The U.S. Centers for Disease Control and Prevention (CDC) has issued new guidance for PrEP clinical services to help maximize resources and minimize disruption in services. Released last week, the guidelines reaffirm that PrEP care is an essential health service, and that clinicians should ensure PrEP availability for new and continuing patients. The CDC recommends:
- Quarterly HIV and STI testing, through a home specimen collection kit when visiting a lab for such testing isn’t possible. This includes a finger-prick blood-sample test for HIV, as well as urine and saliva samples for sexually transmitted infections (STIs).
- An oral (saliva) HIV self-test when lab-only visits or other testing options are not available. CDC says that these tests are not optimal for detecting recent HIV infections or infections that took place while using PrEP, so they should only be used if there is no other option.
- Prescriptions for a 90-day supply of PrEP medication (rather than a 30-day supply with two refills) to minimize trips to the pharmacy and to encourage adherence.
- Establishing referral relationships with other clinics, telemedicine services, and pharmacies so that clients may remain engaged in PrEP care if a clinic closes or suspends services.
If PrEP clinical services have not been disrupted, providers should continue to follow recommendations outlined in the 2017 PrEP Clinical Guidelines and Clinical Provider Supplement, the CDC says.