Preventing the transmission of HIV is an important public health goal. One approach in the fight against HIV is the focus of next week’s PrEP Awareness Week (Oct. 25-31). Pre-exposure prophylaxis (PrEP) is the use of antiretroviral medication to prevent acquisition of HIV infection. PrEP is used by people without HIV who are at risk of being exposed to HIV through sexual contact or injection drug use.
Pre-Exposure Prophylaxis (PrEP)
What is PrEP?
PrEP is short for pre-exposure prophylaxis. It is the use of antiretroviral medication to prevent acquisition of HIV infection. PrEP is used by people without HIV who are at risk of being exposed to HIV through sexual contact or injection drug use. Two medications have been approved for use as PrEP by the FDA. Each consists of two drugs combined in a single oral tablet taken daily:
· Emtricitabine (F) 200 mg in combination with tenofovir disoproxil fumarate (TDF) 300 mg (F/TDF – brand name Truvada®)
· Emtricitabine (F) 200 mg in combination with tenofovir alafenamide (TAF) 25 mg (F/TAF – brand name Descovy®)
These medications are approved to prevent HIV infection in adults and adolescents weighing at least 35 kg (77 lb) as follows:
· Daily oral PrEP with F/TDF is recommended to prevent HIV infection among all persons at risk through sex or injection drug use.
· Daily oral PrEP with F/TAF is recommended to prevent HIV infection among persons at risk through sex, excluding people at risk through receptive vaginal sex. F/TAF has not yet been studied for HIV prevention for receptive vaginal sex.
PrEP should be considered part of a comprehensive prevention plan that includes a discussion about adherence to PrEP, condom use, other sexually transmitted infections (STIs), and other risk reduction methods.
What are the guidelines for prescribing PrEP?
Comprehensive guidelines for prescribing PrEP have been published by the Centers for Disease Control and Prevention (CDC) in A Clinical Practice Guideline,[1] including a Clinical Providers’ Supplement.[2]
The Clinical Providers’ Supplement contains additional tools for clinicians providing PrEP, such as a patient/provider checklist, patient information sheets, provider information sheets, a risk incidence assessment, supplemental counseling information, billing codes, and practice quality measures. If questions arise or if prescribing advice is needed, clinicians should consult the National Clinicians Consultation Center PrEP Line @ 1-855-448-7737 (9:00 AM – 8:00 PM EST).
The U.S. Preventive Services Task Force has given PrEP a grade A recommendation.[3] This grade indicates that their review found that there is high certainty that the net benefit of this service is substantial. For more information, view the full recommendation rationale at www.uspreventiveservicestaskforce.org.
How will my patients pay for PrEP medication, clinical visits, and lab tests?
ALL EmblemHealth LOB and state Medicaid programs cover PrEP. Prior authorization is usually not required.
Patient assistance program: There are medication assistance programs that provide free PrEP medications to people with no insurance to cover PrEP care. To learn more, call 855-447-8410 or visit www.getyourprep.comexternal icon
Co-pay assistance program: Income is not a factor in eligibility. More information is available at: https://www.gileadadvancingaccess.com/external icon Some states have their own PrEP assistance programs. Some cover medication, some cover clinical visit and lab costs, some cover both. To learn more visit: https://www.nastad.org/prepcost-resources/prep-assistance-programsexternal icon
More information for your practices To get a PDF version of the information above, access other print resources for your practice and patients, visit our PrEP/PEP materials page.