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Get PrEPared! A Pill to Prevent HIV

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by

Elizabeth Argo-Wilbanks

on 29 July 2014

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Transcript of Get PrEPared! A Pill to Prevent HIV

PrEP Medicines
Truvada -
tenofovir disoproxil fumarate (also called TDF,or tenofovir) and emtricitabine (also called FTC)
A Simple PrEP tutorial
Research Supporting PrEP
The risk of getting HIV infection was lower—up to 92% lower—
for participants who took the medicines
consistently
than for those who did not take the medicines.
Guidelines for PrEP use
PrEP should be considered for people who are HIV-negative and at substantial risk for HIV infection.
Detecting Substantial Risk
PrEP Access
Clinically Eligible
• Documented negative HIV test before prescribing PrEP

• No signs/symptoms of acute HIV infection

• Normal renal function, no contraindicated medications

• Documented hepatitis B virus infection and vaccination status
Prescription & Follow-up
• Follow-up visits at least every 3 months to provide:
• HIV test, medication adherence counseling, behavioral risk reduction support,side effect assessment, STD symptom assessment
• At 3 months and every 6 months after, assess renal function
• Every 6 months test for bacterial STDs
• Do oral/rectal STD testing
• Assess pregnancy intent
• Pregnancy test every 3 months
• Access to clean needles/syringes and drug treatment services
HIV
Reduction
PrEP
A Pill to Prevent HIV
FDA approved in July 2012
Taken in a single pill daily for HIV prevention
Trials evaluated PrEP among gay and
bisexual men, heterosexual men and women, and injection drug users.
US Public Health Service released the first comprehensive clinical practice guidelines for PrEP in May 2014
www.cdc.gov/hiv/pdf/guidelines/PrEPguidelines2014.pdf
Sexual Transmission
ongoing relationship with an HIV-positive partner
Anyone in a non-mutually monogamous relationship and 1) gay or bisexual man who has anal sex without a condom or diagnosed with an STI within 6 months 2) heterosexual man or woman who does not regularly use condoms during sex with partners of unknown HIV status
People who inject drugs
Those who have injected illicit drugs in past 6 months
Men who have sex with Men (MSM)
• Sexual partner with HIV
• Recent bacterial STD
• High number of sex
partners
• History of inconsistent or
no condom use
• Commercial sex work



Heterosexual Men and Women
• Sexual partner with HIV
• Recent bacterial STD
• High number of sex
partners
• History of inconsistent or
no condom use
• Commercial sex work
• Lives in high-prevalence
area or network
Injection Drug Users
• HIV-positive injecting
partner
• Sharing injection
equipment
• Recent drug treatment
(but currently injecting)
Truvada is covered by many insurance plans
- Gilead offers a Co-Pay assistance program & access program uninsured

Some insurers require pre-authorization

Coding guidelines outlined in CDC Providers' Guide
Full transcript