HIV Immediate Exposure Reference Guide
PEP PROTOCOL FOR MEDICAL PROVIDERS
PEP: Post Exposure Prophylaxis
– Exposure to HIV is a Medical Emergency
– Medicines are available that can PREVENT HIV Transmission
– There is a 72 Hour MAXIMUM window from the time of exposure to when the person MUST start the 28 days of the prescribed medicine
– Copay assistance is available that might pay for the total cost of the medicine
PEP PROTOCOL STEP 1: Treat or Refer
Can the patient be seen immediately, or within a reasonable time frame, by your medical staff to get the required prescriptions?
– If so, immediately treat for PEP.
– If not, and it’s during M-F Business Hours, send them immediately to the Cempa Community Care Clinic.
– If not, and it’s after hours or a weekend, send them immediately* to Erlanger ER Downtown or Memorial ER.
DO NOT send a patient to a Health Department. They do not treat for PEP.
For more information or to request a 3 day PEP Starter Kit, call Cempa’s 24/7 PEP Hotline at 423.226.1115.
*Before you send your patient away from your office, make sure the patient has the Gilead Copay Card & Merck Drug Assistance information (STEP 3). With this information, regardless of insurance, the cost of the 28 day regimen of pills should be free.
PEP PROTOCOL STEP 2: Evaluate & Test
1) Evaluation* – Discuss exposure and when it occurred.
2) Perform HIV Test – Choose a rapid combined Ag/Ab or Antibody [VII-A1] [VII-B1]
3) If Rapid Blood Test results are unavailable, PEP initiation should take place immediately and can be discontinued if patient is later determined to already be living with HIV.
*STI Testing may be determined as necessary upon evaluation
If patient is HIV Negative and evaluated to have had a high-risk exposure within the last 72 hours, then patient should be prescribed a 28-day course of a 3 drug antiretroviral regimen.
PEP PROTOCOL STEP 3: Prescription Copay Assistance
Give the Patient the following information so that they can apply for the Drug Assistance Copay Cards (Or stay with them while they do it or help them do it).
Gilead Advancing Access Copay Program: Gilead Assistance for TRUVADA
Call 1-877-505-6986
(Monday – Friday, 9am-6pm EST)
gileadadvancingaccess.com/copay-coupon-card
Patient Saving Card: ViiV drug Assistance for TIVICAY
Call 1-844-588-3288
(Monday – Friday, 9am-6pm EST)
us.tivicay.com/patient-savings/
If you are attempting to access a copay assistance coupon after business hours, all coupons are available 24/7 on each listed website. Medicines are typically free to victims of rape or sexual assault.
PEP PROTOCOL STEP 4: Pharmacy Options
Find out which pharmacies have the prescribed medicines in Stock.
Recommended Pharmacies – Chattanooga, TN:
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Cempa Community Care Pharmacy, 1000 E 3rd St. (423) 541-9450
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Walgreens Center of Excellence, 110 N. Market St. (423) 752-8104
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Walgreens Center of Excellence, 3605 Brainerd Rd. (423) 662-7520
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CVS Pharmacy, 979 E. 3rd St. (Inside Erlanger Hospital) (423) 713-9453
Only send a patient to a pharmacy you have verified has medications IN STOCK.
PEP PROTOCOL STEP 5: Follow Up
After 28 Days, contact client for a required follow-up HIV Test that can be administered at the clinic or agency that treated for PEP. Patients can also be referred to Cempa Community Care. Contact Mario Forte at 423.226.1115 or mforte@cempa.org to speak with a PrEP / PEP Navigator.
The follow up test should occur 2 weeks after completing PEP treatment.
Discuss whether they would like to continue on PrEP (Pre-Exposure Prophylaxis) Treatment.
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If so, additional labs may be required and the Truvada script may be written for 60 more days.
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Contact PrEP Navigator for information and protocols on PrEP.
