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

  • The Science of Prevention (JD Stekler and J Baeten, Section Editors)
  • Published:
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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.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Acknowledgments

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

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Authors and Affiliations

  1. Division of Research, Kaiser Permanente Northern California, 2000 Broadway, 2nd Floor, Oakland, CA, 94612, USA

    Julia L. Marcus

  2. Kaiser Permanente Northern California, San Francisco Medical Center, 2238 Geary Boulevard, San Francisco, CA, 94115, USA

    Jonathan E. Volk & C. Bradley Hare

  3. One Medical Group, 201 Spear St. Suite 230, San Francisco, CA, 94105, USA

    Jess Pinder

  4. San Francisco Department of Public Health, University of California, 356 7th Street, San Francisco, CA, 94103, USA

    Albert Y. Liu, Oliver Bacon & Stephanie E. Cohen

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  1. Julia L. Marcus
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  2. Jonathan E. Volk
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  3. Jess Pinder
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  4. Albert Y. Liu
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  5. Oliver Bacon
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  7. Stephanie E. Cohen
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Correspondence to Stephanie E. Cohen.

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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.

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

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Marcus, J.L., Volk, J.E., Pinder, J. et al. Successful Implementation of HIV Preexposure Prophylaxis: Lessons Learned From Three Clinical Settings. Curr HIV/AIDS Rep 13, 116–124 (2016). https://doi.org/10.1007/s11904-016-0308-x

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