Pre-Exposure Prophylaxis (PrEP) for Providers

Healthcare Provider Resources for
Pre-Exposure Prophylaxis (PrEP)
(PDF : 224 kB)

Texas DSHS recommends that pre-exposure prophylaxis (PrEP) be considered for people who are at elevated risk for acquiring HIV. PrEP involves the use of daily oral antiretroviral medication to help prevent HIV acquisition, and is recommended for use in conjunction with other prevention measures, such as barrier methods. PrEP has been extensively studied [CDC] and found to be safe and effective.

The medication that is currently approved by the U.S. Food and Drug Administration (FDA) for use as PrEP is the fixed-dose combination of emtricitabine (FTC) 200 mg and tenofovir disoproxil fumarate (TDF) 300 mg, marketed under the trade name Truvada®. It is given as a single daily dose and is FDA-approved for use in healthy adolescents and adults who are at elevated risk of acquiring HIV infection and who weigh at least 35 kilograms (77 pounds).

To learn more about how to prescribe PrEP and nPEP or for support for your clinical practice, visit Prescribe HIV Prevention [CDC] or call the National Clinical Consultation Center [UCSF] directly at (855) 448-7737 for PrEP consultations and (888) 448-4911 for nPEP consultations. 

The Provider’s Role

Any licensed healthcare provider with prescribing authority can write prescriptions for daily PrEP. 

Below are some steps you can take to play a role in the goal of reducing HIV transmission and acquisition statewide:

1. Take a comprehensive sexual history [CDC] (PDF) from all patients as a part of routine medical care.
   
   
2. Screen patients with elevated risk for HIV and other STDs based on sexual history and clinical practice guidelines [CDC] (PDF).                                                                                                          
   
   
3. Talk about PrEP with patients at elevated risk of acquisition, patients who request the intervention by name, and patients living with HIV with mixed status sex or drug use partners.
   
   
4. Prescribe PrEP according to clinical practice guidelines [CDC] (PDF), or refer patients to sites that provide PrEP. Visit the Texas DSHS PrEP Directory or the National Prevention Information Network Directory for a listing of clinics and providers who prescribe PrEP near you
    

Support for PrEP

Texas DSHS supports PrEP as a highly effective intervention for HIV Prevention:

• DSHS Position Statement on PrEP
  
  
• DSHS Dear Colleague PrEP Letter (PDF : 387 kB)
  
  

PrEP is supported by the following entities:

• U.S. Centers for Disease Control and Prevention (CDC)
  
  
• US Preventive Services Task Force
  
  
• National Institutes of Health
  
  
• Health Resources and Services Administration (PDF)
  
  
• American Medical Association
  
  

Clinical Resources and Tools

• 2017 Clinical Practice Guidelines [CDC] (PDF)                
  
  
• 2017 Provider Supplement [CDC] (PDF)
  
  
• Prescribe HIV Prevention [CDC]
  
  
• #AskTheHIVDoc Video Series [GreaterThan.org]
  
  

Continuing Education

• Training for Clinicians [CDC] 
  
  
• IMPACT on HIV Prevention and Treatment Learning Center
  
  
• Pre-Exposure Prophylaxis for HIV-1 [Harvard Medical School]         
  
  
• Apply Evidence-Based Recommendations for the Prevention of HIV Transmission (HIV Curriculum) [University of Washington]
  
  

Other Resources

• A Preemptive Weapon: PrEP Treatment to Prevent HIV Promising if Physicians Can Identify High-Risk Minority Patients  [TexMed.org] 
  
  
• Vital Signs: Status of Human Immunodeficiency Virus Testing, Viral Suppression, and HIV Preexposure Prophylaxis — United States, 2013–2018 [CDC]                                                                                                                                                                                                                                       
  
  
• Vital Signs: Estimated Percentages and Numbers of Adults with Indications for Preexposure Prophylaxis to Prevent HIV Acquisition - United States, 2015 MMWR [CDC]
  
  

Pre-exposure Prophylaxis for the public