NURSE LED PrEPMODEL IN A COMMUNITY HEALTH CENTER Progress Remains - - PowerPoint PPT Presentation

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NURSE LED PrEPMODEL IN A COMMUNITY HEALTH CENTER Progress Remains - - PowerPoint PPT Presentation

Apr 29, 2023 9 likes •222 views

NURSE LED PrEPMODEL IN A COMMUNITY HEALTH CENTER Progress Remains Uneven in Reducing New HIV Infections Estimated HIV Incidence Among MSM a , New HIV Infections by Age, United States, 20082014 in the United States, 2014 12,000

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NURSE –LED PrEPMODEL IN A COMMUNITY HEALTH CENTER

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  • Estimated annual HIV infections declined 18% in the US from 2008 to 2014
  • MSM were the only group that did not experience an overall decline from 2008 to 2014

Progress Remains Uneven in Reducing New HIV Infections

MSM, men who have sex with men.

  • a. Adjusted for missing risk factor information.

Singh S, et al. CROI 2017. Seattle, WA. #30. Adapted from CDC at

https://www.cdc.gov/nchhstp/newsroom /docs/factsheets/hiv‐incidence‐fact‐ sheet_508.pdf. Accessed April 2017.

Estimated HIV Incidence Among MSMa, by Age, United States, 2008–2014

2,000 4,000 6,000 8,000 10,000 12,000 2008 2009 2010 2011 2012 2013 2014 13–24 25–34 35–44 45–54 ≥55 Age range:

Heterosexuals 8,600 infections (36% decline since 2008) People who inject drugs 1,700 infections (56% decline since 2008) MSM who inject drugs 1,100 infections MSM 26,200 infections (Stable since 2008)

New HIV Infections in the United States, 2014 37,600

New HIV Infections in 2014 23% 5% 3% 70%

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18.9 6 3.2 3 1.2 1.2 0.6 2.6 1.3 1.5 1 5.8 3.9 2.5 0.4

5 10 15 20 South Africa Kenya Nigeria Rwanda Thailand Burundi Brazil New York City, NY (blacks) New York City, NY New Orleans, LA (blacks) New Orleans, LA Washington, DC (black men) Washington, DC (blacks) Washington, DC United States Prevalence (%)

HIV Prevalence in Certain Populations in the United States Is Higher Than in Some Nations With High Prevalence of HIV

  • 1. Centers for Disease Control and Prevention. HIV Surveillance Report, 2014; vol. 26. http://www.cdc.gov/hiv/library/reports/surveillance/. Published November 2015.

Accessed April 2017; 2. U.S. Census Bureau. Population estimates. http://www.census.gov/programs‐surveys/popest/data/data‐sets.2013.html. Accessed April 2017; 3. Annual Epidemiology and Surveillance Reports for the District of Columbia. HIV/AIDS, Hepatitis, STD and TB Administration (HAHSTA) Annual Report 2014; 4. AIDSVu. https://aidsvu.org/state/louisiana/new‐orleans/. Accessed April 2017; 5. AIDSVu. https://aidsvu.org/state/new‐york/new‐york‐city/. Accessed April 2017; 6. Prevalence of HIV, World Bank Group. http://data.worldbank.org/indicator/SH.DYN.AIDS.ZS. Accessed April 2017.

1,2 3 3 4 4 5 5 6 6 6 6 6 6 3 6

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Lifetime Risk of HIV Diagnosis

1 in 20 1 in 48 1 in 48 1 in 227 1 in 132 1 in 880 African- American MSM Total MSM 1 in 6 1 in 2 Hispanic MSM White MSM 1 in 11 1 in 4

Lifetime Risk of HIV Diagnosis by Race/Ethnicity Lifetime Risk of HIV Diagnosis Among MSM by Race/Ethnicity

  • The overall lifetime risk of HIV in the United States is 1 in 99
  • African-American men have highest lifetime risk of HIV of all races and ethnicities (1 in 20)
  • African-American MSM (1 in 2) and Hispanic MSM (1 in 4) have even higher lifetime risk of HIV

African- American Men Hispanic Men White Men White Women Hispanic Women African-American Women

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What is PrEP?

  • Pr E

P

One Pill Once-A-Day

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PrEP: Safe & Effective to Reduce Risk

  • f HIV Acquisition in Adults
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PrEP Guideline Highlights

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The Risks

  • Men who have sex with men (MSM)
  • Heterosexual women & men
  • Injection drug users (IDU)
  • HIV positive injecting partner
  • Sharing injection equipment
  • Recent drug treatment (but currently

injecting)

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The Setting

On site pharmacy, lab, x-ray, mammogram, primary care, ob/gyn, BH/SA, WIC, eye care, dental, MIHP, rheumatology, HCV services, & many more

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The Departments Involved in PrEP

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Nurse Leader: HIV Clinical Nurse Manager

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Registered Nurses:

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Patient Section

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Nurse Practitioner: High Quality, Cost‐ Effective Health Care

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Provider Checklist for Initiating PrEP (US Public

Health Service PrEP for the Prevention of HIV Infection in the US, 2014)

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PrEP & PEP Billing Codes

ICD-10= Z20.6, Z20.2, Z20.828, Z20.89, Z20.9 ICD-10= Z72.51, Z72.52, Z72.53 ICD-10= Z77.21, Z77.9 ICD-10= W46.0XXA, W46.0XXD, W46.1XXA, W46.1XXD ICD-10= Z79.899 99401 99402 99403 99404

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PrEP Guidelines & Resources: UCSF Clinician Consultation Center (2016)

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