PrEP for Providers

Healthcare Provider Resources for Pre-Exposure Prophylaxis (PrEP)

Texas DSHS recommends that physicians consider pre-exposure prophylaxis (PrEP) for people who have an elevated chance of acquiring HIV or for those who want additional protection against HIV. PrEP is an antiretroviral medication that helps prevent HIV acquisition before potential exposure. PrEP is safe and effective for most individuals.

The Centers for Disease Control and Prevention (CDC) recommends PrEP for adults and adolescents who weigh at least 35 kilograms (77 pounds), are HIV negative, and may be vulnerable to HIV acquisition.

For patients who have experienced a recent exposure to HIV within the last 72 hours, the CDC recommends that clinicians assess patients for Post-Exposure Prophylaxis (PEP). The CDC provides Recommendations for Antiretroviral Post-Exposure Prophylaxis to guide physicians in assessing patients and prescribing PEP.
 

Prescribing PrEP

The U.S. Food and Drug Administration (FDA) has approved the following treatment regimens for use as PrEP: two daily oral PrEP medications and two long-acting injectable PrEP medications.

The approved daily oral PrEP medications are: 

  • Emtricitabine and tenofovir disoproxil fumarate 200/300 mg (F/TDF) – Gilead Pharmaceuticals markets F/TDF under the brand name Truvada®, but it is also available as a generic medication. Individuals of both genders can take F/TDF for PrEP.
  • Emtricitabine and tenofovir disoproxil alafenamide 200/25 mg (F/TAF) – Gilead Pharmaceuticals markets F/TAF under the brand name Descovy®. Currently, F/TAF for PrEP is limited for use by males only. 

The approved long-acting injectable PrEP medications are:

  • Long-Acting Injectable Cabotegravir 600mg/3ml (LA-CAB) – Clinicians administer LA-CAB as an injection into the gluteal muscle every 8 weeks after initiation. ViiV Pharmaceuticals markets LA-CAB under the brand name Apretude®. Individuals of both genders can take LA-CAB. 
  • Long-Acting Injectable Lenacapavir 927mg/3ml (LA-LEN) – Clinicians administer LA-LEN in two doses (463.5/1.5ml) by subcutaneous injection to the abdomen once every six months after initiation. Gilead Pharmaceuticals markets LA-LEN under the brand name Yeztugo®. Individuals of both genders can take LA-LEN.

To learn more about how to prescribe PrEP and nPEP or for support for your clinical practice, visit the following resources:

The Provider's Role

Licensed healthcare providers with prescribing authority can write prescriptions for PrEP. A licensed healthcare provider or nurse must administer injectable PrEP. 

Here are some steps you can take to reduce HIV transmission and acquisition across Texas:

  1. Take a comprehensive sexual history from patients as part of routine medical care.
  2. Screen patients with indications for HIV and other STDs based on sexual history and the CDC 2021 Clinical Practice Guidelines.
  3. Talk about PrEP with adults and adolescents who are sexually active or may be sharing needles. Providers should also discuss PrEP with people living with HIV, who may have partners or social contacts that could benefit from PrEP.
  4. Prescribe PrEP according to clinical practice guidelines to patients with a greater likelihood of acquiring HIV and those who request PrEP, even when a risk factor is not indicated.
  5. Refer to other local PrEP providers if your practice is unable to provide PrEP. Visit the DSHS PrEP Directory or the National Prevention Information Network Directory for a listing of clinics and providers who prescribe PrEP near you.
     

Support for PrEP

Texas DSHS supports PrEP as a highly effective intervention for HIV Prevention:

The following entities support PrEP:

Clinical Resources and Tools

Long-Acting Injectable (LAI) PrEP resources

Post-Exposure Prophylaxis resources

Continuing Education

Other Resources

Pre-exposure Prophylaxis for the public