DIS Training for
Pre-Exposure Prophylaxis
(PrEP) In Tennessee
Objectives
By the end of the training, participants will be able to:
– Accurately and simply describe PrEP to clients.
– Describe the role of PrEP in HIV prevention.
– Identify barriers for clients to obtaining PrEP, and help them
overcome them.
– Identify referral and payment options for PrEP
– List approaches/aspects of adherence to PrEP
– Identify methods to increase community involvement and
discussion around PrEP
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Five Modules
Training is designed to be delivered in 4.5 hours
Module 1:
Background and PrEP Basics
Module 2:
Who Should Get on PrEP and How?
Module 3:
Prevention Counseling for PrEP
Module 4:
Payment Options and Resources
Module 5:
Practice
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Agenda
9:00-9:20
9:20 – 10:35
WELCOME AND INTRODUCTION
MODULE 1: BACKGROUND AND PREP BASICS
HIV in TN
What is PrEP?
Studies Overview
Prevention Options Brainstorm
Pros and Cons Exercise
What is PrEP? video
Activity 1: To PrEP or Not to PrEP
10:35 – 10:45
10:45 – 11:25
BREAK
MODULE 2: WHO SHOULD GET ON PREP AND HOW?
11:25 – 11:55
MODULE 3: PREVENTION COUNSELING FOR PREP
11:55 – 1:00
1:00 – 1:20
LUNCH
MODULE 4: PAYMENT OPTIONS AND RESOURCES
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Activities
1. What prevention strategies are already in our
toolbox? (Pros and Cons exercise)
2. To PrEP or not to PrEP? (8 scenarios; in dyads)
3. Is PrEP right for you? (Barriers exercise)
4. PrEP payment scenarios
5. Practice counseling (in triads)
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PrEP Providers in TN
Current as of April 20, 2016
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Kesean
Kesean is a 26 yo MSM who reports about 25
sex partners in the past 3 months. Three were
regular partners who were HIV-negative. No
condoms were used (Kesean was top and
bottom). The rest of the partners were new
and told Kesean they were HIV-negative. He
used condoms (top and bottom) about 50% of
the time, depending on whether or not the
partner wanted to use them. Kesean uses
meth 1-2 time per month with sex partners.
He has never been diagnosed with an STI.
When you ask him what he thinks his HIV risk
is, he responds, “Medium, I guess.”
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Who will the DIS target to refer?
Knox County -- Clients selected for PrEP follow-up counseling/referral
Any STD clinic clients that meet the following criteria should be targeted for PrEP counseling and
referral:
1. Any male or TG client that is positive for syphilis & HIV negative
2. Any male or TG client that is positive for a rectal swab of GC or CT & HIV negative
3. Any male or TG partner (HIV -)of a male or TG that is positive for any STD, including HIV
4. Any male or TG (HIV-) that answers a sexual history that is anal sex = yes
5. Any male or TG (HIV-) that answers a sexual history that is IDU = yes
For Knox County, in 2015 these numbers were as follows in PRISM:
1. 56
2. 30
3. 249
4. 156
5. 1
Total = 492 (370 de-duplicated)
With 5 DIS in this region, this is an average of 74 clients per year per DIS.
We are asking that each DIS submit the PRISM numbers for each client they counsel to the STD supervisor in
their area to submit to us monthly until we can update PRISM to include a PrEP checkbox.
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Melissa Morrison, MA
HIV Prevention Director
TN Department of Health
[email protected]