Preventing HIV in Primary Care: Preexposure Prophylaxis

Description: The purpose of this project was to create a continuing online education module to improve primary care provider knowledge in prescribing the preexposure prophylaxis (PrEP) medication emtricitabine-tenofovir (FTC-TDF) in high-risk men who have sex with men. Problem Statement: In 2012, the Food and Drug Administration approved the brand name drug Truvada (FTC-TDF) for the prevention of HIV in high-risk men who have sex with men. Despite being 99% effective in preventing HIV transmission in this high-risk population, primary care provider prescription of PrEP remains low. One of the biggest barriers to PCP prescribing of PrEP is a lack of knowledge regarding indications, patient selection, monitoring parameters, safety, and effectiveness. Objectives: The objectives of this project were to identify effective methods and resources for online learning, create an online education program incorporating current evidence-based guidelines for PrEP use in high-risk patients, and disseminate the project to PCPs in Utah through submission to a continuing medical education (CME) program and as an on-demand tool available through the Utah AIDS Foundation. Literature Review: FTC-TDF has been available as an effective antiretroviral HIV treatment for years, but in 2010, a study was published with evidence that this medication could prevent HIV transmission in patients without HIV infection. Follow-up studies demonstrated PrEP had even greater efficacy in real-world use. The studies found no increases in sexually transmitted infections in patients. PrEP is a cost-effective choice to lower the rates of HIV infection. PrEP has been extensively studied in HIV-positive patients and is considered safe. Implementation and Evaluation: Project implementation and evaluation included (a) evaluation, selection, and learning of online learning software based on established criteria; (b) creation of a script of the video portion and completion of a mock-up, followed by transcription and production of the mock-up video format; (c) creation of a website, www.knowPrEPnow.org, to host the online material and assist in dissemination; and (d) presentation of the project to the Utah AIDS Foundation for their use in provider education and submission for CME accreditation. Summary: This final product met the goals of this project by being a sustainable, modifiable, and accessible CME education program to help reduce HIV infection in high-risk individuals. The project is sustainable through a low yearly upkeep cost for the domain name. As new information or evidence regarding PrEP becomes available, the project is easily modifiable to keep the information current. The project is accessible to anyone with an Internet connection, free of charge, on any type of Internet-capable device.