Strengthening Federal Efforts on PrEP and PEP

Improving knowledge about pre-exposure prophylaxis (PrEP) and access for those who need it most are national priorities. In order to promote and improve the dissemination of accurate information about PrEP, the Office of HIV/AIDS and Infectious Disease Policy (OHAIDP) and the Office of Minority Health (OMH) co-hosted a webinar on June 2, 2016 for Federal staff about PrEP and post-exposure prophylaxis (PEP). On June 20, 2016 OHAIDP, OMH, and the White House Office of National AIDS Policy are hosting a community listening session on PrEP that will be conducted via webinar from 1:30-3:00 pm (EDT).PrEP is a highly effective way of preventing HIV infection before exposure occurs, and PEP is an emergency strategy that is used after a high-risk exposure occurs. PEP must be started no later than 72 hours following a high-risk exposure to be effective.

The response to the Federal staff webinar was overwhelming. More than 600 listening sites across 19 agencies allowed project officers and other Federal employees to participate in the webinar. (Unfortunately, some staff who had pre-registered were not able to log into the webinar. We’re working to assess this problem and figure out how to resolve it for the future.) Agencies with staff participating included:

• Department of Education
• Department of Housing and Urban Development
• Department of Labor
• Department of State
• Department of Veteran Affairs
• Department of Health and Human Services
  • Administration for Children and Families
  • Administration for Community Living
  • Centers for Disease Control and Prevention
  • Food and Drug Administration
  • Health Resources and Services Administration
  • Indian Health Service
  • National Institutes of Health
  • Substance Abuse and Mental Health Services Administration
  • Office of Adolescent Health
  • Office for Civil Rights
  • Office of Global Affairs
  • Office of Minority Health
  • Office of the Secretary
  • Regional Offices

My co-facilitator for the webinar was Dr. Nadine Gracia, the Deputy Assistant Secretary for Minority Health. I really appreciated her participation, and especially her remarks about the disproportionate impact of HIV on racial and ethnic minorities in the United States and the risk that these disparities could worsen if some people have greater difficulty than others obtaining PrEP.

Dr. Amy Lansky, the Acting Director of the Office of National AIDS Policy at the White House, discussed the central importance of PrEP to achieving the goals of the National HIV/AIDS Strategy. Dr. Lansky noted that the NHAS calls for full access to comprehensive PrEP services for those whom it is appropriate and desired, with support for medication adherence for those using PrEP.

The science behind PrEP and efforts at the National Institutes of Health to develop even more convenient and effective forms of PrEP were discussed by Dr. Carl Dieffenbach. The review of the science was rounded out by a presentation by Dr. Dawn Smith from the Centers for Disease Control and Prevention (CDC) who reviewed the Public Health Service recommendations for PrEP , who is most likely to benefit from PrEP , and what is currently known about access to PrEP and barriers to its use. Recently updated guidelines about the use of PEP and its benefits were summarized by Dr. Ken Dominguez from the CDC.

The participants also heard about PrEP and PEP from the perspective of a physician who treats persons who are at-risk for HIV infection and those living with HIV. Dr. Theo Hodge, Jr., who is a physician in Washington, DC, spoke about his patients’ interest in PrEP, his approach to prescribing PrEP and PEP to his patients, and some of the successes and challenges to PrEP and PEP use in the real-world. It was especially heartwarming to hear from Dr. Hodge about the healthy, HIV-negative babies born to HIV-negative mothers in serodiscordant relationships who used PrEP.

Participants were provided with information about key Federal actions and additional resources about PrEP and PEP, which included information from CDC’s and VA’s websites. They were encouraged to do their part to improve awareness of and access to PrEP and PEP in the work and the programs they oversee.

Given the success of this first webinar for Federal staff and to further Federal coordination and collaboration in support of the NHAS, OHAIDP will host other webinars this year for Federal project officers and staff. The webinars will address emerging HIV trends and developments, innovative Federal and community efforts, emerging challenges, and opportunities to accelerate progress toward achieving the goals of the National HIV/AIDS Strategy.