{"id":2375,"date":"2014-11-25T18:25:00","date_gmt":"2014-11-25T23:25:00","guid":{"rendered":"https:\/\/www.med.unc.edu\/ncaidstraining\/prep\/for-providers\/for-interested-providers\/"},"modified":"2014-11-25T18:25:00","modified_gmt":"2014-11-25T23:25:00","slug":"for-interested-providers","status":"publish","type":"page","link":"https:\/\/www.med.unc.edu\/nchivtraining\/clincian-resources\/prep\/for-providers\/for-interested-providers\/","title":{"rendered":"For Providers Interested in PrEP"},"content":{"rendered":"<div>\n<h2 class=\"section-som\"><span>For Providers Interested in PrEP<\/span><\/h2>\n<p>&nbsp;<\/p>\n<p class=\"lead\">These resources are intended to help you understand how PrEP can benefit your at-risk patients.<\/p>\n<div>\n<p>Thanks for your interest in this new strategy for HIV prevention. On this page, we have put together some answers to questions that providers often ask about PrEP.<\/p>\n<p>We encourage you to take some time to review this information, but we realize your time is at a premium. If you\u2019re in a hurry, we\u2019d suggest reviewing the CDC\u2019s <a href=\"http:\/\/www.cdc.gov\/hiv\/prevention\/research\/prep\/\">PrEP page<\/a> or their <a href=\"http:\/\/www.cdc.gov\/hiv\/pdf\/PrEP_fact_sheet_final.pdf\">one-page fact sheet<\/a> (PDF format) that provides very basic information about PrEP. You could also take a few minutes and watch this brief video from Dr. Christopher Hurt, a faculty member in the UNC School of Medicine\u2019s Division of Infectious Diseases.<\/p>\n<p style=\"text-align: center\"><!-- iframe plugin v.4.3 wordpress.org\/plugins\/iframe\/ --><\/p>\n<h2><span style=\"color: #000000\"><strong><br \/>\n<\/strong><\/span><\/h2>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<h2><span style=\"color: #000000\"><strong>Providers\u2019 Frequently Asked Questions<\/strong><\/span><\/h2>\n<div role=\"tablist\" class=\"panel-group yourcustomclass oscitas-bootstrap-container\" id=\"unc-accordion-0\">\n\n<div class=\"panel panel-default oscitas-bootstrap-container\">\n\n    <div id=\"panel-heading-details-0-0\" class=\"panel-heading oscitas-bootstrap-container\" role=\"tab\">\n\n        <h4 class=\"panel-title oscitas-bootstrap-container\">\n\n            <button class=\"accordion-toggle oscitas-bootstrap-container collapsed\" \n                id = \"button-details-0-0\"\n                data-toggle=\"collapse\"\n                data-parent=\"#unc-accordion-0\"    \n                aria-controls=\"#details-0-0\"  \n                aria-expanded=\"true\" \n                href=\"#details-0-0\">\n                What is PrEP?            <\/button>\n\n        <\/h4>\n\n    <\/div>\n\n    <div id=\"details-0-0\" class=\"panel-collapse collapse in oscitas-bootstrap-container\">\n\n        <div class=\"panel-body oscitas-bootstrap-container\">\nPrEP is an abbreviation for \u201cpre-exposure prophylaxis.\u201d The concept behind PrEP is simple: having anti-HIV (antiretroviral) medications in an uninfected person\u2019s body makes it very difficult for HIV to infect them if they are exposed. You can think of PrEP as a pharmacological \u201cshield\u201d that helps protect your patient from becoming infected if s\/he is exposed through sex or the sharing of needles or \u201cworks\u201d during drug use.<\/p>\n<p>In 2012, the <a class=\"external-link\" title=\"\" href=\"http:\/\/www.fda.gov\/NewsEvents\/Newsroom\/PressAnnouncements\/ucm312210.htm\" target=\"_self\" rel=\"noopener noreferrer\">FDA approved an existing tablet called Truvada<\/a> (true-VAH-duh) for use as PrEP among individuals at risk for HIV infection. This decision was made on the basis of several large clinical trials showing this strategy works well at preventing HIV infection among uninfected <a class=\"external-link\" title=\"\" href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/22784037\" target=\"_self\" rel=\"noopener noreferrer\">heterosexual men<\/a> <a class=\"external-link\" title=\"\" href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/22784038\" target=\"_self\" rel=\"noopener noreferrer\">and women<\/a>, <a class=\"external-link\" title=\"\" href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/21091279\" target=\"_self\" rel=\"noopener noreferrer\">men who have sex with men<\/a>, <a class=\"external-link\" title=\"\" href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/21091279\" target=\"_self\" rel=\"noopener noreferrer\">transgender women<\/a> (male-to-female transsexuals), and <a class=\"external-link\" title=\"\" href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/23769234\" target=\"_self\" rel=\"noopener noreferrer\">injection drug users<\/a>.<br \/>\n<\/div>\n\n    <\/div>\n        \n<\/div>\n\n<div class=\"panel panel-default oscitas-bootstrap-container\">\n\n    <div id=\"panel-heading-details-0-1\" class=\"panel-heading oscitas-bootstrap-container\" role=\"tab\">\n\n        <h4 class=\"panel-title oscitas-bootstrap-container\">\n\n            <button class=\"accordion-toggle oscitas-bootstrap-container collapsed\" \n                id = \"button-details-0-1\"\n                data-toggle=\"collapse\"\n                data-parent=\"#unc-accordion-0\"    \n                aria-controls=\"#details-0-1\"  \n                aria-expanded=\"false\" \n                href=\"#details-0-1\">\n                What exactly is Truvada?            <\/button>\n\n        <\/h4>\n\n    <\/div>\n\n    <div id=\"details-0-1\" class=\"panel-collapse collapse  oscitas-bootstrap-container\">\n\n        <div class=\"panel-body oscitas-bootstrap-container\"><a class=\"external-link\" title=\"\" href=\"http:\/\/aidsinfo.nih.gov\/drugs\/406\/emtricitabine---tenofovir-disoproxil-fumarate\/0\/patient\" target=\"_self\" rel=\"noopener noreferrer\">Truvada<\/a> is a fixed-dose, combination tablet containing two anti-HIV medications: emtricitabine (em-TRY-site-uh-bean) and tenofovir (ten-OFF-uh-veer). It\u2019s about the size of a large multivitamin tablet. When used for treating patients already living with HIV, these drugs help prevent the virus from making copies of itself within infected cells. When an uninfected person takes Truvada before an exposure, the drugs accumulate in cells that are susceptible to infection \u2013 so any virus that does enter the body never has a chance to make any copies; replication is blocked from the very start.<\/p>\n<p>Truvada is also used for treating hepatitis B virus (HBV) \u2013 so knowing the infection status of patients prior to initiating PrEP is important. If a patient who has HBV is started on Truvada and then discontinues it for some reason, s\/he may experience a \u201cflare\u201d of hepatitis and can become ill. Though some evidence suggests Truvada may reduce the likelihood of acquiring HBV, it is not recommended for HBV prevention; <a class=\"external-link\" title=\"\" href=\"http:\/\/www.cdc.gov\/vaccines\/hcp\/acip-recs\/vacc-specific\/hepb.html\" target=\"_self\" rel=\"noopener noreferrer\">vaccination is recommended<\/a> for those who are susceptible based on serologic testing.<\/div>\n\n    <\/div>\n        \n<\/div>\n\n<div class=\"panel panel-default oscitas-bootstrap-container\">\n\n    <div id=\"panel-heading-details-0-2\" class=\"panel-heading oscitas-bootstrap-container\" role=\"tab\">\n\n        <h4 class=\"panel-title oscitas-bootstrap-container\">\n\n            <button class=\"accordion-toggle oscitas-bootstrap-container collapsed\" \n                id = \"button-details-0-2\"\n                data-toggle=\"collapse\"\n                data-parent=\"#unc-accordion-0\"    \n                aria-controls=\"#details-0-2\"  \n                aria-expanded=\"false\" \n                href=\"#details-0-2\">\n                Why do we need a pill for HIV prevention? Aren\u2019t condoms good enough?            <\/button>\n\n        <\/h4>\n\n    <\/div>\n\n    <div id=\"details-0-2\" class=\"panel-collapse collapse  oscitas-bootstrap-container\">\n\n        <div class=\"panel-body oscitas-bootstrap-container\">Condoms prevent pregnancy and sexually transmitted diseases, but only if they\u2019re used properly and consistently. Whether we like it or not, not everyone uses condoms. Some are in relationships and feel that condoms limit intimacy with their partner. Some aren\u2019t in a position to negotiate for condom use with sex partner(s). Others have difficulty with sexual performance while wearing a condom. Still others simply prefer the way condomless sex feels. With PrEP, we now have a viable and effective option for HIV prevention to offer these individuals.<\/p>\n<p>\u201cDiscordant\u201d couples (one with HIV, one without) trying to conceive can also benefit from PrEP. If the HIV-infected partner is on treatment and her\/his viral load is \u201cundetectable,\u201d and the negative partner is initiated on PrEP, the risk of the uninfected partner acquiring HIV is extremely small \u2013 perhaps even zero. We can help connect such couples with high-risk obstetricians for additional counseling and support, as well.<\/div>\n\n    <\/div>\n        \n<\/div>\n\n<div class=\"panel panel-default oscitas-bootstrap-container\">\n\n    <div id=\"panel-heading-details-0-3\" class=\"panel-heading oscitas-bootstrap-container\" role=\"tab\">\n\n        <h4 class=\"panel-title oscitas-bootstrap-container\">\n\n            <button class=\"accordion-toggle oscitas-bootstrap-container collapsed\" \n                id = \"button-details-0-3\"\n                data-toggle=\"collapse\"\n                data-parent=\"#unc-accordion-0\"    \n                aria-controls=\"#details-0-3\"  \n                aria-expanded=\"false\" \n                href=\"#details-0-3\">\n                How good is PrEP at preventing HIV infection?            <\/button>\n\n        <\/h4>\n\n    <\/div>\n\n    <div id=\"details-0-3\" class=\"panel-collapse collapse  oscitas-bootstrap-container\">\n\n        <div class=\"panel-body oscitas-bootstrap-container\">At first glance, the results of the clinical trials are a little confusing and made some people question whether or not PrEP was ready for \u201cprime time.\u201d When considering all the participants in the clinical trials, the protective effect varied significantly, with reductions in the risk of acquiring HIV ranging from <a class=\"external-link\" title=\"\" href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/21091279\" target=\"_self\" rel=\"noopener noreferrer\">44%<\/a> to <a class=\"external-link\" title=\"\" href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/22784037\" target=\"_self\" rel=\"noopener noreferrer\">75%<\/a>. (\u201cPerfect\u201d protection would be a 100% reduction.) However, these main estimates included all participants \u2013 including those who took their medications as directed and those who did not. When sub-analyses were conducted looking at those individuals who were highly adherent (compliant), the protection afforded by PrEP was much higher \u2013 in the range of <strong>90% to<\/strong> <a class=\"external-link\" title=\"\" href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/22972843\" target=\"_self\" rel=\"noopener noreferrer\">99%<\/a><\/div>\n\n    <\/div>\n        \n<\/div>\n<div class=\"panel panel-default oscitas-bootstrap-container\">\n\n    <div id=\"panel-heading-details-0-4\" class=\"panel-heading oscitas-bootstrap-container\" role=\"tab\">\n\n        <h4 class=\"panel-title oscitas-bootstrap-container\">\n\n            <button class=\"accordion-toggle oscitas-bootstrap-container collapsed\" \n                id = \"button-details-0-4\"\n                data-toggle=\"collapse\"\n                data-parent=\"#unc-accordion-0\"    \n                aria-controls=\"#details-0-4\"  \n                aria-expanded=\"false\" \n                href=\"#details-0-4\">\n                Why does adherence (compliance) matter so much for PrEP?            <\/button>\n\n        <\/h4>\n\n    <\/div>\n\n    <div id=\"details-0-4\" class=\"panel-collapse collapse  oscitas-bootstrap-container\">\n\n        <div class=\"panel-body oscitas-bootstrap-container\">As with any prescription, the medication doesn\u2019t provide any benefit if it\u2019s still in the bottle. This is especially true for PrEP. Studies showed that the protective effect of Truvada was directly related to how consistently the tablets were taken, with the best \u201cadherers\u201d having the lowest risk of becoming infected with HIV. Individuals who didn\u2019t take their Truvada as directed (at about the same time every single day, without fail) were much more likely to acquire HIV.<\/p>\n<p>Adherence can be made easier by scheduling pill-taking with something your patient already does routinely \u2013 like eating a meal, brushing her\/his teeth, or plugging in a cell phone before going to sleep. Setting an alarm on a cell phone or clock also helps some people remember.<\/div>\n\n    <\/div>\n        \n<\/div>\n\n<div class=\"panel panel-default oscitas-bootstrap-container\">\n\n    <div id=\"panel-heading-details-0-5\" class=\"panel-heading oscitas-bootstrap-container\" role=\"tab\">\n\n        <h4 class=\"panel-title oscitas-bootstrap-container\">\n\n            <button class=\"accordion-toggle oscitas-bootstrap-container collapsed\" \n                id = \"button-details-0-5\"\n                data-toggle=\"collapse\"\n                data-parent=\"#unc-accordion-0\"    \n                aria-controls=\"#details-0-5\"  \n                aria-expanded=\"false\" \n                href=\"#details-0-5\">\n                What are Truvada\u2019s side effects?            <\/button>\n\n        <\/h4>\n\n    <\/div>\n\n    <div id=\"details-0-5\" class=\"panel-collapse collapse  oscitas-bootstrap-container\">\n\n        <div class=\"panel-body oscitas-bootstrap-container\">Most people experience very few side effects. The most common issues in clinical trials of PrEP have been <strong>fatigue<\/strong>, <strong>nausea<\/strong> (with or without vomiting) and <strong>flatulence<\/strong>. For the majority of participants, these side effects went away after the first month of use.<\/p>\n<p>Extended use of tenofovir (one of the two agents in Truvada) has two adverse effects that are important to consider for patients who might be on PrEP long-term:<\/p>\n<p><em><span style=\"text-decoration: underline\">Nephrotoxicity<\/span><\/em>. About 10% of HIV-infected patients taking tenofovir have slight elevations in serum creatinine. You don\u2019t have to stop the drug, provided that the estimated creatinine clearance (eCrCl) remains at or above 60 mL\/min. Although no patients in clinical trials of PrEP developed more severe renal impairment, we do sometimes see this in HIV-infected patients on Truvada long-term. Rarely, patients have developed proximal (type 2) renal tubular acidosis with or without the Fanconi syndrome (loss of glucose, phosphate, and bicarbonate into the urine). If you suspect renal injury, stopping tenofovir is recommended. Cessation of the drug allows for recovery of renal function for the majority of people.<\/p>\n<p><span style=\"text-decoration: underline\"><em>Loss of bone mineral density<\/em><\/span>. Within the first 6 months of taking tenofovir, at least 25% of patients on long-term tenofovir therapy have a small but measurable loss of bone density. This then stabilizes over time. Baseline bone densitometry is not routinely recommended unless otherwise clinically indicated.<\/div>\n\n    <\/div>\n        \n<\/div>\n\n<div class=\"panel panel-default oscitas-bootstrap-container\">\n\n    <div id=\"panel-heading-details-0-6\" class=\"panel-heading oscitas-bootstrap-container\" role=\"tab\">\n\n        <h4 class=\"panel-title oscitas-bootstrap-container\">\n\n            <button class=\"accordion-toggle oscitas-bootstrap-container collapsed\" \n                id = \"button-details-0-6\"\n                data-toggle=\"collapse\"\n                data-parent=\"#unc-accordion-0\"    \n                aria-controls=\"#details-0-6\"  \n                aria-expanded=\"false\" \n                href=\"#details-0-6\">\n                How long does it take before PrEP is fully active? How long does it take to \u201cwash out\u201d?            <\/button>\n\n        <\/h4>\n\n    <\/div>\n\n    <div id=\"details-0-6\" class=\"panel-collapse collapse  oscitas-bootstrap-container\">\n\n        <div class=\"panel-body oscitas-bootstrap-container\">For blood and cervicovaginal tissues to be fully protected, <a class=\"external-link\" title=\"\" href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/21118913\" target=\"_self\" rel=\"noopener noreferrer\">it takes about 20 days<\/a> of daily Truvada use. For rectal tissue to be maximally protected, <a class=\"external-link\" title=\"\" href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/21118913\" target=\"_self\" rel=\"noopener noreferrer\">it takes only about 7 days<\/a>. About the same amount of time would be needed for these drugs to wash out from these different tissue types \u2013with waning anti-HIV protection as those levels drop, over time.<\/div>\n\n    <\/div>\n        \n<\/div>\n<div class=\"panel panel-default oscitas-bootstrap-container\">\n\n    <div id=\"panel-heading-details-0-7\" class=\"panel-heading oscitas-bootstrap-container\" role=\"tab\">\n\n        <h4 class=\"panel-title oscitas-bootstrap-container\">\n\n            <button class=\"accordion-toggle oscitas-bootstrap-container collapsed\" \n                id = \"button-details-0-7\"\n                data-toggle=\"collapse\"\n                data-parent=\"#unc-accordion-0\"    \n                aria-controls=\"#details-0-7\"  \n                aria-expanded=\"false\" \n                href=\"#details-0-7\">\n                Are there any other medications I should have my patient avoid, while taking PrEP?            <\/button>\n\n        <\/h4>\n\n    <\/div>\n\n    <div id=\"details-0-7\" class=\"panel-collapse collapse  oscitas-bootstrap-container\">\n\n        <div class=\"panel-body oscitas-bootstrap-container\">Because tenofovir can be nephrotoxic in some patients, it\u2019s reasonable to try to avoid other known nephrotoxic agents, like high-dose NSAIDs.<\/div>\n\n    <\/div>\n        \n<\/div>\n\n<div class=\"panel panel-default oscitas-bootstrap-container\">\n\n    <div id=\"panel-heading-details-0-8\" class=\"panel-heading oscitas-bootstrap-container\" role=\"tab\">\n\n        <h4 class=\"panel-title oscitas-bootstrap-container\">\n\n            <button class=\"accordion-toggle oscitas-bootstrap-container collapsed\" \n                id = \"button-details-0-8\"\n                data-toggle=\"collapse\"\n                data-parent=\"#unc-accordion-0\"    \n                aria-controls=\"#details-0-8\"  \n                aria-expanded=\"false\" \n                href=\"#details-0-8\">\n                How will my patient pay for PrEP?            <\/button>\n\n        <\/h4>\n\n    <\/div>\n\n    <div id=\"details-0-8\" class=\"panel-collapse collapse  oscitas-bootstrap-container\">\n\n        <div class=\"panel-body oscitas-bootstrap-container\">The manufacturer of Truvada, <a class=\"external-link\" title=\"\" href=\"http:\/\/www.gilead.com\/\" target=\"_self\" rel=\"noopener noreferrer\">Gilead Sciences<\/a>, has a medication assistance program that was specifically set up to handle requests related to PrEP. This program is available to insured patients as a copayment assistance program, and to uninsured patients as a medication access program. There are two ways you or your patient can begin this process:<\/p>\n<p>\u2022 Call to determine eligibility, toll-free at <strong>1-855-330-5479<\/strong>, M-F, 9A-8P EST<br \/>\n\u2022 <a class=\"external-link\" title=\"\" href=\"http:\/\/start.truvada.com\/Content\/pdf\/Medication_Assistance_Program.pdf\" target=\"_self\" rel=\"noopener noreferrer\">Click here to download and fax the application directly from the Gilead website<\/a><\/p>\n<p>To date, there have been no reports to the \u201cwatchdog\u201d website <a class=\"external-link\" title=\"\" href=\"http:\/\/myprepexperience.blogspot.com\/\" target=\"_self\" rel=\"noopener noreferrer\">MyPrEPExperience<\/a> about insurance refusals from private companies or state Medicaid programs, though pre-authorizations may be required before the prescription will be approved.<\/div>\n\n    <\/div>\n        \n<\/div>\n\n<div class=\"panel panel-default oscitas-bootstrap-container\">\n\n    <div id=\"panel-heading-details-0-9\" class=\"panel-heading oscitas-bootstrap-container\" role=\"tab\">\n\n        <h4 class=\"panel-title oscitas-bootstrap-container\">\n\n            <button class=\"accordion-toggle oscitas-bootstrap-container collapsed\" \n                id = \"button-details-0-9\"\n                data-toggle=\"collapse\"\n                data-parent=\"#unc-accordion-0\"    \n                aria-controls=\"#details-0-9\"  \n                aria-expanded=\"false\" \n                href=\"#details-0-9\">\n                How do I manage my patient who is interested in PrEP?            <\/button>\n\n        <\/h4>\n\n    <\/div>\n\n    <div id=\"details-0-9\" class=\"panel-collapse collapse  oscitas-bootstrap-container\">\n\n        <div class=\"panel-body oscitas-bootstrap-container\">NCATEC has detailed information on managing PrEP patients available on our <a class=\"internal-link\" title=\"\" href=\"https:\/\/www.med.unc.edu\/ncaidstraining\/clincian-resources\/prep\/for-providers\/for-prep-prescribers\/#collapseOne\" target=\"_self\" rel=\"noopener noreferrer\">Prescribing Providers<\/a> page.<\/div>\n\n    <\/div>\n        \n<\/div>\n<div class=\"panel panel-default oscitas-bootstrap-container\">\n\n    <div id=\"panel-heading-details-0-10\" class=\"panel-heading oscitas-bootstrap-container\" role=\"tab\">\n\n        <h4 class=\"panel-title oscitas-bootstrap-container\">\n\n            <button class=\"accordion-toggle oscitas-bootstrap-container collapsed\" \n                id = \"button-details-0-10\"\n                data-toggle=\"collapse\"\n                data-parent=\"#unc-accordion-0\"    \n                aria-controls=\"#details-0-10\"  \n                aria-expanded=\"false\" \n                href=\"#details-0-10\">\n                How often will tests need to be done to monitor my patient on PrEP?            <\/button>\n\n        <\/h4>\n\n    <\/div>\n\n    <div id=\"details-0-10\" class=\"panel-collapse collapse  oscitas-bootstrap-container\">\n\n        <div class=\"panel-body oscitas-bootstrap-container\">All patients should be seen and assessed every 1-3 months while on PrEP. Our recommended schedule of assessments and tests is available on our <a class=\"internal-link\" title=\"\" href=\"https:\/\/www.med.unc.edu\/ncaidstraining\/clincian-resources\/prep\/for-providers\/for-prep-prescribers\/#collapseOne\" target=\"_self\" rel=\"noopener noreferrer\">Prescribing Providers<\/a> page. More frequent testing is reasonable, depending on how things are going with your patient \u2013 this is just a guide for the <em>minimum<\/em> number of assessments and tests needed during follow-up.<\/div>\n\n    <\/div>\n        \n<\/div>\n\n<div class=\"panel panel-default oscitas-bootstrap-container\">\n\n    <div id=\"panel-heading-details-0-11\" class=\"panel-heading oscitas-bootstrap-container\" role=\"tab\">\n\n        <h4 class=\"panel-title oscitas-bootstrap-container\">\n\n            <button class=\"accordion-toggle oscitas-bootstrap-container collapsed\" \n                id = \"button-details-0-11\"\n                data-toggle=\"collapse\"\n                data-parent=\"#unc-accordion-0\"    \n                aria-controls=\"#details-0-11\"  \n                aria-expanded=\"false\" \n                href=\"#details-0-11\">\n                I\u2019m concerned I may get a test result that I\u2019m not sure what to do with. Is there someone who can help me?            <\/button>\n\n        <\/h4>\n\n    <\/div>\n\n    <div id=\"details-0-11\" class=\"panel-collapse collapse  oscitas-bootstrap-container\">\n\n        <div class=\"panel-body oscitas-bootstrap-container\">Absolutely. You can get in touch with someone from UNC Infectious Diseases in a couple of ways (listed below). We only ask that when you do call, please have the following information readily available:<\/p>\n<p>\u2022 patient age<br \/>\n\u2022 risk factor for HIV acquisition<br \/>\n\u2022 date(s) and results of all available HIV tests<br \/>\n\u2022 date(s) and results of most recent serum creatinine level<br \/>\n\u2022 date(s) and results of most recent syphilis, gonorrhea, and chlamydia testing<\/p>\n<p><strong>For urgent or time-sensitive questions<\/strong>, call the North Carolina AIDS Training and Education Center (NCATEC) Clinician Line at <strong>1-855-862-2832<\/strong>.<\/p>\n<p>As a backup, you can also call the <strong>Carolina Consultation Center<\/strong> and ask to speak with someone from UNC Infectious Diseases. The phone number is <strong>1-800-862-6264<\/strong>. Between 8 AM and 5 PM on weekdays, you\u2019ll be speaking with an attending physician; after hours and on weekends, you\u2019ll be speaking with one of our fellows (who can reach an attending physician quickly, if needed).<\/p>\n<p>For non-urgent or general questions, please feel free to email one of our providers who has agreed to provide clinical guidance for PrEP. <em>Please allow up to 48 hours for a response<\/em>.<\/p>\n<p>\u2022 Christopher Hurt, MD <a class=\"email-link\" title=\"\" href=\"mailto:christopher_hurt@med.unc.edu\" target=\"_self\" rel=\"noopener noreferrer\">christopher_hurt@med.unc.edu<\/a><br \/>\n\u2022 Lisa Hightow-Weidman, MD, MPH <a class=\"email-link\" title=\"\" href=\"mailto:lisa_hightow@med.unc.edu\" target=\"_self\" rel=\"noopener noreferrer\">lisa_hightow@med.unc.edu<\/a><br \/>\n\u2022 David Wohl, MD <a class=\"email-link\" title=\"\" href=\"mailto:david_wohl@med.unc.edu\" target=\"_self\" rel=\"noopener noreferrer\">david_wohl@med.unc.edu<\/a><br \/>\n<\/div>\n\n    <\/div>\n        \n<\/div>\n\n<div class=\"panel panel-default oscitas-bootstrap-container\">\n\n    <div id=\"panel-heading-details-0-12\" class=\"panel-heading oscitas-bootstrap-container\" role=\"tab\">\n\n        <h4 class=\"panel-title oscitas-bootstrap-container\">\n\n            <button class=\"accordion-toggle oscitas-bootstrap-container collapsed\" \n                id = \"button-details-0-12\"\n                data-toggle=\"collapse\"\n                data-parent=\"#unc-accordion-0\"    \n                aria-controls=\"#details-0-12\"  \n                aria-expanded=\"false\" \n                href=\"#details-0-12\">\n                I\u2019m still skeptical. Convince me that PrEP is a good idea for my at-risk patients.            <\/button>\n\n        <\/h4>\n\n    <\/div>\n\n    <div id=\"details-0-12\" class=\"panel-collapse collapse  oscitas-bootstrap-container\">\n\n        <div class=\"panel-body oscitas-bootstrap-container\">Two of UNC\u2019s providers, David Wohl and Christopher Hurt, have written opinion pieces for NCATEC related to PrEP. They are:<\/p>\n<p><a class=\"internal-link\" title=\"\" href=\"\/ncaidstraining\/clincian-resources\/blog\/embracing-pre-exposure-prophylaxis\" target=\"_self\" rel=\"noopener noreferrer\">There\u2019s No Shame in Being PrEPared: Embracing Pre-Exposure Prophylaxis<\/a><br \/>\nChristopher Hurt, MD<\/p>\n<p><a class=\"internal-link\" title=\"\" href=\"\/ncaidstraining\/clincian-resources\/blog\/whose-job-is-it\" target=\"_self\" rel=\"noopener noreferrer\">Whose Job Is It? Hint: Look in The Mirror<\/a><br \/>\nDavid Wohl, MD<\/p>\n<p>Additionally, in June 2014, <a class=\"external-link\" title=\"\" href=\"https:\/\/aetcnec.virtualforum.com\/pifidform.cfm?erid=31923&amp;sc=456812&amp;aetccode=15\" target=\"_self\" rel=\"noopener noreferrer\">NCATEC hosted a webinar with Mitchell Warren<\/a>, the director of AVAC, a non-profit organization dedicated to supporting efforts in HIV prevention and education.<\/div>\n\n    <\/div>\n        \n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>&nbsp; These resources are intended to help you understand how PrEP can benefit your at-risk patients. Thanks for your interest in this new strategy for HIV prevention. On this page, we have put together some answers to questions that providers often ask about PrEP. We encourage you to take some time to review this information, &hellip; <a href=\"https:\/\/www.med.unc.edu\/nchivtraining\/clincian-resources\/prep\/for-providers\/for-interested-providers\/\" aria-label=\"Read more about For Providers Interested in PrEP\">Read more<\/a><\/p>\n","protected":false},"author":81071,"featured_media":0,"parent":2312,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"templates\/front-page.php","meta":{"_acf_changed":false,"footnotes":"","_links_to":"","_links_to_target":""},"class_list":["post-2375","page","type-page","status-publish","hentry","odd"],"acf":[],"_links_to":[],"_links_to_target":[],"_links":{"self":[{"href":"https:\/\/www.med.unc.edu\/nchivtraining\/wp-json\/wp\/v2\/pages\/2375","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.med.unc.edu\/nchivtraining\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.med.unc.edu\/nchivtraining\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.med.unc.edu\/nchivtraining\/wp-json\/wp\/v2\/users\/81071"}],"replies":[{"embeddable":true,"href":"https:\/\/www.med.unc.edu\/nchivtraining\/wp-json\/wp\/v2\/comments?post=2375"}],"version-history":[{"count":0,"href":"https:\/\/www.med.unc.edu\/nchivtraining\/wp-json\/wp\/v2\/pages\/2375\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/www.med.unc.edu\/nchivtraining\/wp-json\/wp\/v2\/pages\/2312"}],"wp:attachment":[{"href":"https:\/\/www.med.unc.edu\/nchivtraining\/wp-json\/wp\/v2\/media?parent=2375"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}