Pre-exposure prophylaxis (PrEP) is a strategy to prevent HIV, whereby users take oral medication daily to lower their chances of getting HIV. According to the Centers for Disease Control and Prevention (CDC), taking PrEP medication as prescribed reduces the risk of getting HIV via sexual contact by about 99% and reduces the risk of getting HIV by at least 74% among persons who inject drugs.

CDC will now allow domestic HIV prevention funding to be used to support PrEP ancillary services (such as laboratory testing costs) through the flagship health department program, PS18-1802.

Recipients of PS18-1802 may provide assistance, no more than 15 percent (15%) of the overall award amount, to support PrEP ancillary support services. Recipients are required to notify CDC if coverage demands exceed the allotted 15% to secure permission to redirect additional resources to meet the projected demand.

This guidance allows flexibility for program recipients to utilize CDC’s flagship health department funding to pay for CDC-recommended clinical care costs related to PrEP as payor of last resort. Further, this guidance allows flexibility for recipients to provide immediate, transitional support while seeking alternative, long-term support for individuals as other eligible resources are secured for clients.

Funds may be used for, but are not limited to, the following:

• PrEP Awareness, Education, and Program-Related Services:
• Planning for how to most effectively incorporate PrEP into prevention education and services, including evaluating what collaborations will be needed.
• Educational materials about how to use PrEP in conjunction with other HIV prevention and care services, as well as STI, viral hepatitis, mental health and substance abuse treatment.
• Development and delivery of the HIV risk-reduction counseling and behavioral interventions that must be provided with PrEP.
• Communication activities related to disseminating information about PrEP.
• Evaluation activities for PrEP-related activities.
• Personnel (e.g., program staff) conducting the above PrEP-related activities.

Additional Ancillary Support Services:

• Laboratory costs for screening or monitoring PrEP per CDC guidelines for uninsured or underinsured people receiving PrEP in not-for-profit or governmental clinics.
• Services provided via mobile units and other novel engagement strategies.
  • PrEP candidates may need assistance with transportation, communication with clinicians, and
  • Navigating other support services.
• Limited personnel costs related to the provision of PrEP medication if coupled with other supportive PrEP services, e.g., eligibility assessments, risk reduction education, referral/navigation support to other essential services, etc.
• These activities must be a well-defined set of duties that are in addition to writing prescriptions and provision of clinical care.
• The funded percentage for these duties may not exceed 75% of the FTE.
• Other sources of funding are needed to support any duties specifically related to clinical care.

Note: Funding may not be used to pay for PrEP medications.

With greater access and utilization by populations who benefit, PrEP has the potential to alter the course of the HIV epidemic in the United States.

For more information on the guidelines and other supporting documents, visit CDC PrEP Website. Should you need additional information, specific to capacity building assistance, or to request training and technical assistance for the health department, please contact your HIV prevention project officer in CDC’s Division of HIV Prevention, Program Development, and Implementation Branch.

Review the PrEP Grantee Letter and HIV PrEP Program Ancillary Support Services Guidance from CDC’s Division of HIV Prevention for more details related to this guidance change.