Demetre Daskalakis, MD, MPH is an infectious disease specialist with a focus on LGBTQAI communities. He is the Acting Director of the National Center for Immunization and Respiratory Diseases, deployed from his position as the Director of the Division of HIV Prevention in the National Center for HIV, Viral Hepatitis, STD, and TB Prevention at CDC.
Ask Me Anything About PrEP: For Healthcare Providers is a video series that covers the basics of prescribing PrEP and having open conversations with patients about sexual health.
This video is a joint production of KFF’s GREATER THAN HIV and CDC’s LET’S STOP HIV TOGETHER. This information is shared for educational purposes and should not be used as a substitute for professional medical advice. The views expressed are those of the featured medical professional and reflect information available to that professional at the time of filming. Always consult a healthcare provider for any personal health decisions.
The marks “CDC” and “Let’s Stop HIV Together” are owned by the US Dept. of Health and Human Services and are used with permission. Use of these logos is not an endorsement by HHS or CDC of any particular product, service, or enterprise.
TRANSCRIPT:
So, if you have someone who wants PrEP, the first step is to do the right HIV testing to make sure that they don't have HIV.
HIV positivity is a contraindication to PrEP. So, probably the most important thing to remember is, if someone has a HIV test that's positive, PrEP is not a complete regimen for treatment.
Also, it's not just about HIV. It's also about other sexually transmitted infections. And so make sure that you're doing all the appropriate screening for viral hepatitis, so think about hep B, think about hep C, gonorrhea, chlamydia, syphilis.
And, it's also a great time to step back and say, “Is my patient up to date with all their vaccines?” And, if they're not, really start thinking about those as well. So whether it's hepatitis or mpox, etcetera, make sure that they're up to date.
Also important to get some baseline tests. So you may be looking at their kidney function, you're gonna be looking potentially at their cholesterol levels. Once you have all that information, you start them on PrEP, and then you plan to see them again on a recurrent basis. So that you can continue to do HIV testing and monitor for any of the rare lab abnormalities that you can see with PrEP. Again, thinking about doing kidney function testing in some people. It varies by age, so check the guidelines out to see how often. And also thinking about doing cholesterol screenings for some people on certain PrEP medicines.
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