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PrEP in clinical settings

The following resources can be used to support the delivery of PrEP in clinical settings. They include guidelines, program models, and clinical tools.

Contents

Clinical guidelines and models

Canadian clinical guidelines: National

Canadian guideline on HIV pre-exposure prophylaxis and nonoccupational postexposure prophylaxis
CIHR Canadian HIV Trials Network (CTN)

This national guideline provides recommendations on PrEP and non-occupational post-exposure prophylaxis screening, administration, and monitoring.

Dr. Darrell Tan: Pre-exposure prophylaxis (PrEP) for HIV prevention in Canada
CATIE

In this video, physician Darrell Tan discusses PrEP in Canada, including the Canadian PrEP guidelines and the role of frontline providers in supporting PrEP use.

How to prescribe HIV pre-exposure prophylaxis (PrEP): The basics

This online continuing education module covers the prescription of PrEP as recommended in the Canadian PrEP guidelines. Topics include a review of PrEP efficacy, assessing if PrEP is right for your patient, and caring for patients on PrEP. The module was originally created as part of a Canadian research project on PrEP education and includes information on PrEP access and billing that is specific to Ontario.

Canadian clinical guidelines: Provincial/territorial

Guidance for the use of pre-exposure prophylaxis (PrEP) for the prevention of HIV acquisition in British Columbia
British Columbia Centre for Excellence in HIV/AIDS

This guidance provides recommendations on PrEP in specific populations in BC, prescribing and stopping PrEP, and monitoring while on PrEP. Additional resources and tools are available on the British Columbia Centre for Excellence in HIV/AIDS website.

2018 Alberta HIV pre-exposure prophylaxis (PrEP) guidelines
Alberta Health Services

These guidelines provide recommendations on PrEP eligibility, starting and stopping PrEP, and PrEP prescribing and monitoring in Alberta. The appendices also address additional areas of patient support such as risk reduction discussions and adherence support.

Pre-exposure prophylaxis: Guideline review for primary care practitioners in Saskatchewan
Saskatchewan HIV Collaborative

This review summarizes PrEP care within a Saskatchewan context and is informed by Canadian and US PrEP guidelines.

La prophylaxie préexposition au virus de l'immunodéficience humaine : Guide pour les professionnels de la santé du Québec
Ministry of Health and Social Services of Quebec

These guidelines review the evidence supporting PrEP and provide recommendations on PrEP use in different populations including men who have sex with men, heterosexuals, and people who use injection drugs.

Canadian clinical program models

HIV Prevention Clinic
Toronto General Hospital

This case study reviews the HIV Prevention Clinic, a comprehensive, inter-professional HIV prevention service housed in the Immunodeficiency Clinic at the Toronto General Hospital in Toronto which offers PrEP and PEP services.

Text message reminder tool – The Sex You Want
Gay Men's Sexual Health Alliance (GMSH)

This program summary profiles a text message reminder tool for HIV treatment adherence that can also be used to support and promote PrEP adherence.

Providing HIV PrEP: Steps to patient engagement
CTAC

This guide provides practical recommendations for health care providers on assessing patients for PrEP and delivering care to those on PrEP.

International clinical guides and models

PrEP education for youth-serving primary care providers toolkit
SIECUS

This toolkit provides information and resources on providing PrEP to youth for primary care providers. While this toolkit contains access and legal information for a US audience, the general information on PrEP and working with youth can still be of interest to Canadian health care providers.

Family planning provider PrEP toolkit
HIVE

This US toolkit gathers resources and tools from different sources including HIVE, a multidisciplinary program and clinic on reproductive and sexual health for women living with HIV and HIV-affected couples in San Francisco. The toolkit aims to help family planning providers address PrEP with patients.

Provider information sheet – PrEP during conception, pregnancy, and breastfeeding
Centers for Disease Control and Prevention (CDC)

This information sheet reviews US-based recommendations for PrEP use during conception, pregnancy, and breastfeeding including potential benefits and risks.

WHO implementation tool for pre-exposure prophylaxis (PrEP) of HIV infection: Module 1: Clinical
World Health Organization (WHO)

This module of the WHO PrEP implementation tool addresses PrEP delivery in clinical settings. It covers screening, PrEP initiation, and ongoing monitoring.

WHO implementation tool for pre-exposure prophylaxis (PrEP) of HIV infection: Module 10: Testing providers
World Health Organization (WHO)

This module of the WHO PrEP implementation tool addresses the delivery of testing services related to starting and monitoring PrEP, including HIV, kidney function, and sexually transmitted infection testing.

Clinical tools

Canadian clinical tools

British Columbia HIV pre-exposure prophylaxis baseline assessment tool
British Columbia Centre for Excellence in HIV/AIDS

This baseline assessment tool for health care providers in British Columbia addresses HIV risk as well as other medical and personal history information. The document also includes a check list of activities and tests for baseline and follow-up medical visits related to PrEP use. Additional resources and tools are available on the British Columbia Centre for Excellence in HIV/AIDS website.

PrEP: Quick reference
Saskatchewan HIV Collaborative

This quick reference document for health care providers in Saskatchewan covers baseline and follow-up tests for PrEP, risk assessment questions for men who have sex with men, symptoms of acute HIV infection, and an algorithm for providing PrEP to men who have sex with men and trans women, heterosexuals, and people who use injection drugs.

Pre-exposure prophylaxis (PrEP) for HIV prevention: Health care provider
Nine Circles Community Health Centre | Manitoba HIV Program

This reference sheet summarizes PrEP dosage, cost in Manitoba, and assessment and monitoring for health care providers.

International clinical tools

Prescribing pre-exposure prophylaxis (PrEP) for HIV prevention: A guide for medical providers
Cascade AIDS Project and Mountain West AETC – Oregon Program

This short reference guide addresses PrEP indications, screening, counselling topics, side effects, and monitoring tests, as well as information on paying for PrEP and PrEP resources specific to the United States.

Long-term use medications and TDF/FTC PrEP
University of Liverpool

This chart summarizes potential drug interactions between tenofovir/emtricitabine (TDF/FTC) for PrEP and key long-term use medications, such as pain medication.