For many health centers, PrEP, or Pre-Exposure Prophylaxis, is a new and yet to be implemented tool for preventing HIV. It’s actually a game changer.
According to the Centers for Disease Control and Prevention, PrEP can prevent HIV infection risk by 90-99% for very high-risk patients when it’s used properly. It’s recommended for men who have sex with men (MSM), intravenous drug users (IDUs), transgender men and women, and heterosexual adults who are at high risk for HIV infection. It consists of one pill taken once per day, every day (currently Truvada® or Descovy®, though new options including an injectable PrEP (Cabotegravir) are in the pipeline). This medication should be coupled with regular quarterly medical visits that include HIV and STD screening tests and time to evaluate a patient for safety related to their overall prescription plan.
A person with HIV who takes HIV medication as prescribed and gets and stays virally suppressed with PrEP, can stay healthy and has almost no risk to sexually transmit HIV to an HIV-negative partner.
Any licensed provider can prescribe PrEP
Any licensed health center provider can prescribe PrEP. The patient-centered medical home is the ideal setting to assess a patient’s risk for HIV and engage patients in prevention options, like PrEP. If this is the right option for a patient, health center patients can be monitored as part of their primary care plan.
Health centers can and should encourage eligible patients to learn about and use PrEP as part of their primary care.
“Community health centers are well equipped to be major PrEP providers. The PrEP package is more than just a pill. It entails sexual health discussions, screening for treatable sexually transmitted infections, as well as offering medication to those who would benefit. At Fenway Health, we have had a clinical PrEP program in place for more than a decade, and we found that our patients appreciate being able to avail themselves of this protective intervention as part of engaging in primary care,” said Kenneth H. Mayer, M.D., Medical Research Director, Fenway Health, Co-Director, The Fenway Institute.
$9.8B for PrEP in Biden’s Budget
There is so much buzz around PrEP, that President Biden’s 2023 budget includes an investment of $9.8 Billion over 10 years for PrEP plus funds for other HIV care and prevention initiatives based on his goal to “End the HIV Epidemic in the United States.”
Equity has been a serious issue, however, when it comes to gaining access. Coverage for PrEP is a huge obstacle for the 30 million people who have no insurance. With new funding proposed for FY23 – and the proposed creation of an expanded PrEP access network for uninsured, under-insured, and Medicaid-covered individuals — many of these barriers to care can be overcome.
NACHC is helping health centers great ready for PrEP
NACHC is invested in supporting health centers who offer PrEP and would encourage educating patients about PrEP. Our Action Guide for PrEP Adherence and Retention Management in Health Centers can help your health center get started.
Additional resources for clinicians
- HIV Nexus – CDC shares everything you need to know https://www.cdc.gov/hiv/clinicians/index.htm
- PrEPline 855-448-7737 (855-HIV-PrEP) Toll-free – Clinical care questions – Access to advanced diagnostics for ambiguous test results and person who acquire HIV while prescribed PrEP
- NASTAD – Billing and coding guidance https://www.nastad.org/resource/billing-coding-guide-hiv-prevention