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Effective Interventions

PrEP and Health Departments

Health Departments

Delivery of PrEP in the United States includes a system of prevention and support services, or the PrEP care system, that contributes to making PrEP available, accessible, and acceptable.

PrEP is listed as an essential component of the notice of funding opportunity (NOFO), “Integrated HIV Surveillance and Prevention Programs for Health Departments,” or PS18-1802. According to this NOFO, health departments should work to expand awareness of and access to PrEP through:

  • Screening for PrEP eligibility;
  • Linkage and support for PrEP;
  • Supporting adherence to PrEP;
  • Increasing consumer knowledge, access, and use of PrEP; and
  • Enhancing provider knowledge and support for PrEP.

Additional Information

Funds from PS18-1802 cannot be used to pay for medications, clinical care, or labs other than HIV or viral hepatitis screening. However, jurisdictional health departments can also use non-CDC funds to implement PrEP services within sexually transmitted infection (STI) clinics. These can range from counseling and referral services to the provision of clinical services for PrEP. States may also consider implementing PrEP assistance programs for the uninsured to assist with payment for clinic visits and laboratory costs related to PrEP.

Screening for PrEP Eligibility

PrEP services and referrals can be worked into health departments’ pre-existing HIV preventions strategies. At the time of HIV testing, presentation for an STI, or when accessing post-exposure prophylaxis services, patients should be evaluated for PrEP eligibility and linked to a PrEP provider, as appropriate.

Linkage and Support for PrEP

Health departments can help educate and motivate on PrEP implementation using social and behavioral strategies and interventions, such as PrEP navigation, education, and counseling services. Health departments should evaluate the availability of PrEP services in their jurisdictions to determine areas of need to scale up services and increase use.

Support Adherence to PrEP

PrEP users should be provided all the information and support needed to ensure they take PrEP  daily as directed.  Health departments can support clinics and community-based organizations with adherence-related activities by providing PrEP education to clinical providers and providing resources for patients. Section 10 of the clinical providers’ supplement contains details on counseling patients on adherence. Every Dose Every Day is a toolkit designed to improve medication adherence in persons who are HIV positive, and can also be used to improve adherence to PrEP. 

Health departments can also address access to PrEP, which may vary between jurisdictions. Currently, CDC funds may not be used to pay for Truvada®, but health departments may be able to establish PrEP assistance programs within their jurisdictions. The states of Virginia, Massachusetts, and Washington have implemented PrEP drug assistance programs, or “PrEP DAP,” to increase access to and use of PrEP using state funds.

Increase Consumer Knowledge and Support for PrEP

Health departments can help increase knowledge of PrEP within the community to help increase the acceptability of PrEP among HIV-negative persons at risk of HIV infection. Community-wide education on PrEP can occur in a variety of complementary ways, including:

  • Visuals, brochures, and pamphlets; 
  • Media campaigns, including the use of social media; 
  • Radio and television public service announcements; and
  • Partnering with community members, key stakeholders, and peers to build trust and credibility.

CDC has educational materials and resources for campaigns available.

Enhance Provider Knowledge and Support of PrEP

Health departments can develop their own educational materials for PrEP and provide training for local clinicians through public health detailing and implementation workshops.

Compiling and maintaining a directory for PrEP providers and PrEP-related services is a great way to provide information to providers, the public, and partner organizations on the availability of services. This directory information can also be shared with to help build the database of this online resource provided by CDC’s National Prevention Information Network.

CBA Request Information System (CRIS) is a web-based application that allows CDCfunded and other organizations to request CBA services. It also serves as a tool to monitor, track, and follow-up on CBA Requests. A user ID and password are required to access this CDC-sponsored web application.

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