PrEP Provider Toolkit

PrEP Initiation

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)

Recommendation Indication Test
(most commonly used)
Cervical Cancer Screening Women 21-65yo Pap-smear (w/ or w/ out HPV)
Colorectal Cancer Screening Adults 45-75yo FIT, colonoscopy
Intimate Partner Violence Women of reproductive age PVS, AAS
Latent Tuberculosis 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)
Hypertension All adults Blood pressure
Diabetes Adults 35-70yo with BMI>25 HbA1c
Depression Everyone PHQ-2/ PHQ-9
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 Adults 40-75yo ASCVD Risk Calculator
Tobacco Smoking Screening and Cessation Counseling All adults Directly Asking and Counseling
Alcohol Abuse Screening All adults AUDIT-C
Drug Abuse Screening All adults NIDA Quick Screen-C
Table 9. Relevant Screening Recommendations


   For the purposes of PrEP, the following vaccinations are most relevant.

Vaccine Indication
COVID-19 Primary series and boosters recommended for everyone.
Hepatitis A No immunity based on labs.
Hepatitis B No immunity based on labs (HBsAb<10mIU/mL)
Human Papillomavirus Recommended up to 26yo. If not previously vaccinated, shared decision with patients between 27-45yo
Hypertension All adults
Influenza Recommended for everyone, annually.
Meningococcal B Shared decision for patients 16-23yo
Monkeypox (30) 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.
Pneumococcal 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
Zoster All adults over 50yo
Table 10. Relevant Vaccination Recommendations

Family Planning

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.