A lack of equitable access to HIV/AIDS, and STI prevention and treatment begins at a systematic level with a lack of comprehensive sex education, including PrEP, in schools. While the majority of states require HIV/AIDS education, there are huge disparities in who receives said education and the quality of said information. This is further compounded by budget/appropriations and policy reforms, which further strain the workforce capable of delivering comprehensive sex education. Inaccurate and stigmatizing education creates barriers to HIV prevention, care, testing, and treatment for everyone – which further perpetuates inequities in care for marginalized populations, especially among Black and Latino men, MSM, and transgender women. This presentation provides an update on federal reproductive healthcare and access litigation and policy, and highlights strategies for systems change, including policy reforms, advocacy, research, collaboration, and capacity-building to address the implications of unequal access to sex education.