PrEP Story Bank

Communities across the United States are at varying stages of PrEP awareness and implementation, and many are asking themselves what they could or should be doing and how to go about doing it. NACCHO’s PrEP Story Bank aims to help answer these questions by sharing examples of what local health departments are already doing to support functions along the PrEP delivery cascade.

We hope that this will be an expanding and growing resource for local health departments and their HIV prevention partners. If you are interested in adding your story, please contact Gretchen Weiss at gweiss@naccho.org.

When the Champaign-Urbana Public Health District first began discussing PrEP, it expected that it would conduct education and outreach with community members, increase provider capacity to deliver PrEP, and link interested individuals to providers. However, a number of barriers to accessing PrEP from providers in the community quickly emerged. After assessing the clinical practice guidelines for PrEP and internal capacity, the health department determined that it would be feasible to deliver PrEP from the STI clinic. Since starting to prescribe PrEP, it has become apparent that it is not only a tool for HIV prevention, but also serves as an access point for health insurance and the delivery of other preventive services. Listen to the recorded presentation to learn how the health department is implementing PrEP from its STI clinic.

Tarek Mikati, HIV/STI Medical Director at the Chicago Department of Public Health (CDPH) explains the process he and his colleagues undertook to explore how PrEP might be implemented within an STI clinic. Dr. Mikati and his colleagues, in conjunction with Howard Brown Health Center (HBHC), determined that an active referral process for high-risk patients from the STI clinic to the PrEP program at HBHC would be best suited for their setting. In September 2014, CDPH and HBHC initiated their active referral pilot project. Dr. Mikati details the project planning process, active referral protocol, successes, challenges, and next steps. View the recorded presentation.

Julie Myers, Director of HIV Prevention at the New York City Department of Health and Mental Hygiene (NYCDHMH) shares what they are doing to integrate biomedical interventions, specifically PrEP and PEP, into existing HIV and STI prevention activities. NYCDHMH’s work began by speaking to other jurisdictions, forming a workgroup, and conducting a needs assessment among STD clinic attendees at high risk of HIV. This information was used to develop a plan that includes four main activities: (1) increasing PrEP/PEP awareness for patients and providers; (2) increasing PrEP/PEP access; (3) supporting appropriate implementation; and (4) monitoring appropriate implementation. Dr. Myers details what NYCDHMH is doing in each of these areas. View the recorded presentation.

Mark Thrun, Director of HIV/STD Prevention and Control and Michael Fuhriman, HIV Linkage/PEP/PrEP Case Coordinator share how Denver Public Health’s PrEP program evolved over the past few years and discuss case examples of individuals who have initiated PrEP through the program at Denver Metro Health STD Clinic. Dr. Thrun details how he and his colleagues explored and embraced the STD clinic’s role in PrEP and established an internal referral system for PrEP from the STD clinic to the HIV care clinic. Some of the key steps along the way included assessing who might benefit from PrEP, identifying clinicians willing to see patients for PrEP, engaging with linkage to care and prevention counseling staff, developing a protocol for the internal referral system, and creating informational and marketing materials. View the recorded presentation

Mary Jo Meuleners, Community Health Program Supervisor, Jennifer Drazkowski, Nurse Practitioner, and Javier Bucher, PrEP Program Coordinator share how PrEP was added to existing HIV prevention services offered by the Hennepin County Public Health Clinic. PrEP was incorporated in the clinic’s Red Door Services’ Health Interventions for Men program, which provides sexual health services for MSM. Hennepin County established its PrEP program with support from an HIV prevention grant from the Minnesota Department of Health. Additionally, by leveraging existing clinic services, resources, infrastructure, and partnerships, a seamless “in-house” referral to PrEP was established for high-risk MSM presenting for STI evaluation, treatment, and care or referred for PrEP by DIS. Between April 2013 and December 2014, the program assessed approximately 180 clients for PrEP, approximately 120 clients are on PrEP, and no patients taking PrEP have become HIV positive. Additionally, the program has supported early identification of four individuals living with HIV, who were subsequently linked to care. View the recorded presentation.