{"id":2376,"date":"2014-11-25T18:05:00","date_gmt":"2014-11-25T23:05:00","guid":{"rendered":"https:\/\/www.med.unc.edu\/ncaidstraining\/prep\/for-providers\/for-prep-prescribers\/"},"modified":"2014-11-25T18:05:00","modified_gmt":"2014-11-25T23:05:00","slug":"for-prep-prescribers","status":"publish","type":"page","link":"https:\/\/www.med.unc.edu\/nchivtraining\/clincian-resources\/prep\/for-providers\/for-prep-prescribers\/","title":{"rendered":"For PrEP Prescribers"},"content":{"rendered":"<h2 class=\"section-som\"><span>For PrEP Prescribers<\/span><\/h2>\n<div>\n<p><b>Step-by-Step Guidance<\/b><\/p>\n<ul>\n<li>Condensed <b><a href=\"http:\/\/www.cdc.gov\/hiv\/pdf\/PrEPguidelines2014.pdf\">2014 US Public Health Service guidelines for PrEP<\/a><\/b><\/li>\n<li><b><a href=\"http:\/\/www.cdc.gov\/hiv\/pdf\/PrEPProviderSupplement2014.pdf\">Clinical providers\u2019 supplement<\/a><\/b><\/li>\n<\/ul>\n<p class=\" \"><em><strong>To download this information in checklist form:<\/strong><\/em><\/p>\n<ul>\n<li>April 2016 Update \u2013<a class=\"internal-link\" title=\"\" href=\"\/ncaidstraining\/files\/2018\/07\/PrEPchecklist_v3_CLEAN_20May2019.pdf\" target=\"_blank\" rel=\"noopener noreferrer\"> Clean Copy Guidelines<\/a> or with <a class=\"internal-link\" title=\"\" href=\"\/ncaidstraining\/files\/2018\/07\/prep-checklist-hilighted-changes.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Changes Highlighted<\/a><\/li>\n<li><a class=\"external-link\" title=\"\" href=\"https:\/\/drive.google.com\/file\/d\/0B3mxgMF5rYAJTl9aMXhIdUhrakU\/view?usp=sharing\" target=\"_blank\" rel=\"noopener noreferrer\">November 2014 Guidelines<\/a> (Original Version)<\/li>\n<\/ul>\n<p class=\" \">The UNC ID Clinic working group on PrEP uses a <strong>Patient\/Provider contract for PrEP<\/strong>, which sets some \u201cground rules\u201d at baseline. Modeled on a contract for patients receiving narcotics, this document spells out expectations of the patient and provider surrounding PrEP management. A signed copy is given to the patient.<\/p>\n<ul>\n<li><a class=\"external-link\" title=\"\" href=\"https:\/\/drive.google.com\/file\/d\/0B3mxgMF5rYAJZWU0M2R6RUM5TFk\/view?usp=sharing\" target=\"_blank\" rel=\"noopener noreferrer\">Patient\/provider contract for PrEP<\/a><\/li>\n<\/ul>\n<h3><em><strong>Step by Step Provider Checklist<\/strong><\/em><\/h3>\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                Step 1: Assess Need for 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\">If your patient has <span style=\"text-decoration: underline\">one or more<\/span> of the risk factors below, s\/he could benefit from PrEP as part of an overall HIV risk-reduction plan.<\/p>\n<table class=\"table table-bordered\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n<tbody>\n<tr>\n<td valign=\"top\" width=\"270\"><b>Risks for sexual transmission<\/b><\/p>\n<p>\u25a1 Condomless sex in prior 6 mos.<\/p>\n<p>\u25a1 Any STI diagnosed in prior 6 mos.<\/p>\n<p>\u25a1 Sex with partners of unknown HIV status<\/p>\n<p>\u25a1 Monogamous relationship with HIV+ partner(s)<\/p>\n<p>\u25a1 Commercial sex work<\/p>\n<p>\u25a1 High-prevalence area \/ sexual network<\/td>\n<td valign=\"top\" width=\"270\"><b>Risks for parenteral transmission<\/b><\/p>\n<p>\u25a1 Shared injection equipment (needles or \u201cworks\u201d)<\/p>\n<p>\u25a1 Known HIV+ injecting partner(s)<\/p>\n<p>\u25a1 Recent drug treatment<br \/>\n(but currently still injecting)<\/p>\n<p>\u25a1 Sexually active with injecting partner(s)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><b>NOTE:<\/b> In North Carolina, the sexual networks of young, Black men who have sex with men have a <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/22972020\">very high HIV prevalence<\/a> of at least 30%. If you\u2019d like to examine the prevalence of HIV in your county or city, check out <a href=\"http:\/\/aidsvu.org\/map\/\">AIDSvu<\/a> (a service of Emory University and the CDC).<\/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                Step 2: Determine Clinical Eligibility            <\/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\">Before starting PrEP, you must confirm that your patient is negative for hepatitis B and HIV, and that her\/his renal function is normal at baseline. Links to ordering menus from LabCorp and Quest Diagnostics can be found below.<\/p>\n<p><b>Within 30 days BEFORE starting PrEP:<\/b><\/p>\n<table class=\"table table-bordered\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n<tbody>\n<tr>\n<td valign=\"top\" width=\"306\">\u25a1 Hepatitis B surface <b>antigen<\/b> (sAg)<\/p>\n<p>\u25a1 Hepatitis B surface <b>antibody<\/b> (sAb)<\/td>\n<td valign=\"top\" width=\"234\"><b>Must be HBsAg negative<\/b><\/p>\n<ul>\n<li>Truvada treats HBV, and stopping it abruptly can cause a \u201cflare\u201d with illness<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"306\">\u25a1 Serum creatinine<\/p>\n<p>\u25a1 Estimated creatinine clearance<\/p>\n<p>\u25a1 Urinalysis<\/td>\n<td valign=\"top\" width=\"234\"><b>eCrCl must be \u2265 60 mL\/min<br \/>\n<\/b>(preferably by Cockcroft-Gault)<b>Urinalysis establishes a baseline <\/b><\/p>\n<ul>\n<li>This will help evaluate abnormalities in unlikely event they occur later on<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><b>Within 7 days BEFORE starting PrEP:<\/b><\/p>\n<table class=\"table table-bordered\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n<tbody>\n<tr>\n<td valign=\"top\" width=\"306\"><b>Test for HIV with ONE of the following<\/b><\/p>\n<p>\u25a1 HIV RNA (viral load)<\/p>\n<p>\u25a1 Antigen\/antibody combination assay (\u201c4th generation\u201d)<\/p>\n<p>\u25a1 Rapid test with <b>fingerstick blood<\/b><\/p>\n<p>\u25a1 \u201cTraditional\u201d blood test with ELISA (EIA) and reflexive confirmatory testing<\/td>\n<td valign=\"top\" width=\"234\"><b>Must be HIV negative<\/b><\/p>\n<ul>\n<li>Preference for HIV RNA (viral load) or 4th generation Ag\/Ab assay; both can detect early HIV infection<\/li>\n<li>Do NOT rely on oral rapid testing; sensitivity lower than with blood<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"306\"><b>Any of these symptoms in prior <span style=\"text-decoration: underline\">month<\/span>?<\/b><\/p>\n<p>\u25a1 Fever<\/p>\n<p>\u25a1 Fatigue<\/p>\n<p>\u25a1 Skin rash<\/p>\n<p>\u25a1 Pharyngitis<\/p>\n<p>\u25a1 Cervical adenopathy<\/td>\n<td valign=\"top\" width=\"234\"><b>No symptoms of acute HIV infection<\/b><\/p>\n<ul>\n<li><b>Must<\/b> be free of these symptoms in the month prior to starting PrEP<\/li>\n<li><b>If ANY symptoms are present,<\/b> <b>rule out acute HIV infection by ordering HIV RNA (viral load)<\/b><\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><b>Quest Diagnostics<\/b><\/p>\n<p><a href=\"http:\/\/www.questdiagnostics.com\/testcenter\/TestDetail.action?ntc=8475\">Hepatitis B surface antibody<\/a> \u2013 test number 8475<\/p>\n<p><a href=\"http:\/\/www.questdiagnostics.com\/testcenter\/TestDetail.action?ntc=498\">Hepatitis B surface antigen<\/a> \u2013 test number 498<\/p>\n<p><a href=\"http:\/\/www.questdiagnostics.com\/testcenter\/TestDetail.action?ntc=91431\">HIV 4th generation antigen\/antibody combination assay<\/a> \u2013 test number 91431<\/p>\n<p><a href=\"http:\/\/www.questdiagnostics.com\/testcenter\/TestDetail.action?ntc=40085\">HIV RNA viral load<\/a> \u2013 test number 40085<\/p>\n<p><b>LabCorp<\/b><\/p>\n<p><a href=\"https:\/\/www.labcorp.com\/wps\/portal\/provider\/testmenu\">Click here for test menu search<\/a> and enter the test numbers below<\/p>\n<p>Hepatitis B surface antibody \u2013 test number 006530<\/p>\n<p>Hepatitis B surface antigen \u2013 test number 006510<\/p>\n<p>HIV 4th generation antigen\/antibody combination assay \u2013 test number 083935<\/p>\n<p>HIV RNA viral load \u2013 test number 550430<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-0-2\" 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                Step 3: Consider STI Screening            <\/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\">PrEP is part of helping patients maintain their sexual health, so you should consider testing for other sexually transmitted infections (STIs), if not already done in the prior 3-6 months. Screening should include:<\/p>\n<p>\u25a1 <b>Serum RPR<\/b> for syphilis<\/p>\n<p>\u25a1 <b>Nucleic acid amplification tests (NAATs) for gonorrhea and chlamydia<\/b> \u2013 with samples from cervix, urine, or urethra <i>along with extragenital sites (pharynx, rectum) as appropriate<\/i><\/p>\n<p>\u25a1 <b>Nucleic acid amplification test for <i>Trichomonas vaginalis<\/i><\/b> (or wet prep) for sexually active women and heterosexual men<\/p>\n<p>\u25a1 Strongly consider <b>hepatitis C antibody<\/b> for anyone who injects drugs, has had sex with an injection drug user, and men who have sex with men<\/p>\n<p>NOTE: Independent labs like LabCorp and Quest Diagnostics have validated the use of NAATs from pharyngeal and rectal specimens. Whatever test kit you use in your office to collect cervical or urethral samples can probably also be used to collect extragenital samples. If you have a question, you should contact your lab vendor to make sure. They may be able to provide dedicated kits, if needed.<\/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                Step 4: Counsel the Patient            <\/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\">Counseling about medication side effects, adherence strategies, and symptoms of sexually transmitted infections is important prior to starting PrEP.<\/p>\n<p><b>Side effects<\/b><\/p>\n<p>Generally Truvada is well-tolerated and side effects are minimal. Key points:<\/p>\n<ul>\n<li>Some patients develop mild headaches, nausea or flatulence after starting PrEP.<\/li>\n<li>For most, these symptoms go away within the first month (a so-called \u201cstartup syndrome\u201d).<\/li>\n<li>If your patient develops any unexpected reaction \u2013 especially a skin rash \u2013 s\/he should contact your office and request a follow-up evaluation.<\/li>\n<\/ul>\n<p><b>Adherence and dosing strategies<\/b><\/p>\n<p>Encourage your patient to:<\/p>\n<ul>\n<li><b>Pair pill-taking with a daily task<\/b> \u2013 something they do consistently every day, <i>including on weekends<\/i>. Examples include eating breakfast, brushing teeth, or plugging in a cell phone before bedtime.<\/li>\n<li><b>Set an alarm<\/b> on a clock, wristwatch, or cell phone<\/li>\n<li><b>Use a pill box<\/b> to help verify they\u2019ve taken the day\u2019s dose, thus avoiding missed or doubled doses<\/li>\n<li><b>Keep an extra dose handy<\/b> at work or in the car to help avoid missing a dose<\/li>\n<\/ul>\n<p>Provide some anticipatory guidance:<\/p>\n<ul>\n<li><b>A<\/b> <b>dose can safely be taken 3-4 hours before or after a planned dosing time<\/b>. <i>It\u2019s better to take a dose a bit early or a bit late rather than miss a dose entirely!<\/i> Outside that window, it\u2019s probably best to skip the dose and begin the following day on the pre-planned schedule.<\/li>\n<li>There are <b>no interactions with Truvada and alcohol or recreational drugs<\/b> \u2013 but you should encourage patients to avoid using substances around the time of sexual activity. Some patients skip medications if they know they\u2019re going to be going out to a bar or club out of concern for interactions with alcohol.<\/li>\n<\/ul>\n<p><b>Signs and symptoms of sexually transmitted infections<\/b><\/p>\n<p>Encourage your patient to contact you promptly if s\/he develops:<\/p>\n<ul>\n<li><b>pain or burning with urination<\/b> (urethritis from multiple possible causes)<\/li>\n<li><b>sore throat<\/b> with or without lymphadenopathy following a sexual encounter (differential includes gonococcal pharyngitis and acute HIV infection)<\/li>\n<li><b>urethral, rectal, or vaginal discharge<\/b> (typically from gonorrhea or chlamydia)<\/li>\n<li><b>skin rashes<\/b>, especially involving the palms and soles (possible herpes, HPV, or syphilis)<\/li>\n<\/ul>\n<p>The CDC\u2019s <a href=\"http:\/\/www.cdc.gov\/std\/\">STD website<\/a> also has information for patients about these infections, testing, and treatment.<br \/>\n<\/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                Step 5: Initiate 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\"><strong>Prescription should read:<\/strong><br \/>\nTruvada (emtricitabine\/tenofovir) 200\/300mg<br \/>\nOne tablet PO daily<\/p>\n<p><b>First prescription should be for 30 tablets (one month)<\/b>. This allows a short-interval follow-up to assess adherence and side effects.<\/p>\n<p><b>Subsequent prescriptions<\/b> <b>be for 30 tablets with 2 refills<\/b>. This allows for the patient to return for their <b>required HIV testing every 3 months while on PrEP<\/b>.<\/p>\n<h3><em><span style=\"color: #000000;background-color: #ffffff\">Helping Your Patient Pay for PrEP<\/span><\/em><\/h3>\n<p class=\" \">Patient assistance is available from Gilead Science, the manufacturer of Truvada. <i>This program is available to <span style=\"text-decoration: underline\">insured<\/span> patients as a copayment assistance program, and to <span style=\"text-decoration: underline\">uninsured<\/span> patients as a medication access program<\/i>. For additional details, visit Gilead\u2019s dedicated webpage for PrEP patient assistance: <a href=\"http:\/\/start.truvada.com\/individual\/truvadaprep-copay\">http:\/\/start.truvada.com\/individual\/truvadaprep-copay<\/a>.<\/p>\n<p>You or your patient can begin the application process by:<\/p>\n<ul>\n<li>Calling to determine eligibility, toll-free at <b>1-855-330-5479<\/b>, M-F, 9A-8P EST<\/li>\n<li>Downloading and fax the application directly from the address below: <a href=\"http:\/\/start.truvada.com\/Content\/pdf\/Medication_Assistance_Program.pdf\">http:\/\/start.truvada.com\/Content\/pdf\/Medication_Assistance_Program.pdf<\/a><\/li>\n<\/ul>\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-0-5\" 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                Step 6: Follow-Up            <\/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\"><b>The most important component of follow-up is frequent testing for HIV \u2013 <span style=\"text-decoration: underline\">at least every 3 months, for ALL patients on PrEP<\/span>.<\/b><\/p>\n<p>The recommended schedule of assessments below is the <b>minimum follow-up<\/b>. Providers should feel free to schedule interim visits or assessments more frequently, depending on the patient\u2019s individual circumstances.<\/p>\n<p><b>At least every 3 months:<\/b><\/p>\n<p>\u25a1 <b>HIV testing<\/b> with <span style=\"text-decoration: underline\">strong preference<\/span> given to a 4th generation antigen\/antibody combination assay (see ordering info for LabCorp and Quest above, under <b>Step 2<\/b>)<\/p>\n<p>\u25a1 Assess adherence<\/p>\n<p>\u25a1 Assess side effects<\/p>\n<p>\u25a1 Assess risk-reduction behaviors<\/p>\n<p>\u25a1 Pregnancy testing, as appropriate<\/p>\n<p>\u25a1 Provide a refill prescription<\/p>\n<p><b>ADDITIONALLY, at least every 6 months:<\/b><\/p>\n<p>\u25a1 Serum creatinine with estimated creatinine clearance calculation<\/p>\n<p>\u25a1 STI testing, if not already done (see <b>Step 3<\/b> above)<\/p>\n<p><b>ADDITIONALLY, at least every 12 months:<\/b><\/p>\n<p>\u25a1 Urinalysis with dipstick<br \/>\n<\/div>\n\n    <\/div>\n        \n<\/div>\n<\/div>\n<p>If after reviewing the information here you still have a specific question about a patient on PrEP, scroll to the bottom of this page for contacts who can help.<\/p>\n<\/div>\n<h3>Clinician Contacts for Help with PrEP<\/h3>\n<ul>\n<li>Call <a href=\"http:\/\/nccc.ucsf.edu\/2014\/09\/29\/introducing-the-ccc-prepline\/\">PrEPline<\/a>, a service of the <strong>Clinician Consultation Center<\/strong> at the University of California, San Francisco, at <strong>1-855-448-7737<\/strong> (11 AM and 6 PM EST)<\/li>\n<li>Contact a UNC Infectious Diseases clinical fellow or attending physician through the <strong>Carolina Consultation Center<\/strong>, at <strong>1-800-862-6264<\/strong>. Between 8 AM and 5 PM on weekdays, you\u2019ll speak with an attending physician. After hours and on weekends, you\u2019ll speak with a fellow (who can reach an attending physician quickly, if needed).<\/li>\n<li>Email a UNC Infectious Diseases provider who has agreed to provide clinical guidance on issues related to PrEP. <i>Please allow up to 48 hours for a response<\/i>.\n<ul>\n<li>Christopher Hurt, MD <a href=\"mailto:christopher_hurt@med.unc.edu?subject=Question%20about%20PrEP%20(via%20NCATEC)\">christopher_hurt@med.unc.edu<\/a><\/li>\n<li>David Wohl, MD <a href=\"mailto:david_wohl@med.unc.edu?subject=Question%20about%20PrEP%20(via%20NCATEC)\">david_wohl@med.unc.edu<\/a><\/li>\n<li>Lisa Hightow-Weidman, MD, MPH <a href=\"mailto:lisa_hightow@med.unc.edu?subject=Question%20about%20PrEP%20(via%20NCATEC)\">lisa_hightow@med.unc.edu<\/a><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<div><a class=\"internal-link\" title=\"\" href=\"\/ncaidstraining\/files\/2018\/07\/moving-beyond-condoms-to-prevent-hiv-transmission.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Click Here<\/a> for Dr. Wohl\u2019s presentation <em>Moving beyond condoms to prevent HIV transmission<\/em>.<\/div>\n<div><a class=\"external-link\" title=\"\" href=\"\/ncaidstraining\/videos-1\/videos#PrEP-Network-Webinar\" target=\"_self\" rel=\"noopener noreferrer\">Click Here<\/a> for Dr. Hurt\u2019s webinar presentation on prescribing PrEP.<\/div>\n<h3>Are You Providing PrEP?<\/h3>\n<p>If you would like to have your practice added to our <a class=\"internal-link\" title=\"\" href=\"\/ncaidstraining\/prep\/PrEP-for-consumers\" target=\"_self\" rel=\"noopener noreferrer\">map of PrEP providers in North Carolina<\/a>, please email Christopher Hurt, MD with UNC Infectious Diseases at <a class=\"email-link\" title=\"\" href=\"mailto:christopher_hurt@med.unc.edu?subject=Provider Map Addition (via NCATEC)\" target=\"_self\" rel=\"noopener noreferrer\">christopher_hurt@med.unc.edu<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Step-by-Step Guidance Condensed 2014 US Public Health Service guidelines for PrEP Clinical providers\u2019 supplement To download this information in checklist form: April 2016 Update \u2013 Clean Copy Guidelines or with Changes Highlighted November 2014 Guidelines (Original Version) The UNC ID Clinic working group on PrEP uses a Patient\/Provider contract for PrEP, which sets some \u201cground &hellip; <a href=\"https:\/\/www.med.unc.edu\/nchivtraining\/clincian-resources\/prep\/for-providers\/for-prep-prescribers\/\" aria-label=\"Read more about For PrEP Prescribers\">Read more<\/a><\/p>\n","protected":false},"author":81071,"featured_media":0,"parent":2312,"menu_order":1,"comment_status":"closed","ping_status":"closed","template":"templates\/front-page.php","meta":{"_acf_changed":false,"footnotes":"","_links_to":"","_links_to_target":""},"class_list":["post-2376","page","type-page","status-publish","hentry","odd"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>For PrEP Prescribers - North Carolina HIV Training &amp; Education Center<\/title>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"For PrEP Prescribers - North Carolina HIV Training &amp; 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