Chapter 4: Biomedical HIV Interventions
Biomedical HIV interventions take HIV prevention a step beyond behavioral interventions. They utilize antiretroviral therapy (ART) to not only treat HIV infection, but also to prevent transmission. In the previous chapter, you saw examples of the importance of HIV viral suppression and the role of PLWH in preventing new infections through a strategy called “treatment as prevention (TasP)”. In addition to TasP, there are two other examples of biomedical HIV interventions: pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). Biomedical HIV interventions are integral tools in the HIV prevention landscape.
PrEP is a medication that people who are not infected with HIV can take to proactively prevent acquiring HIV. The pill is derived from an HIV treatment medication, and like ART, it must be taken daily to be effective. When taken consistently and correctly, it can reduce HIV acquisition by more than 90% through sexual transmission and more than 70% through injective drug use. PrEP does not prevent STDs or pregnancy, so it is important to consider using condoms in conjunction with PrEP. 1 min, 29 sec
PEP is the act of taking ART after an exposure to HIV to prevent acquiring HIV. PEP is only effective when initiated within 72 hours of exposure and is more effective the sooner it is started. A person taking PEP must take the ART for 30 consecutive days to gain the ultimate protection. PEP can be prescribed by a healthcare provider and is most commonly utilized in emergency situations in which a person may have been exposed to HIV through sexual intercourse, sharing needles, or sexual assault. 1 min, 32 sec
Health Department Examples
The Georgia Department of Public Health and community partners co-host the “Ladies Who PrEP Summit” to raise awareness about the effect of HIV African American women, and to empower them to take control of their sexual health by discussing women’s sexual health issues and learning about PrEP. They blended education and fun through food, celebrity guest panels, music, and interactive skill-building activities from health experts.
The Rhode Island STD Clinic’s PrEP implementation program is the only dedicated clinic providing PrEP services in the state. With the support and collaboration of the Rhode Island Department of Health, the program raises PrEP awareness among the community by providing brief educational sessions and supporting materials to all MSM that present at the clinic. The program then links individuals interested in receiving PrEP to available medical providers.
Iowa’s TelePrEP program is an in-home telemedical delivery model for PrEP. Patients visit with a Pharmacist using a HIPAA compliant (secured) app on a smartphone, laptop, or tablet. Labs can be obtained locally by visiting an outpatient lab site or utilizing Iowa's extensive network of public health providers.
PrEP Cost Calculator | NASTAD website
Check Your Understanding
What are three examples of biomedical HIV prevention?
Treatment as prevention (TasP), pre-exposure prophylaxis (PrEP), and post-exposure prophylaxis (PEP)
In your state, what challenges exist to accessing PrEP and PEP?
Challenges may include, but are not limited to: lack of community education regarding PrEP and PEP, lack of provider education regarding PrEP and PEP, provider reluctance to prescribing PrEP and PEP, restrictions on access to PEP (e.g., only available to people who experience sexual assault or an occupational needlestick), financial burden, low engagement of specific population groups, etc.
In your state, what populations have the highest uptake of PrEP? Do these populations represent those who experience the highest burden of HIV in your state? If not, how can your health department work to increase access?
Traditionally, people of color and women have lower rates of PrEP uptake. Check out the health department examples on this page to learn about other jurisdictions’ efforts to increase access.