Adolescents and young adults in California don’t have to travel to a health care facility in order to get a prescription for pre-exposure prophylaxis (PrEP), the daily tablet that’s highly effective at reducing the risk of contracting HIV. Instead, youth can access HIV prevention services through a virtual PrEP program recently launched by Stanford Children’s Hospital.
What’s more, the telemedicine program offers pediatricians throughout the state online training regarding best practices for prescribing and monitoring PrEP.
The Stanford Medicine Virtual Pre-exposure Prophylaxis (PrEP) Program for Adolescents and Young Adults is available to any adolescent or adult 25 or younger in California. According to a Stanford Children’s Health press release, the cost is usually covered through patient assistance programs.
Participants use a cellphone or computer to connect with the Stanford health team. After their initial appointment, Stanford staff mails them at-home HIV tests. (It’s important that people taking PrEP are HIV negative.) Prescriptions are then filled at patients’ local pharmacies. Clients meet with a PrEP navigator via video every two weeks and can have the required lab work done every three months at a local clinic.
“The remote nature of the Virtual PrEP Program eliminates the need for patients to travel to a care facility, making ongoing care convenient and efficient, which is especially important during the COVID-19 pandemic,” said the program’s director Geoff Hart-Cooper in the press release. “Virtual care allows us to meet youth where they are, even during transition to college or other moves, and offers an added layer of confidentiality, as it allows providers to communicate with patients one-on-one, without involving a parent or other guardian if that is the patient’s preference.”
Stanford Children’s Health has launched a virtual HIV-prevention program. Using telehealth virtual visits, the Stanford...Posted by Stanford Children’s Health - Lucile Packard Children’s Hospital Stanford on Thursday, November 19, 2020
Scientists estimate PrEP to be about 99% effective among men who have sex with men and to be greater than the current 88% to 90% estimate for heterosexual men and women. For more details, see the POZ article “How Well Do U=U and PrEP Work? The CDC Updates Its Answers.” In the United States, PrEP is available as Truvada and Descovy tablets; both consist of two meds, and both are manufactured by Gilead Sciences. For more details, see “What’s the Difference Between Truvada and Descovy for PrEP?” For more general information, see the POZ Basics on HIV Prevention.
Hart-Cooper and Megen Vo, MD, launched the Stanford Virtual PrEP program in 2019 with a $50,000 grant and have now opened it to clients outside the Stanford network. “This was novel when we started doing it,” Vo told The Bay Area Reporter. But the COVID-19 pandemic has made telehealth more common, and the PrEP program has seen an uptick in referrals.
“Some providers, particularly pediatricians, may not be aware of or trained to provide HIV prevention tools, such as PrEP, or may not have experience discussing sexual health with young patients, which can make it difficult for youth to disclose sexual behavior or lead to concerns about confidentiality,” added Vo, associate medical director of the virtual PrEP program. “By connecting patients with providers specifically dedicated to administering PrEP support, the Virtual PrEP Program is mitigating these existing barriers to treatment, and the remote nature of the program enables us to accept youth referrals from physicians all over the state of California.”
In California, according to the press release, young people make up 20% of new HIV cases but are the age group least likely to be using PrEP. In addition, minority youth, notably Black and Latino men who have sex with men, experience higher rates of HIV. It’s hoped that increased access to PrEP will help reverse these trends, especially amid the COVID-19 pandemic, which also disproportionately affects these minority populations.
“Throughout the pandemic, providers have witnessed a dramatic decrease in PrEP use among new and continuing patients alike and most commonly among minority patients younger than 26 years old,” said Carrie Chan, NP, associate medical director of the Virtual PrEP Program, in the press release. “Our virtual care model can improve access to PrEP among racial and ethnic minorities, as well as provide specialized youth support, which is more critical than ever as we face the economic insecurities and health outcomes that are disproportionately affecting these groups during the COVID-19 pandemic.”