alt Hacker NewsCost and compliance are still 2 major factors that have not been solved.
We also have education and stigma. While within the LGBT community it is far more common to be open about status and taking prep and doxy (far from perfect though), it still feels like outside of that the conversations are not happening as much as they should.
Throw in doctors that are not being proactive about the conversation.
Right now it seems like having prep and doxy is largely considered only if you are engaged in "risky" behavior (not saying that in a judgmental way to be clear), instead of just being sexually active and protecting yourself. Money and investment alone won't fix that, that is a societal shift around how we talk about sex.
That is also before we get into the cost issues in many other countries just for those that do need it.
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Compliance is the big thing.
Vaccines are the "an ounce of prevention is worth a pound of cure"
PrEP is freely available in the UK and there is almost no requirement in practice of engaging in risky sex. I don't know anyone turned down for not having risky enough sex
Which countries are you talking about out of curiosity?
The LGBT community should also think about abandoning some risky practices which allow infections, and promote antibiotic resistance in the case of doxycicline "prep".
But I guess that sex without condoms is worth it, right?
PReP has some side effects. While they are rare, they are things you need to be aware of. If you are not doing risky sex it isn't for you.
Most people want to believe they are in a monogamous relationship and thus not having risky sex - even though they are the one cheating. Either PReP needs to be more common, are people need to stop their risky sex activities (that they are not even admitting to).