—or PrEP—reduces a person’s risk of getting HIV by up to 99 percent. States with higher rates of PrEP use saw a 38 percent decrease in new HIV diagnoses over a ten-year period. But estimates suggest only about 5-9 percent of PrEP users are women. 

“PrEP use is still very poor amongst women, and when we think about who’s getting HIV in terms of [U.S.] women, it’s Black women,” Dr. Jenell Coleman, one of the authors of the new recommendations, said in an interview with Rewire News Group. “And Black women are the least likely to have a prescription for PrEP.”

Coleman, chair of OB-GYN at Sidney Kimmel Medical College and system lead for the Women and Children’s service line at Jefferson Health in Philadelphia, spoke with RNG about lesser-known HIV risk factors—and why she hopes the new guidance will reduce stigma for both patients and providers.

The following conversation has been edited for length and clarity.

I was struck by the language that said providers “should prescribe PrEP to any individual who requests it.” What are you hoping will come out of that?

Sometimes when people go and see their OB-GYN, they may not trust them. They may not want to tell them about their sexual behaviors. They may feel judged just through other interactions. 

They [may not] feel comfortable saying that they go to sex clubs or have multiple partners. But they may say, “You know what, I heard about this medication PrEP, and I really want to start taking it right now.”

[We want OB-GYNs] to trust that and go with it, and not try to talk them out of it … just knowing that the patient may not feel comfortable telling you all of the behaviors she may be involved in, or about her other partner, or that she’s just worried about it.

If someone’s asking you for it, just prescribe it. If you don’t know how to prescribe it, link her up with a group that knows how to prescribe it. But don’t deny her this opportunity. 

That’s interesting, because if I walked into an OB-GYN clinic and wanted to be on birth control, I don’t think they’d bat an eye. 

Yeah, there are some things you come into an OB-GYN’s office, you ask for it, and we’ll say, “Okay, sure.” I mean, we would not blink an eye. 

We’re saying, “What brings you here?” [Someone says], “I want birth control.” “Okay, let’s talk about birth control.” We wouldn’t try to talk folks out of it. But for some reason, with PrEP and HIV, even amongst health-care providers, we stigmatize. We’re part of the problem.

How would you address OB-GYNs who are a little skittish about implementing the guidelines?

I’m hoping that everyone can at least mention [PrEP]. And they should figure out where they can send a patient who wants to be on it or learn more if they’re not comfortable, whether it’s their friendly infectious disease folks or family medicine, there are groups out there prescribing PrEP. 

I think many heterosexual people think they don’t need to worry about HIV. What would you say to them?

So the first thing is knowing the HIV prevalence where you live. If you’re sexually active in [a high-prevalence city,] there’s a risk that’s there. 

[Folks] are usually like, “Well I’m in a monogamous relationship.” And then I ask, “Did you guys get tested for HIV before you came together?” Because a lot of people assume that their partner is not living with HIV.

It’s just trying to get people to understand that it’s not necessarily their behavior. … A lot of people acquire HIV from who they think are their stable partners, who may be doing other things that they don’t know about.

Do you think that’s a holdover from the AIDS crisis and stigma around “promiscuity” being a risk factor for HIV?

Exactly. And people injecting drugs. … It is a whole stigma. They have this vision of what someone living with HIV looks like. And it’s like no, it’s a chronic disease. If people are taking their medicine, they can live a long time. You cannot tell.

So I think the biggest thing is letting people know: You just don’t know. And it’s up to you whether or not there’s enough to say, “I really want to protect myself at this point in my life.”

You could have one partner. But all it takes is that one partner. 

How should a patient who is PrEP-curious broach the conversation with their OB-GYN?

I would start before I even go to see the OB. They have these PrEP locator widgets online that you can [use to] figure out whether or not someone in that clinic prescribes PrEP. So then you know going into it that they’re more likely to be open to prescribing it, if they made it into this online prescriber forum. …

I think sometimes patients are afraid to ask. They may [think], Oh my gosh, if I ask for this, my doctor may think I’m doing all sorts of things, which is a valid fear. So they can even say, “Hey I heard about this new medication that’s out there to help prevent HIV. Can you tell me more?” 

I would just bring it up like that. 

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