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Post-exposure prophylaxis
 
If you believe you were exposed to HIV- it is important to be treated within 72 hours. Call 913-722-3100.  
 

 

HIV PEP (Post-Exposure Prophylaxis) and PrEP (Pre-Exposure Prophylaxis)are programs of Family Health Care that follow the Centers for Disease Control (CDC) recommendations to provide PEP and PrEP medication when needed or requested. As a leader in HIV care in KC, FHC was first to step up to provide these important preventive services.

 

 

Pre-Exposure Prevention (PrEP)

To prevent HIV infection BEFORE being exposed.

 

Studies have shown that taking a single pill every day helps reduce new HIV infections. This preventive medicine was approved by the US Food and Drug Administration (FDA) in July, 2012. It is most effective if used with condoms or clean needles. The medicine has possible side effects and people who take it should have periodic test of their kidney functions and other systems. 

 

 

 

 Family Health Care responded to the needs of the community, particularly those with HIV+ sexual partners who are sero-negative for HIV and are therefore at risk for acquiring infection with HIV. PrEP is recommended by the CDC as an effective means of preventing new HIV infections. The medication- Truvada is taken daily and allows discordant couples to have more routine relationships and plan pregnancies.

 
 
There is only one medication currently approved by the FDA and recommended by the CDC to help prevent HIV infection. While this use has been approved and recommended by some, there remain controversies. Some insurers cover the prescriptions, many do not. Few physicians or other prescribers are providing prescriptions for Truvada for this purpose. Family Health Care is one of the first medical practices in the country to establish a clinic for the purpose of prescribing PrEP.
 
To make an appointment to see if PrEP is right for you, call 913-PACE100 (913-722-3100).

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PrEP Care Clinic at Family Health Care- News Release (click here)

Buzzfeed report on PrEP CARE Clinic

Channel 9 Reports on PrEP CARE Clinic

KC Business Journal Reports on PrEP CARE Clinic

KC Star Reports on PrEP CARE Clinic

Channel 41 News on the PrEP CARE Clinic

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PrEP CARE Information Sheet

Click here to view the CDC PrEP guidelines

CDC PrEP Information

 

If you answer yes to any of these these questions, you should consider the protection from HIV of taking daily Truvada:

  • Do you currently have a sexually transmitted infection (STI), such as syphilis or gonorrhea?
  • Do you ever have sex without condoms?
  • Do you have many sexual partners or do you exchange sex for food, money, or shelter?
  • Do you use recreational drugs or have an alcohol problem?
  • Are you currently or have you ever been in prison?
  • Do you have any sexual partners whose HIV status is not known and who would answer “yes” to any of the above questions?

Consider if this medicine will work for you.

1- Are you willing to take a pill every day?

2- Are you willing to have lab testing requiring blood draws completed regularly?

3- Do you qualify for medication assistance or have resources to buy Truvada for yourself?

 

 

The Partnership for Prescription Assistance (PPA) program is designed to help uninsured Americans get the prescription medicines they need at no or low cost. Click here...

Gileads U.S. Medication Assistance Program provides assistance to eligible, HIV-negative people in the United States who need financial assistance to pay for TRUVADA for PrEP. Click here for a faxable form to apply.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administrations (FDA) MedWatch Adverse Event Reporting program online by clicking here- or by phone (1-800-332-1088).

 

Family Health Care's PrEP Care Clinic offers preventive services package for people who are at risk for HIV and other infections. This is different from treatment of HIV because it includes giving medicine to prevent the infection. It is similar to using birth control pills to prevent pregnancy, in that the medicine needs to be taken every day whether there is exposure on that day or not.

 

Some insurance companies pay for this medication, but not all. Our clinic is not able to absorb the costs of the testing or the medicine. But, we are willing to provide these services and access to the medicine at more affordable charges. FHC will also provide receipts that may be passed to insurance companies for repayment. Uninsured and low-income people may apply for additionally reduced fees.

 

The costs of the physical and laboratory evaluation for the first visit is about $300. Visits are required every three months to help ensure the safety of continueing the medicine. The follow-up visits will be charged at about $140 (including laboratory, etc.) Other preventives are recommended such as Hepatitis B vaccinations. In addition, information and techniques for preventing other sexually transmitted and blood-borne diseases will be provided.

 

People who are uninsured may qualify for reduced cost services. Please bring your last year's tax form for reduced fee consideration.

 

 

 

 

Truvada Medication Information Sheet for Patients

 

From the CDC: National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention - Division of HIV/AIDS Prevention

 

 

Brand name: Truvada (tru va duh)

Generic name: tenofovir disoproxil fumarate and emtricitabine

 

Why is this medication prescribed?

  1. Truvada is one of several medications that are currently used to treat human immunodeficiency virus (HIV) and hepatitis B virus infection.

  2. Truvada is now being used to prevent HIV infection.

  3. Truvada is sometimes prescribed to some people who do not have HIV infection (for example, those who do not always use condoms or who have a sex partner that has HIV infection) to help reduce their chances of getting HIV infection

  4. When you take Truvada to prevent HIV infection, doctors refer to this use as “pre-exposure prophylaxis” or “PrEP”.

     

How does Truvada (PrEP) help prevent HIV infection?

  1. HIV is a virus that attacks your body’s immune cells (the cells that work to fight infections).

  2. The 2 medications that make up Truvada (tenofovir and emtricitabine) block important pathways that viruses use to set up infection.

  3. If you take Truvada as PrEP daily, the presence of the medication in your bloodstream can sometimes stop the virus from establishing itself and slow the spread of HIV in your body.

  4. By itself, PrEP with Truvada does not work all the time so youshould also use condoms during sex for the most protection from HIV infection.

     

How should this medicine be used?

  1. You must take one tablet of Truvada by mouth every day .

  2. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand.

  3. Do not stop taking Truvada without talking to your doctor. When your supply of Truvada starts to run low, contact your doctor or pharmacist to get more.

  4. You may be at higher risk of becoming infected with HIV if you miss doses or stop taking Truvada than if you take it every day.

     

What special precautions should I follow?

Before taking Truvada (tenofovir and emtricitabine) you must do the following:

  1. Tell your doctor and pharmacist if you are allergic to tenofovir, emtricitabine, or any other medications.

  2. Tell your doctor and pharmacist about all prescription and nonprescription medications, (vitamins, nutritional supplements, and herbal products) you are taking. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

  3. Tell your doctor if you have or have ever had kidney or liver disease.

  4. Tell your doctor if you become pregnant or if you are breastfeeding

     

What special dietary instructions should I follow?

  1. Continue your normal diet unless your doctor tells you otherwise.

     

What should I do if I forget a dose?

  1. Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule.

  2. Do not take a double dose to make up for a missed one.

     

What side effects can this medication cause?

You may experience the following side effects while taking Truvada:

  1. upset stomach

  2. headache

  3. vomiting

  4. loss of appetite

     

These side effects usually fade during the first month of taking Truvada for PrEP. Tell your doctor if any of these symptoms are severe or do not go away.

Truvada may cause other side effects. Some side effects can be serious. Call your doctor immediately if you have any unusual problems while taking this medication or if you have any of the following:

  1. fever or chills especially with

  2. sore throat, cough, rash or other signs of infection

      

How should I store Truvada in my home?

  1. You should keep Truvada in the container it came in, tightly closed, and out of reach of children.

  2. You must store it at room temperature and away from excessive heat and moisture.

  3. Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

     

What should I do in case of emergency/overdose?

  1. In case of overdose, call your local poison control center at 1-800-222-1222. If the person has collapsed or is not breathing, call local emergency services at 911.

     

What other information should I know?

  1. Do not let anyone else take your medication.

  2. Ask your pharmacist if you have any questions about refilling your prescription.

  3. Write a list of all of your prescription and over-the-counter medicines, as well as any vitamins, minerals, or other dietary supplements that you take.

  4. Bring your medication list with you each time you visit a doctor or if you are admitted to a hospital. Keep it with you always in case of emergencies.

 

PrEP CARE Clinic: It is recommended that clients discuss this and all medications with their personal provider.

The PrEP CARE Clinic has the limited purpose of a focused examination and if appropriate, provision of PrEP medication. Family Health Care staff provides services for the PrEP CARE Clinic clients which are limited to evaluation and review of physical, laboratory and historic data that pertains to the use of Pre-Exposure Prophylaxis of HIV and other preventive measures.  If any significant medical condition is uncovered during the course of the directed evaluation for use of Truvada to prevent HIV infection, the patient will be advised of the condition and recommended follow-up with their primary care provider. No other illnesses will be treated through the PrEP CARE Clinic which is for prophylaxis (prevention) only. Patients who prefer to change to Family Health Care for their primary care may make this request at the visit.

 

 

 

 

 

Click here to learn about starting a PrEP clinic.


Post-Exposure Prophylaxis (PEP)
 
To reduce the likelihood of HIV disease AFTER potential exposure to body fluids that may have HIV. 
 
PEP is provided for people who believe they have been exposed to HIV in the previous 72 hours. It is an important adjunct to help prevent acute infections and at the time of this writing, FHC is the ONLY community agency offering this treatment.

Click here for the CDC website information on PEP.

HIV Transmission Rates (likelihood of getting HIV from specific exposures)

 
Estimated rate per act risk for transmission of HIV. 
      From known active carrier.
Per 10,000 exposures
Blood Transfusion9,250
Needle Sharing (IV drug use)63
Needlestick (occupational)23
Receptive anal intercourse138
Receptive vaginal intercourse8
Insertive anal intercourse11
Insertive vaginal intercourse4
Other - not documented 
      http://www.cdc.gov/hiv/policies/law/risk.html
 

 

Symptoms of Acute HIV Infection

 

 

 

Features

Overall (n = 375),

%

Fever

75

Fatigue

68

Myalgia

49

Skin rash

48

Headache

45

Pharyngitis

40

Cervical adenopathy

39

Arthralgia

30

Night sweats

28

Diarrhea

27

 

Treatment 28 day (CDC)

 

tenofovir DF 300 mg and emtricitabine 200 mg (Truvada) once daily

with

raltegravir (Isentress) 400 mg twice daily or dolutegravir (Tivacay) 50 mg once daily

 

tenofovir DF 300 mg and emtricitabine 200 mg (Truvada) once daily

with

darunavir 800 mg once daily and cobisistat 150 mg (Prescobix)

 

or darunavir 800 mg once daily

and ritonavir 100 mg


 

 

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