Gift Cards, Greater Impact: 2026 Playbook for HIV Testing, PrEP Starts & Retention

HIV prevention in the U.S. is at an inflection point. PrEP use grew 17% from 2023 to 2024 to 591,475 users, yet large equity gaps persist across race/ethnicity, age, and regions—especially in the South [1]. At the population level, higher PrEP coverage is linked to fewer new HIV diagnoses: a 2025 analysis in The Lancet HIV found states with the highest PrEP coverage saw a 38% decline in new diagnoses (2012–2022), while states with the lowest coverage saw a 27% increase [2][3]. 

Policy momentum is aligned with these findings. In August 2024, CDC awarded roughly $400 million to 59 health departments to scale “high-impact HIV prevention and surveillance,” with a supplement focused on accelerating PrEP uptake among priority populations [4]. Meanwhile, prevention options continue to expand: on June 18, 2025 the FDA approved lenacapavir (Yeztugo), the first twice-yearly injectable PrEP—a breakthrough that could attract new starters and improve adherence if paired with robust outreach and retention supports [5].

The challenge for 2026 isn’t knowing what works—it’s doing what works at scale in communities that need it most. When designed and delivered with compliance in mind, gift cards are powerful, practical incentives to increase HIV testing, drive PrEP initiation, and strengthen 30-/90-day follow-up. 

Table of Contents

1. Why Incentives Matter for HIV Prevention
2. Filtered Gift Cards Explained
3. What to Incentivize in HIV Testing & PrEP
4. Key Performance Indicators (KPIs) to Track
5. 2025–2026 HIV Prevention Incentives Roadmap
6. Filtered Card Use: Real-World Examples
7. Budget Snapshot
8. FAQ: Incentives for HIV Prevention & PrEP
9. Conclusion: Doing What Works, Equitably

Why gift cards for HIV prevention—and why “filtered” matters 

For many people, the hurdles to testing and starting PrEP are mundane but real: transit costs, lost wages, childcare, stigma, or simple competing priorities. A modest gift card can offset those costs and signal that a clinic values the person’s time. In a 2024 study, 88% of Medicaid members said they were interested in a wellness incentive card usable for essentials but excluding alcohol, tobacco, or firearms [6].

However, compliance rules matter. Under federal guidance summarized by the National Association of Community Health Centers (NACHC), the OIG’s “de minimis” interpretation permits in-kind items of nominal value (≤ $15 per item; ≤ $75 per person per year) but not cash or cash equivalents (e.g., general-purpose prepaid cards usable anywhere) [7].

The solution for healthcare programs is filtered reward cards: compliance-aligned incentives that restrict use by category or merchant type. That lets institutions preserve participant dignity and choice while minimizing misuse risk and aligning with compliance counsel. 

Three filtered options available via the Engage2Reward™ Gift Card Ordering Platform: 

• CVS Select+™ Gift Card — Redeemable at CVS^®, Longs Drugs^®, and Navarro Discount Pharmacy^® locations; excludes alcohol, lottery, prescriptions, gift cards, and MinuteClinic^® services. A strong choice for testing events and general wellness needs.
• Visa^® Reward Card: ATF Restricted — Cannot be used for alcohol, tobacco, or firearms purchases; otherwise widely accepted where Visa debit is accepted in the U.S. Useful for follow-up visit incentives when you want flexibility with guardrails.
• Visa Reward Card: Pharmacy — For pharmacy use only (qualified pharmacy locations, including digital wallet use); ideal for PrEP initiation and refill/injection appointments. 

Compliance Reminder: Always consult your organization’s legal and compliance teams to document the purpose, value limits, recipient eligibility, and card restrictions for each touchpoint; keep an immutable issuance log; and audit quarterly against policy [7]. 

What to incentivize in HIV prevention & PrEP outreach 

Design the incentive journey around three milestones: 

• HIV testing (clinic, mobile unit, or outreach event) 
  • Suggested value: $10–$20 
  • Card fit: CVS Select+ for practical purchases without high-risk categories.
  • Example: A 19-year-old in rural Mississippi walks into a mobile testing unit during a back-to-school drive. After completing their HIV test, they receive a $15 CVS Select+ Gift Card, usable for school supplies or wellness items, reinforcing a positive and respectful care experience.
• PrEP initiation (oral or injectable; same-day where feasible) 
  • Suggested value: $20–$40 
  • Card fit: Visa Pharmacy to keep spending aligned with health/wellness at qualified pharmacy locations. 
  • Example: A 28-year-old Latina woman in Texas learns about PrEP at a local STI clinic. She initiates same-day PrEP with an on-site prescriber and gets a $25 Visa Pharmacy card, helping her afford other essentials tied to her health without spending on unrelated items.
• Follow-up appointments (e.g., 30-day and 90-day visits; injection visits if on lenacapavir) 
  • Suggested value: $20–$40 each 
  • Card fit: Visa ATF Restricted for broader acceptance without alcohol/tobacco/firearms merchants. 
  • Example: A recently incarcerated man in Atlanta returns for his 90-day injection on time. He's supported by a peer navigator and receives a $35 Visa ATF Restricted card, spendable almost anywhere but excluding alcohol/tobacco, reinforcing progress in a dignity-centered way.

Escalating incentives (for instance, $15 for testing → $25 for initiation → $35 for 90-day follow-up) often outperform flat values, rewarding continuity through the care cascade. And remember the equity imperative: AIDSVu’s 2024 data show the South bears 53% of new diagnoses but only 39% of PrEP users, reinforcing the need to tailor outreach by region and demographic [1].

KPIs that prove impact (track monthly; review weekly during surges) 

• Volume & conversion: HIV tests completed → % starting PrEP; same-day start rate 
• Retention: 30-day and 90-day visit completion (or injection on-time rate) 
• Equity: Outcomes by race/ethnicity, age, gender, ZIP/language; region (watch the South) [1]
• Ops & integrity: Incentives issued vs. redeemed; delivery success rate (SMS/email); fraud/exception rate; time from encounter → incentive 
• Satisfaction: One-question client CSAT/NPS via SMS; frontline staff feedback 
  

Your HIV prevention incentives roadmap from now through 2026 

Below is a practical month-by-month plan starting now (mid-August 2025) and running through December 2026. Use it to stand up, pilot, scale, and optimize an incentives program centered on HIV testing, PrEP starts, and retention—with filtered reward cards baked in. 

AUG–SEP 2025 — Stand-up the program 

• Governance & compliance: Assign a Program Owner; map OIG/CMP considerations with counsel; set per-patient annual caps; choose card types per touchpoint (favor filtered/in-kind to avoid cash-equivalent issues) [7].
• Data & tracking: In your EHR/CRM, add fields for incentive type, value, code, encounter ID, patient ID, delivery status; enable deduplication. 
• KPI dashboards: Pre-build test→start and 30/90-day funnels with equity cuts (race/ethnicity, age, ZIP). 
• Vendor onboarding: Activate the Engage2Reward Platform to source CVS Select+, Visa ATF, and Visa Pharmacy; confirm digital + physical fulfillment flows.
• Training v1: Scripts for incentive disclosure, redemption help, fraud flags; quick-reference one-pager for staff. 

OCT 2025 — Pilot (2–3 sites or one mobile unit) 

• Scope: 300–400 incentives to learn fast. 
• Design tests: Flat vs. escalating values; digital-only vs. hybrid delivery; instant issuance vs. next-day. 
• QA: Reconcile 10% of records to inventory; fix SMS/email bounce/fail issues. 

NOV 2025 — Expand pilot + outreach push 

• Add CBO partners/STI clinics; embed same-day PrEP initiation (starter packs; on-site prescribers). 
• Equity check #1: Compare uptake/conversion by demographic & ZIP; adjust hours, languages, and channels to reach priority groups highlighted by AIDSVu [1]. 

DEC 2025 — Year-end retro + scale plan 

• Lock 2026 budget and inventory buffers for category-restricted cards; finalize SOP v1.1 from pilot learnings.  

Q1 2026 (JAN–MAR) — Scale & winter resiliency 

• Standardize processes across all sites; centralize issuance logs and weekly reconciliations. 
• Same-day PrEP starts: Streamline pharmacy pickup; if offering lenacapavir, align scheduling with twice-yearly injection windows [5].
• Retention play: Automated SMS reminders tied to incentive milestones; allow on-the-spot rescheduling at visits. 
• Audit #1: Monthly spot checks of caps, documentation, and restricted-card usage. 

Q2 2026 (APR–JUN) — Optimization + seasonal surge 

• Friction busters: Provide Visa Pharmacy for follow-ups when travel/ancillary items are needed at qualified pharmacy locations.
• Campaigns: 
  • Pride Month (June): High-visibility testing + same-day starts with on-site issuance. 
  • National HIV Testing Day (June 27): One-week blitz (extended hours; mobile units). 

Q3 2026 (JUL–SEP) — Deepen retention; target cohorts 

• Launch tailored cohorts (youth, women, recently incarcerated, unhoused); pair incentives with peer navigator check-ins (7- and 21-day). 
• Audit #2 & midyear retro: Confirm caps and category restrictions; prune low-ROI channels. 

Q4 2026 (OCT–DEC) — Sustain & showcase 

• Fall tie-ins: Back-to-school and flu-clinic testing collabs. 
• World AIDS Day (Dec 1): Capstone events; publish public outcomes report (testing volume, starts, 90-day retention, equity progress). 

Putting filtered cards to work to prevent HIV (concrete pairings) 

• Testing events: $15 CVS Select+ Gift Card to nudge first steps without allowing alcohol/lottery/prescriptions. 
• PrEP initiation (oral or injectable): $25 Visa Reward Card - Pharmacy, usable only at qualified pharmacy locations to help with essentials tied to the start visit. 
• 90-day follow-up: $35 Visa Reward Card - ATF Restricted, offering broad acceptance while blocking alcohol/tobacco/firearms. 

Why this mix works: It aligns incentives with each step of the prevention journey, minimizes misuse, and squares with de minimis and cash-equivalent concerns in federal guidance summarized by NACHC [7]. 

HIV prevention budget snapshot (edit to fit your volumes) 

Assume 2,000 tests → 60% start PrEP (1,200) → 70% of starters complete 90-day visit (840). 

With $15 testing / $25 initiation / $35 90-day, incentives ≈ $89,400; add ~10% ops buffer → ~$98,340.

This structure is modular: scale up or down, and shift value between touchpoints to close your largest leaks (e.g., if test→start conversion lags, enrich the initiation value). 

The bottom line 

The science is clear: more PrEP, fewer new HIV diagnoses [2][3]. The policy environment is supportive, and 2025’s approval of twice-yearly injectable PrEP expands the ways patients can stay protected [5]. In 2026, your edge won’t be a new miracle; it will be operational excellence: removing friction, rewarding key behaviors at the right moments, and doing it equitably with filtered reward cards that are compliant, targeted, and dignified. 

Ready to get started? Schedule a call with our team today.

References 

[1] AIDSVu. AIDSVu Releases 2024 PrEP Use Data Showing Growing Use Across the U.S. (2025). https://aidsvu.org/news-updates/aidsvu-releases-2024-prep-use-data-showing-growing-use-across-the-u-s/

[2] Sullivan PS, et al. Association of state-level PrEP coverage and new HIV diagnoses in the USA from 2012 to 2022: an ecological analysis of the population impact of PrEP. The Lancet HIV (2025). https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(25)00036-0/fulltext

[3] AIDSVu. PrEP Use Significantly Associated with Decreasing New HIV Diagnoses Across U.S. States. (2025). https://aidsvu.org/news-updates/prep-use-significantly-associated-with-decreasing-new-hiv-diagnoses-across-u-s-states/ 

[4] CDC/NCHHSTP. CDC Awards HIV Prevention and Surveillance Funding to Health Departments. (Aug 1, 2024). https://www.cdc.gov/nchhstp/director-letters/hiv-prevention-surveillance-funding-award.html 

[5] Reuters. US FDA approves Gilead’s twice-yearly injection for HIV prevention. (June 18, 2025). https://www.reuters.com/business/healthcare-pharmaceuticals/us-fda-approves-gileads-twice-yearly-injection-hiv-prevention-2025-06-18/

[6] InComm Healthcare. Wellness Incentives Card: Driving Member Engagement and Closing Care Gaps. (Aug 2024). https://www.incomm.com/insights/wellness-incentives-card-driving-member-engagement-and-closing-care-gaps/

[7] NACHC Issue Brief. Structuring Patient Incentive Programs to Minimize Risk Under Federal Laws. (Oct 2024). https://www.nachc.org/wp-content/uploads/2024/12/Issue-Brief-Struc-Patient-Incentive-Programs-FINAL-11.25.2024.pdf