PrEP Provider Toolkit
PrEP Provider Toolkit
Primary Care Considerations
General health screening
Sometimes, patients engaged in PrEP care do not routinely see other providers to address other aspects of preventive medicine. PrEP follow-up visits are generally straightforward and can be quick visits. Utilize this opportunity to incorporate these Grade A and B United States Preventive Services Task Force (USPSTF) recommendations. (29)
U.S. Preventive Services Task Force. A & B Recommendations.
(most commonly used)
|Cervical Cancer Screening
|Pap-smear (w/ or w/ out HPV)
|Colorectal Cancer Screening
|Intimate Partner Violence
|Women of reproductive age
|Adults with a risk factor: born or lived in countries with high TB prevalence, lived or is living in homeless shelters or correctional facilities, currently homeless, etc.
|QuantiFERON-TB Gold, TST (PPD)
|Adults 35-70yo with BMI>25
EPDS in postpartum and pregnant women
|Folic Acid to Prevent Neural Tube Defects
|All women planning or capable of pregnancy
|Part of Sexual History (6 P’s)
|Primary Prevention of Cardiovascular Disease With Statin Medication
|ASCVD Risk Calculator
|Tobacco Smoking Screening and Cessation Counseling
|Directly Asking and Counseling
|Alcohol Abuse Screening
|Drug Abuse Screening
|NIDA Quick Screen-C
|Table 9. Relevant Screening Recommendations
For the purposes of PrEP, the following vaccinations are most relevant.
|Primary series and boosters recommended for everyone.
|No immunity based on labs.
|No immunity based on labs (HBsAb<10mIU/mL)
|Recommended up to 26yo. If not previously vaccinated, shared decision with patients between 27-45yo
|Recommended for everyone, annually.
|Shared decision for patients 16-23yo
Centers for Disease Control and Prevention. (2022). Monkeypox vaccination basics. Department of Health and Human Services.
|Rapidly changing guidelines based on local health departments though for currently: adults with risk factors such as MSM/TGWSM, engages in transactional sex, or had a known exposure.
|Adults 19-64yo with a risk factor: alcoholism, cigarette smoker, DM, etc.
|Tetanus, diphtheria, and pertussis (Tdap)
|Booster (Td or Tdap) generally recommended every 10 years
|All adults over 50yo
|Table 10. Relevant Vaccination Recommendations
Given that PrEP is most often discussed along with sexual practices, it is good practice to incorporate components of family planning into your approach. There continue to be high rates of unintended pregnancies, particularly among the same groups disproportionately affected by HIV. (31) At a time when women’s reproductive rights are constantly being challenged, it is increasingly important to provide guidance, support, and comfort to women of childbearing potential. Utilize "the 6 P’s” framework to expand on topics related to family planning and reproductive health.
Finer, & Zolna, M. R. (2016). Declines in Unintended Pregnancy in the United States, 2008–2011. The New England Journal of Medicine, 374(9), 843–852.