Title : Nurse practitioner implemented pre-exposure prophylaxis clinic (prep) in a local health department
Issue: Uninsured and/or underinsured individuals living in Wake County, NC USA do not have affordable access to PrEP services. Wake County had 138 new diagnoses of HIV from January to December 2017 among adult and adolescent (over 13 years old) population. The presentation will review how our local health department nurse practitioners implemented a PrEP clinic offering day one starter pack of Truvada, while patients awaited approval from the Gilead Advancing Access medication assistance program. The data presented in this presentation documents the demographics, adherence, and retention of patients in the program. It will also review the documents used in our Electronic Health Record (EHR) to collect data, assess adherence, document education, and STI/HIV rates.
Setting: Local Health Department in Wake County, NC USA that provides STI/HIV services to individuals living in the surrounding area.
Project: Nurse practitioners offer low cost PrEP services to individuals who are mostly uninsured and/or underinsured who are at high risk for HIV acquisition and would benefit from PrEP. Provide patients with a 30-day supply of Truvada to start on the day that they present to clinic after a complete history and physical, which includes a negative rapid HIV, while awaiting patient assistance approval through Gilead Advancing Access.
Results: This presentation will share the results of over one year of PrEP services offered in a local health department to assist with HIV prevention. The presentation will review how a starter pack (30-day supply of Truvada) provided at day one can be offered to patients to prevent a delay in medication start.
Lessons Learned: Even low-cost services are not always affordable to some of the most vulnerable individuals who are at highest risk for HIV acquisition. Local government agencies offering PrEP services need to find innovative ways to cover the cost related to starting individuals on PrEP. Local health departments can make a significant impact on local HIV rates by implementing day one starter pack PrEP programs. Due to delays in submission of paperwork and the need to clarify income information it was necessary to increase 10 days of medication on day one to 30 days to cover any delays that could occur while awaiting patient assistance approval. The goal of offering prevention services to patients through PrEP can be achieved through implementing programs similar to this day one starter pack program implemented and managed by nurse practitioners.