Celebrating HIV Awareness Month with Clinical Practice Updates on PrEP
By: Ellen Smith, MSN, MPH, NP-C, WHNP-BC, CIC, CPH
Given the COVID-19 pandemic over the past two years, many nurse practitioners may be unfamiliar with recent clinical practice updates and treatment options in other corners of the infection control field. As we celebrate the month of July as HIV Awareness Month, we turn our attention to developments in the field of HIV prevention, namely HIV PrEP (Pre-exposure prophylaxis). Pre-exposure prophylaxis consists of medications that are prescribed to people at risk for HIV acquisition (such as people who use IV drugs or have high-risk sex)1. When taken as prescribed, PrEP reduces the risk of acquiring HIV through sex by about 99% and reduces the risk of acquiring HIV through IV drug use by at least 74%1. Given that 1.7 million people are newly infected with HIV each year, PrEP has been a huge breakthrough in the HIV field2. However, it is dependent on prescribers being familiar with its use and effectively counseling people who may benefit.
The CDC now recommends talking about PrEP to all sexually active adolescents and adults and offering PrEP to all those who request it; including those who do not report a history of high-risk sexual activity or drug use3. Given the stigma that still surrounds HIV, this strategy helps patients overcome embarrassment or shame. In addition to stigma, another barrier that has prevented patients from seeking PrEP is the cost; however, as of July 2021, the federal government announced that nearly all health insurers are required to cover not only the cost of PrEP medications but associated lab tests and clinic visits as well4. A barrier to compliance is patient’s reluctance to take a daily pill, even if it can have such a positive benefit. A new injectable treatment option (Cabotegravir) has surmounted this obstacle. One injection of Cabotegravir prevents HIV infection for up to 2 months3. It was approved by the FDA in 2021 and may be particularly beneficial for patients who have a hard time taking oral medications as prescribed, have severe kidney disease, or simply prefer more infrequent medication administration3. The final obstacle to maximizing the utility of PrEP is prescriber and patient awareness.
This HIV Awareness Month, make it a point to talk about PrEP with your colleagues and friends. Also, get into the habit of discussing the benefits of PrEP with your patients. Given the wide availability of this effective tool, now is the time to step up our fight against HIV! For more prescriber information, visit the updated PrEP guideline from the CDC at www.cdc.gov/hiv/pdg/risk/prep/cdc-hiv-prep-guidelines-2021.pdf.
Ryan, Benjamin. PrEP, the HIV prevention pill, must now be totally free under almost all insurance plans. NBC News. July 20th, 2021. Accessed May 16th, 2021. https://www.nbcnews.com/news/amp/rcna1470
Celebrating HIV Awareness Month with Clinical Practice Updates on PrEP
By: Ellen Smith, MSN, MPH, NP-C, WHNP-BC, CIC, CPH
Given the COVID-19 pandemic over the past two years, many nurse practitioners may be unfamiliar with recent clinical practice updates and treatment options in other corners of the infection control field. As we celebrate the month of July as HIV Awareness Month, we turn our attention to developments in the field of HIV prevention, namely HIV PrEP (Pre-exposure prophylaxis). Pre-exposure prophylaxis consists of medications that are prescribed to people at risk for HIV acquisition (such as people who use IV drugs or have high-risk sex)1. When taken as prescribed, PrEP reduces the risk of acquiring HIV through sex by about 99% and reduces the risk of acquiring HIV through IV drug use by at least 74%1. Given that 1.7 million people are newly infected with HIV each year, PrEP has been a huge breakthrough in the HIV field2. However, it is dependent on prescribers being familiar with its use and effectively counseling people who may benefit.
The CDC now recommends talking about PrEP to all sexually active adolescents and adults and offering PrEP to all those who request it; including those who do not report a history of high-risk sexual activity or drug use3. Given the stigma that still surrounds HIV, this strategy helps patients overcome embarrassment or shame. In addition to stigma, another barrier that has prevented patients from seeking PrEP is the cost; however, as of July 2021, the federal government announced that nearly all health insurers are required to cover not only the cost of PrEP medications but associated lab tests and clinic visits as well4. A barrier to compliance is patient’s reluctance to take a daily pill, even if it can have such a positive benefit. A new injectable treatment option (Cabotegravir) has surmounted this obstacle. One injection of Cabotegravir prevents HIV infection for up to 2 months3. It was approved by the FDA in 2021 and may be particularly beneficial for patients who have a hard time taking oral medications as prescribed, have severe kidney disease, or simply prefer more infrequent medication administration3. The final obstacle to maximizing the utility of PrEP is prescriber and patient awareness.
This HIV Awareness Month, make it a point to talk about PrEP with your colleagues and friends. Also, get into the habit of discussing the benefits of PrEP with your patients. Given the wide availability of this effective tool, now is the time to step up our fight against HIV! For more prescriber information, visit the updated PrEP guideline from the CDC at www.cdc.gov/hiv/pdg/risk/prep/cdc-hiv-prep-guidelines-2021.pdf.
References
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