How 340B Protects HIV Care in Texas

Januari Fox, Director of Policy, Advocacy, and Community Engagement for Prism Health North Texas, on protecting HIV care access, advancing LGBTQ+ health equity, and why coalition-building matters in the fight for 340B.

At Prism Health North Texas, Januari Fox leads policy, advocacy, and community engagement efforts focused on HIV care, prevention services, and culturally competent healthcare for LGBTQ+ communities. It is work that depends on strong safety-net programs and sustainable healthcare funding.

A longtime advocate for health equity and patient access, Fox works at the intersection of public health policy and frontline care, helping providers navigate an increasingly complex healthcare landscape while protecting critical programs such as 340B.

For Fox, the value of the 340B program became especially clear during one of the most difficult periods in recent healthcare history.

Responding to Crisis With Care

When Fox joined Prism Health North Texas in 2020, the healthcare system was rapidly changing under the pressure of COVID-19. Providers across the country were forced to rethink how care could be delivered safely and effectively as telehealth services expanded and traditional healthcare models were disrupted almost overnight.

At Prism Health North Texas, staff worked quickly to adapt critical HIV and STI testing programs while continuing to serve patients facing mounting instability, economic hardship, and disruptions to their healthcare.

For Fox, that moment demonstrated exactly why 340B matters. The program gave providers the flexibility to respond to urgent community needs in real time, especially as other funding streams became strained or increasingly restrictive.

That flexibility allows safety-net providers to respond directly to community needs as they arise, especially when other funding sources fall short.

A Lifeline for Safety-Net Providers

In Texas, where Medicaid has not been expanded and uninsured rates remain among the highest in the country, providers are constantly being asked to do more with fewer resources.

At the same time, HIV cases continue to rise across North Texas and throughout the South, increasing pressure on organizations already navigating funding challenges and growing patient needs.

Fox says 340B helps bridge those gaps and allows organizations like Prism Health North Texas to continue delivering comprehensive care and services that many patients would otherwise struggle to access.

Without the program, communities would likely face longer wait lists, service disruptions, and cuts to critical services such as behavioral health care, dental care, and comprehensive HIV and STI testing.

For providers serving vulnerable populations, those consequences would be devastating.

Building Community Through CV340B

Fox says one of the most valuable parts of working with CV340B has been the organization’s ability to bring providers and advocates together around a shared mission.

Because the 340B program can often feel technical or difficult to explain, organizations need trusted spaces where providers can share resources as political and legal challenges continue to evolve.

Fox also points to the deep expertise and commitment across the CV340B network as one of the coalition’s greatest strengths.

Despite facing powerful pharmaceutical industry opposition, the coalition remains grounded in a shared commitment to public health and patient care.

Looking Ahead

As attacks on the 340B program continue, Fox believes the work of advocacy and coalition-building has never been more important.

She emphasizes that behind every policy discussion are real people whose lives depend on access to affordable healthcare — even if they never fully realize how programs like 340B help make that care possible.

For Fox, the future of 340B depends on continued collaboration, strong advocacy, and providers remaining engaged in the fight to protect the program.

Fox believes providers must continue prioritizing collaboration and advocacy to protect the future of the 340B program and the communities that depend on it.

If this story resonates with you, we invite you to stand with us to defend the 340B program and help ensure communities across the country have access to essential healthcare.

Here are ways you can take action and make a difference: