The North Carolina AIDS Action Network (NCAAN) and the Positive Women’s Network (PWN-USA) have released a 2025 policy brief to inform advocates about the most pressing issues impacting people living with HIV in North Carolina. Over 41,000 North Carolinians are living with HIV and face challenges such as policy barriers, healthcare access issues, and stigma. This policy brief aims to provide advocates with strategic recommendations and up-to-date analysis to help improve the well-being and health of people living with HIV in the state. The brief outlines six key policy issues: three at the federal level and three at the state level.
Understanding the Key Issues
The policy brief focuses on several key areas that need attention and advocacy. At the federal level, issues include:
- Molecular HIV Surveillance (MHS): While MHS tracks HIV transmission patterns to help public health officials, the brief raises concerns about privacy, data security, and the potential for dehumanizing individuals by framing them as part of transmission “clusters”. Recommendations call for enhanced transparency, informed consent, and stronger privacy protections.
- Budget and Appropriations for HIV Programs: Critical federal programs like the Ryan White HIV/AIDS Program are at risk due to potential funding cuts. The brief recommends advocating for continued and expanded funding to protect essential services for people living with HIV.
- Medicaid and Access to Care: Medicaid is the largest source of funding for HIV care in the U.S.. Threats to federal funding or the introduction of work requirements could jeopardize healthcare access, especially for vulnerable populations. The brief advocates for protecting and fully funding Medicaid.
On the state level, the brief highlights:
- HIV Decriminalization: North Carolina has modernized its laws, but they still risk prosecuting individuals who cannot achieve viral suppression. The brief recommends further reforms to require “intent to transmit” and “actual transmission” for prosecution to be valid.
- PrEP in Pharmacies: While pharmacists can provide emergency Post-Exposure Prophylaxis (PEP), they still can’t provide pre-exposure prophylaxis (PrEP). The brief calls for legislation to allow pharmacists to provide PrEP with proper reimbursement measures and protocols.
- HIV Medication Assistance Program (HMAP) Eligibility: North Carolina’s HMAP eligibility threshold is 300% of the federal poverty level, lower than most other Southern states. The brief recommends raising this to 400%-500% to help more people afford life-saving medications.
Download the full policy brief to get all the details and learn how to get involved.
