Considering that the alternative is simply not having unprotected sex, it is hard to convince people that they should subsidize this in rich countries. This is by design, or else we won't have drugs at all
What about being born to a parent with HIV? Or not making a one-time mistake? Or being raped by someone who has HIV? The issue with HIV (unlike with other health issues that could stem from lifestyle habits, e.g., obesity or diabetes, to a certain degree) is that one slip is enough to get your life depending on that drug for the rest of your days.
Even if I disagree with the whole "make people pay for their mistakes, to amortize the costs for the rest of the society", I at least understand the logical train of thought occurring there. But there is no real lifestyle change for someone who got HIV that will cure them, and it doesn't even necessitate to have a certain "wrong" lifestyle to get HIV.
I believe its use is for pre-exposure? Anyway its not about passing judgements about lifestyles, but since there is a much cheaper alternative, people won't be persuaded to subsidize the expensive stuff.
It’s also not a rich vs poor country thing at all. It’s generic in almost all other parts of the world outside the US.
in rich countries it s subsidized by generous healthcare contributions