Our Voices Are Our Movement: Speaking Up for HIV Care
By Ashley Holmes, State Policy Advisor, NMAC
On August 6, 2026, from 6:30–7:30 p.m., I used my voice to publicly testify about Connecticut’s Medicaid Preferred Drug List (PDL).
As Malala Yousafzai reminds us, “When the whole world is silent, even one voice becomes powerful.” Speaking truth to power takes courage. It means standing up when it would be easier to remain silent, and choosing action when fear, uncertainty, or apathy might otherwise hold us back.
But one voice can become a movement. And one moment can spark change.
On behalf of NMAC and the communities we serve, I respectfully urged the Committee to adopt implementation practices that preserve timely access to HIV treatment and prevention services, protect continuity of care, and ensure that clinical decision-making remains centered on the needs of patients.
HIV care is not one-size-fits-all. Federal HIV treatment guidelines and clinical best practices recognize the importance of individualized treatment regimens and continuity of care. People living with HIV may depend on specific antiretroviral medications based on their treatment history, resistance profiles, co-occurring medical conditions, drug interactions, or tolerability.
That is why continuity of HIV treatment matters so deeply. An interruption or unnecessary change to an effective regimen can undermine adherence, lead to viral rebound, contribute to drug resistance, and increase the risk of HIV transmission. Patients should not have to sacrifice the stability of their health because of administrative barriers.
We are particularly concerned that prior authorization, step therapy, and other utilization management requirements could create delays or force unnecessary changes in treatment. These processes must be implemented thoughtfully, with clear exceptions and streamlined pathways that allow providers to maintain clinically appropriate therapy when medically necessary.
This is also an issue of health equity.
Black and Latino communities and LGBTQ+ individuals continue to experience a disproportionate burden of HIV while facing longstanding barriers to care, including insurance instability and provider shortages. Without thoughtful implementation, additional coverage restrictions could unintentionally widen these disparities and place an even greater burden on communities already experiencing inequities in access to care.
As Connecticut moves forward with changes to its Medicaid Preferred Drug List, we urged the Committee to preserve access to the full range of evidence-based HIV treatment and prevention options while protecting individualized, continuous care.
This comes down to three things: people, health, and dignity. We have to ensure that no one living with HIV is forced to choose between an administrative requirement and the treatment that works for them.
Our ask is simple: Protect continuity. Preserve clinical choice. Center patients.
And above all, never underestimate the power of a voice willing to speak up.