Free PrEP in South Dakota
South Dakota expanded Medicaid in July 2023 (the newest expansion nationally) via ballot initiative. Heartland Health Resource Center operates the only two HIV service offices covering the entire state. South Dakota has among the most severe HIV criminalization laws nationally — exposure triggers sex offender registration.
Fastest Path to Free PrEP in South Dakota
If you're on Medicaid
PrEP covered at $0 — newly expanded July 2023. Enroll at dss.sd.gov/medicaid.
If you have insurance
PrEP is covered at $0 under the ACA.
If you're uninsured
Start with MISTR for free PrEP. Also apply to Gilead Advancing Access (1-800-226-2056).
In Sioux Falls
Contact Heartland Health at (605) 271-4813 or Sanford Health ID at (605) 328-8120 for PrEP navigation.
Get PrEP delivered free with MISTR
MISTR provides free telehealth PrEP in South Dakota — consultations, at-home labs, medication, and delivery at $0.
ANDR735
Use code ANDR735 when you sign up — it helps keep FreePrEP.org running so others can find free PrEP too.
South Dakota PrEP Programs & Assistance
South Dakota Medicaid
Expanded via 2022 ballot initiative, effective July 2023 — newest expansion nationally. Adults up to 138% FPL.
Gilead Advancing Access
Free Truvada/Descovy for uninsured at ≤500% FPL.
Clinics & Community Resources
Heartland Health — Sioux Falls
Ryan White services, ADAP, HIV testing (M-F 10am-3pm), PrEP access.
📍 2500 W 46th St Suite 101, Sioux Falls 57105
Heartland Health — Rapid City
Only western SD HIV service office.
📍 2834 Jackson Blvd Suite 102, Rapid City 57702
Sanford Health Infectious Disease
PrEP, navigation, STD treatment, HIV testing.
📍 Sioux Falls
Planned Parenthood North Central States
PrEP, gender-affirming care, LGBTQ+ care coordination.
📍 Sioux Falls
Telehealth PrEP Options
HIV & PrEP Data in South Dakota
South Dakota has 813 PLWH with 52 new diagnoses in 2023. Racial disparities are severe: Black residents are 2% of population but 22% of HIV cases. AI/AN residents are 9% of population but 21% of cases. 19% of transmission is through IDU — nearly double the national average. Only two Heartland Health offices cover the entire state.
Know Your Rights
HIV Criminalization
Among the nation's most severe. HIV exposure is a Class 3 felony that triggers sex offender registration. Criminalizes spitting, biting, and sharing paraphernalia. No viral load defense.
Insurance Coverage
Under the ACA, all private insurance plans must cover PrEP at $0. Medicaid expansion (July 2023) significantly improved coverage.
Native American Communities
Pine Ridge and Rosebud reservations are among the poorest US communities. IHS ETHIC grants provide some syndemic funding.
Rural Access
Outside Sioux Falls and Rapid City, access is extremely limited. Heartland Health has only two offices for the entire state.