Skip to Main Content
Ready to renew your Medicaid coverage? Explore our step-by-step guide to Medicaid renewal. Here's how
Ready to renew your Medicaid coverage? Explore our step-by-step guide to Medicaid renewal. Here's how

HIV SCREENING AND CURRENT PRE-EXPOSURE PROPHYLAXIS (PrEP) GUIDANCE

Date: 01/10/24

HIV is still a significant health problem today. Approximately 1.2 million individuals in the United States are living with HIV.1 As a preventable condition, it's also crucial to recognize the existence of ethnic disparities in HIV prevention efforts. For instance, in 2021, 40 percent of individuals diagnosed with new cases of HIV were reported as African American.2


HIV Screening

Patients aged 13 to 64 should be tested for HIV at least once, as part of their routine care.3 All sexually active patients, regardless of age, sexual orientation, or gender should be screened. Talking about the screening also provides an opportunity to discuss sexual health and risk factors.3 A conversation starter that can be used could include, “Do you know your partner’s status?” or, “Have you had an HIV test?”.4 The Centers for Disease Control and Prevention (CDC) also recommends utilizing an “opt-out” approach by informing the patient that an HIV test will be included as part of their preventive screening with an option to decline if they wish.3 Also, consider recommending annual screenings for patients who are at a higher risk.


PrEP

PrEP is the use of antiretroviral therapy to prevent transmission of HIV via sex or injection drug use. It should be considered a part of the prevention plan discussion with your patients along with condom use and other risk reduction methods.4 The medications in the table below are approved to prevent HIV in adults and adolescents weighing at least 77 pounds. When taken as prescribed, PrEP is highly effective, reducing the risk of HIV infection from sex by approximately 99 percent. The risk of HIV from injectable drug use is reduced by 74 percent.5

Reference the Meridian preferred drug list (PDF) for information on these and other antiretroviral medications:

Brand NameGeneric NameDoseIndicationMeridian Preferred Drug List Status
Truvada®Emtricitabine (F) 200 mg and tenofovir disoproxil fumarate (TDF) 300 mg (F/TDF)One tablet daily with or without food.Prevent HIV among all people at risk through sex or injection drug use.Preferred
Descovy*Emtricitabine (F) 200 mg in combination with tenofovir alafenamide (TAF) 25 mg (F/TAF)One tablet daily with or without food.

Prevent HIV among people at risk through sex, excluding people at risk through receptive vaginal sex.

*F/TAF has not yet been studied for HIV prevention for people assigned female at birth who could get HIV through receptive vaginal sex.5

Preferred
ApretudeCabotegravir (CAB) 600 mg injectionAdminister the first injection followed by a second injection one month after the first. CAB injections are given every two months thereafter.Prevent HIV among all people at risk through sex.Preferred

 

References
 

1.      U.S. Statistics. Accessed October 11, 2023.

2.      Basic Statistics. Accessed October 11, 2023.

3.      How do I screen for HIV?. Accessed October 11, 2023.

4.      How can I help my patients with HIV start treatment?. Accessed October 11, 2023.

5.      How do I prescribe PrEP?. Accessed October 11, 2023.