HIV prevention strategies and guidance from the Washington State
Department of Health
The Health Care Authority (HCA)
is partnering with the Department of Health (DOH) to share a series of messages with
health care providers about HIV prevention and best practices in caring for
priority populations. This is the first of several messages we will share over
the next six months.
Latest prevention strategies
- Pre-Exposure Prophylaxis (PrEP) is a daily pill that can be prescribed to prevent HIV.
- Treatment as Prevention, (TasP), which is when a person living with HIV follows their HIV treatment regimen and the virus is suppressed, and if they continue treatment, cannot transmit HIV to others.
Recommended best practices to prevent HIV
Health care providers play
a critical role in identifying and caring for people living with HIV and those
at risk for HIV who would benefit from Pre-Exposure Prophylaxis (PrEP). These
activities are recommended to be put into practice by clinicians and your care
team:
- Take a thorough sexual health, social and drug use history of all your patients.
- Routinely screen for HIV, HCV, or other sexually transmitted diseases*.
- Identify and test patients who may be at risk for HIV.
- Begin treatment for those that test positive for HIV.
- Begin PrEP for those that test negative for HIV.
- Refer and follow-up based on needs identified through screening and clinical evaluation.Counsel patients living with HIV and those at risk of acquiring HIV on adherence for those receiving treatment or for those on PrEP.
- Counsel persons at risk of acquiring HIV on harm reduction strategies in addition to PrEP.
- Share information about appropriate community-based services.
Clinical guidance for PrEP prescribing and management
PrEP is an FDA-approved
biomedical intervention for people at high risk for HIV. It reduces a person’s
chances of acquiring HIV by 96 percent. Trusted resources health care
providers can turn to for guidance and information:
PrEP coverage and financial support information
PrEP medication and clinical monitoring is covered by major commercial insurance
programs, Medicare, and Washington Apple Health (Medicaid). In addition to
manufacturer patient assistance programs, DOH administers
a PrEP drug assistance program that can help pay for prescription, medical, and
lab costs. DOH is expanding its provider network; interested providers can
request information by emailing PREPDAP@doh.wa.gov. Visit the
PrEP website to learn more
information about PrEP and PrEP DAP at https://www.doh.wa.gov/ PrEPDAP).
Resources and training opportunities for clinicians
Educational courses on
PrEP are available through the University of Washington (UW). The courses are
part of the National HIV Curriculum. Continuing Medical Education (CME) credits
are available per hour of participation. More information is available at https://www.hiv.uw.edu/go/prevention/preexposure-prophylaxis-prep/core-concept/all
The Centers for Disease
Control and Prevention (CDC) hosts an array of resources for providers
including the following continuing education courses. These courses provide an
overview of PrEP as a prevention strategy and discuss the use of PrEP in
primary care settings.
Stigma and health disparities considerations
New legislation removes barriers to routine HIV screening and testing. Effective June 7, 2018, the law
requiring health care providers to obtain exceptional
consent for HIV testing, which allow patients to “opt-out” of HIV screening,
was repealed.
In Washington, all health care
providers are required to obtain consent prior to conducting any medical care
or treatment. Until now, Washington law required specific exceptional
consent before people could be tested for HIV.
Washington joins
Undetectable = Untransmittable HIV prevention campaign
In July, the Washington
State Department of Health became the sixth state health department to join the
Undetectable = Untransmittable or U=U HIV prevention campaign, joining 18 other
state and local health departments and more than 700 organizations from 90
countries. U=U describes the scientific findings that people living with HIV
who have undetectable levels of HIV in their blood, have effectively no risk of
transmitting HIV to their partners. We invite healthcare providers and
organizations to become local supporters and help us end the epidemic. Visit
the U=U campaign page to learn more at https://www.preventionaccess.org/.
*
- CDC recommends that everyone between the ages of 13 and 64 get tested for HIV at least once as part of routine health care.
-
For those with specific risk factors, CDC recommends getting tested at least once a year.
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