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Current HIV/AIDS Reports

, Volume 13, Issue 2, pp 116–124 | Cite as

Successful Implementation of HIV Preexposure Prophylaxis: Lessons Learned From Three Clinical Settings

  • Julia L. Marcus
  • Jonathan E. Volk
  • Jess Pinder
  • Albert Y. Liu
  • Oliver Bacon
  • C. Bradley Hare
  • Stephanie E. CohenEmail author
The Science of Prevention (JD Stekler and J Baeten, Section Editors)
Part of the following topical collections:
  1. Topical Collection on The Science of Prevention

Abstract

The past 3 years have marked a transition from research establishing the safety and efficacy of HIV preexposure prophylaxis (PrEP) to questions about how to optimize its implementation. Until recently, PrEP was primarily offered as part of randomized controlled trials or open-label studies. These studies highlighted the key components of PrEP delivery, including regular testing for HIV and other sexually transmitted infections (STIs), adherence and risk-reduction support, and monitoring for renal toxicity. PrEP is now increasingly provided in routine clinical settings. This review summarizes models for PrEP implementation from screening through initiation and follow-up, focusing on the strengths and weaknesses of three delivery systems: a health maintenance organization, an STI clinic, and a primary care practice. These early implementation experiences demonstrate that PrEP can be successfully delivered across a variety of settings and highlight strategies to streamline PrEP delivery in clinical practice.

Keywords

Preexposure prophylaxis (PrEP) PrEP delivery PrEP implementation Human immunodeficiency virus (HIV) Implementation Sexually transmitted infections Delivery of health care Science of prevention Review 

Notes

Acknowledgments

This work was supported by a Kaiser Permanente Northern California Community Benefit research grant to Dr. Julia L. Marcus.

Compliance with Ethical Standards

Conflict of Interest

Julia L. Marcus reports grants from Merck.

Albert Y. Liu reports non-financial support from Gilead and personal fees from IAS-USA.

Stephanie E. Cohen reports non-financial support from Gilead.

Jonathan E. Volk, Jess Pinder, C. Bradley Hare, and Oliver Bacon declare they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Julia L. Marcus
    • 1
  • Jonathan E. Volk
    • 2
  • Jess Pinder
    • 3
  • Albert Y. Liu
    • 4
  • Oliver Bacon
    • 4
  • C. Bradley Hare
    • 2
  • Stephanie E. Cohen
    • 4
    Email author
  1. 1.Division of ResearchKaiser Permanente Northern CaliforniaOaklandUSA
  2. 2.Kaiser Permanente Northern California, San Francisco Medical CenterSan FranciscoUSA
  3. 3.One Medical GroupSan FranciscoUSA
  4. 4.San Francisco Department of Public HealthUniversity of CaliforniaSan FranciscoUSA

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