Most people have never had a doctor bring up HIV testing or PrEP unless they asked first. New guidance from the American College of Obstetricians and Gynecologists says that has to change.

In August 2026, ACOG released Committee Statement No. 32, replacing the separate PrEP and HIV screening guidance it had used since 2014. The update tells OB/GYNs to offer every patient at least one HIV test in their lifetime using opt-out screening, and to raise PrEP as a normal part of a routine visit rather than something only certain patients get asked about.

What actually changed

The old guidance left a lot of judgment to individual doctors: does this patient look like they’re at risk? The new guidance replaces that guesswork with a baseline. Every patient gets offered at least one HIV test in their lifetime, using an opt-out approach, meaning the test happens unless the patient says no, not only when they ask for it. Patients with ongoing risk factors get tested more often, and pregnant patients get screened at least once per pregnancy.

ACOG also wants OB/GYNs taking comprehensive, nonjudgmental sexual histories from every patient regardless of age or marital status, and using that conversation to bring up PrEP directly with anyone who might benefit, rather than waiting to be asked.

Who PrEP is for, and what’s actually available

The guidance lists specific risk factors that should prompt a PrEP conversation: a recent STI diagnosis, gonorrhea or syphilis within the past six months, inconsistent condom use, a partner known to be HIV-positive, multiple partners of unknown status, injection drug use, transactional sex, or recent time in a correctional facility. Clinicians are told to prescribe PrEP to anyone at increased risk, or anyone who simply asks for it.

For cisgender women, that now means three real options: daily oral emtricitabine/tenofovir, an injectable cabotegravir shot every two months, or a lenacapavir injection every six months. Starting any of them requires a negative HIV test within the preceding week.

Why ACOG is pushing so hard on this

The numbers behind the update are specific. There were more than 38,000 new HIV diagnoses in the US in 2024, and about 7,752 were in women, most from heterosexual contact. Black women accounted for half of those new diagnoses despite being 13% of the population, a diagnosis rate of 21.6 per 100,000 compared with 6.4 for Hispanic and Latina women and 1.8 for white women. People aged 13 to 24 made up 18% of new diagnoses.

PrEP has the same gap. Black individuals make up 40% of people who meet the clinical criteria for it, but only 9% to 17% of the people actually using it. As of 2019, fewer than 40% of adults had ever been tested for HIV at all.

Why it has to come from the doctor

Dr. Jessika Ralph, one of the guidance’s authors, put it plainly: one of the most important factors in someone deciding to get tested is their doctor recommending the screening. Dr. Catherine Cansino made a similar point, that these conversations can be hard for patients to start themselves, which is exactly why she sees it as an opening for clinicians. Dr. Jenell Coleman called PrEP “an underutilized prevention tool” and pointed to shared decision-making, not a rigid risk checklist, as the way to actually talk about it with patients.

What this means for your next visit

If your OB/GYN has never brought this up, it’s not because you didn’t need to hear it. It’s because the old guidance left that call up to them. Under the new guidance, it shouldn’t be optional anymore. Every patient should be hearing about HIV testing and PrEP as a normal part of a routine visit, not a special one reserved for people who ask.

That’s the same shift Protecht is trying to make outside the exam room. A verified status shouldn’t be something you dig for proof of or take on faith. It should be as normal to share as it now is for your doctor to ask.

Sources

• ACOG Committee Statement No. 32: Human Immunodeficiency Virus Screening and Preexposure Prophylaxis
• HIV screening, PrEP counseling get stronger ACOG recommendation — Contemporary OB/GYN
• ACOG Releases New Guidance on HIV Screening and Prevention — Patient Care Online
• ACOG updates guidance on HIV screening and prevention — Healio

The CDC just released its newest national STI data, and the headline looks like good news: cases fell for the third year in a row. The full picture is more complicated than a single downward line.

In 2024, the US reported just over 2.2 million cases of chlamydia, gonorrhea, and syphilis combined, a 9% drop from 2023. Chlamydia was down 8%. Gonorrhea was down 10%. Primary and secondary syphilis, the most infectious stage, fell 22%. Public health officials point to wider use of at-home and point-of-care testing, plus doxycycline as an after-exposure prevention option, as real drivers behind the decline.

The decline is real, but it’s not the whole story

The CDC flagged a catch of its own this year: it released only national numbers, not the usual state, age, and race breakdowns, because it’s still migrating to a new data platform. That transition started in 2022, the same year the declines began, and it has delayed reporting from a number of states.

There’s a second wrinkle. Surveillance data counts positive test results, not how many people got tested in the first place. If clinics are testing fewer people, because of shorter hours, staffing cuts, or insurance changes, fewer positive results don’t necessarily mean fewer infections. It can just mean fewer people looked.

The number moving the wrong way

One trend didn’t improve. Congenital syphilis, passed from a pregnant person to a baby, rose for the 12th year in a row, to nearly 4,000 cases in 2024. That’s up almost 700% from a decade ago, and it’s preventable with timely testing and treatment during pregnancy. Early-stage syphilis in women also climbed nearly 8% last year, a sign of infections progressing before anyone catches them.

As one public health official put it, the rising rate of congenital syphilis is “a completely preventable condition.” Reversing it depends on the same thing driving the good news elsewhere: people actually getting tested, and getting real answers.

What the data means for you

None of this is a reason to panic, and if you’re already testing regularly, it’s not really about you. It’s a reminder that a national trend line doesn’t tell you where you actually stand. The only status update that matters is your own, and it only helps if it’s real.

That’s the whole idea behind Protecht. No self-reported screenshots, no guessing. Results come straight from the provider or lab that ran the test, so what you share is what actually happened.

Sources

• CDC Releases 2024 National STI Data
• CDC data show declines in sexually transmitted infections, rise in newborn syphilis — CIDRAP
• Are sexually transmitted diseases truly declining, or is the data just lacking? — Healthbeat

Global health funding has had a rough couple of years, and this August brought two announcements that partly reverse course. Neither one is really about testing access in the US directly, but both connect back to the same funding streams that keep community health organizations here running, which is worth understanding even if you never think about foreign aid.

What actually got announced

On August 6, 2026, the State Department announced nearly 2 billion dollars in new partnerships with faith-based and community organizations to deliver health and humanitarian assistance, including 1.4 billion dollars for integrated health services across more than 20 countries. A few days earlier, the department confirmed it would release 600 million dollars in funding that Congress had already appropriated for Gavi, the Vaccine Alliance, money that had been held up for roughly a year.

Both announcements followed a period of significant disruption. The prior restructuring of federal foreign assistance had already led to canceled grants and contracts across health, nutrition, and emergency relief programs in multiple countries, and the Gavi funding specifically had been frozen over disagreements about vaccine ingredients. Neither issue is fully resolved, but both point toward money moving again after a long pause.

The public wants more of this, not less

A Rockefeller Foundation poll released this summer found that 72 percent of Americans support restoring some or all global health funding, a figure that held up across party lines even if the specific level of support varied. That is a meaningfully different picture than the one that usually drives funding decisions, where cuts are assumed to be popular and restoration is treated as a hard sell.

Why this connects to domestic testing access

Global funding announcements can feel disconnected from a local clinic’s ability to keep its doors open, but the same instability that hit international programs has rippled through domestic ones too. Programs like Ryan White, Title X, and CDC HIV prevention funding to community organizations have all faced their own periods of uncertainty over the past couple of years, and the organizations we work with, from community health centers to LGBTQ+ centers, feel every one of those funding gaps directly in staffing and hours.

Stability at the federal funding level, whether global or domestic, is what lets local partners keep testing available, keep outreach staffed, and keep the lights on for the people who rely on them. Watching the global funding picture is one way to gauge whether that stability is coming back.

The bottom line

Two funding announcements this August do not undo a year of disruption, and the exclusions and conditions attached to both deals show the recovery is uneven. But the direction matters, and the polling suggests the public would support going further. For anyone who relies on a community clinic, a testing site, or a local health center, the health of that funding pipeline, wherever it starts, eventually shows up as whether the doors are open.

Sources

• United States Announces Historic $2 Billion in Health and Humanitarian Assistance to Faith-Based Organizations, U.S. Department of State
• Gavi welcomes United States government commitment to unlock funding for fiscal years 2025 and 2026
• State Department agrees to reinstate vaccine funding for Gavi, CIDRAP
• New Echelon Insights Survey Commissioned by Rockefeller Foundation: Most Americans Back Foreign Aid a Year After USAID’s End

The fifth edition of the Hologic Global Women’s Health Index came out this March, and one number in it is hard to look away from: only 10% of women surveyed said they had been tested for an STI in the past year. That is down slightly from the Index’s first year of tracking, meaning the number has not meaningfully moved in five years of measurement. Not up. Not down in a way anyone would call progress. Just stuck.

That is not a story about women not caring about their health. It is a story about a system that has made testing feel optional, awkward, or simply beside the point, right up until it very much is not.

Why the Number Is Stuck

There is not one single reason 90% of women are not getting tested annually. It is a stack of smaller reasons that add up. Doctors often do not bring it up unless a patient asks first, and a lot of patients assume that if it mattered, their provider would have mentioned it. Annual physicals frequently do not include STI screening by default, especially for women who are not pregnant or not presenting symptoms. And the conversation itself, the one where you tell a doctor or a partner you would like to get tested, still carries a weight it should not, because testing has long been coded as something you do when something is wrong rather than something you do because your body deserves routine attention.

New guidance from King County Public Health, published this January, points at part of the fix. Rather than treating STI screening as a once-a-year box to check regardless of circumstances, the guidelines set a baseline of at least annual testing for sexually active people, then recommend more frequent testing, every three to six months, for anyone with risk factors that make a longer gap less useful. Those factors include things like a recent STI diagnosis, more than ten partners in the past year, or inconsistent barrier use. It is a more realistic model than a flat annual reminder, because sexual health does not move on a calendar. It moves based on what is actually happening in someone’s life.

The Missing Piece Is the Conversation, Not the Test

Testing itself has gotten easier over the past decade. Clinics are more accessible, at-home kits exist, insurance coverage has broadened in a lot of places. The bottleneck is not really access anymore, in most cases. It is the conversation around it: deciding to go, telling a partner why, and then, afterward, actually sharing the result with the people who need to know it.

That last step is where a lot of good intentions quietly stall out. Someone gets tested, gets a negative result, and then the information just sits in a patient portal or a paper printout that never makes it into an actual conversation with a partner. Not because anyone is hiding anything, but because there is no easy, low-stakes way to share it. Sending a screenshot feels either like overkill or like proof no one asked for. Saying “I got tested, I’m negative” out loud works, but it puts the whole weight of trust on the listener with nothing to verify it against.

This is the exact gap Protecht was built to close. A verified result, connected securely from participating labs, shareable with a partner in a few taps, no screenshot, no paper trail, no awkward follow-up questions about when exactly “recently” was. The testing part still happens the same way it always has, at a clinic, through a provider. What changes is what happens after: the sharing gets as easy as the testing should have been all along.

Moving the Number

If the 10% figure is going to actually move, and not just get reported on again next spring with the same disappointing footnote, it is going to take more than encouraging people to test. People need a reason that feels immediate, not abstract. Making the results genuinely useful, shareable, and easy to act on gives testing a payoff beyond a number on a portal nobody checks.

Routine testing paired with routine, low-friction sharing is what actually closes gaps like this one. Not another awareness campaign asking people to care more. They already do. What is missing is the infrastructure to make that care count for something the next time it matters, in a conversation with a partner who deserves real information instead of a guess.

Sources

• 1.5 Billion Women Miss Essential Preventive Tests, Despite Uptick in Global Screening Rates — Hologic Global Women’s Health Index, 5th edition, released March 17, 2026. Reports 10% of women surveyed had been tested for an STI in the past year, down 1 percentage point from Year 1 of the Index.
  * 2026 HIV and STI Screening Guidelines — King County Public Health, published January 2026. Recommends at least annual STI screening for sexually active individuals, with more frequent testing (every 3-6 months) for those with risk factors including partner count, recent diagnosis, or inconsistent barrier use.