Article submitted by Dr. Winston Tilghman, Health and Human Services Agency, County of San Diego
The County of San Diego Sexually Transmitted Disease (STD) clinics now offer non-occupational post-exposure prophylaxis (nPEP) for HIV to clients who are uninsured and/or meet criteria for the pharmaceutical patient assistance programs. This program is part of the County’s Getting to Zero initiative to end the HIV epidemic and to increase public access to this important intervention.
Prophylaxis is a medical intervention designed to prevent disease. Post-exposure prophylaxis (PEP) for HIV involves taking a 28-day course of HIV medications following a high-risk sexual, needlestick, or other exposure to HIV in order to prevent infection from occurring. PEP must be started within the first 72 hours following exposure to be effective, so time is of the essence. This program is designed to get eligible patients started on medications on the same day in order to maximize the likelihood of success.
The County of San Diego and Live Well San Diego Recognized Partners Family Health Centers of San Diego, Vista Community Clinic, and San Ysidro Health Center offer free, confidential HIV testing throughout the region.
STD clinic providers screen all clients who report recent non-occupational exposure to HIV for nPEP eligibility and make recommendations regarding whether nPEP is indicated and, if so, what medications should be taken, based on national guidelines. STD testing, baseline safety monitoring tests, and Stat (when possible) fourth-generation combination antigen/antibody HIV testing are performed, and eligible clients are prescribed medications. STD clinic staff members are trained to enroll eligible patients in programs that cover the high costs of the medications.
The HIV, STD, and Hepatitis Branch also is assembling a nPEP resource directory in order to direct clients who are established patients in local healthcare systems to nPEP through their medical homes. For more information regarding nPEP, please contact Dr. Winston Tilghman.