TelePrEP Receives $2M CDC Grant

“Getting preventive medicine of any kind should not be a burden to anyone,” Dr. Michael Ohl, Associate Professor in Infectious Diseases, said. For about a year and a half, the TelePrEP program Dr. Ohl directs has steadily worked to reduce the barriers between individuals at risk of HIV infection and a drug that dramatically reduces that risk. That program has just been awarded a four-year, $2M grant from the Centers for Disease Control and Prevention (CDC) to both expand TelePrEP’s services and to conduct a program evaluation in the search for implementation improvements and for potential replication.

TelePrEP_8-1-18In collaboration with the Iowa Department of Public Health (IDPH), the program delivers HIV pre-exposure prophylaxis (PrEP) and comprehensive sexually transmitted infection (STI) prevention services in rural areas. The IDPH assists in identifying candidates for PrEP through a mix of digital advertising, patient referral, and screening in IDPH-administered STI clinics statewide. Once identified, clients connect with providers in the TelePrEP program via a HIPAA-compliant video-messaging platform that clients can access through any smartphone, tablet, or other mobile device. This platform, though by necessity more secure, has an interface that both providers and patients find familiar and easy to use.

A typical interaction between pharmacists and clients involves a mix of education, screening, and evaluation. In-home testing kits are mailed directly to the client, as is—once approved—the prophylaxis drug Truvada. Connecting directly with individuals in their homes—especially those who might be discouraged from seeking HIV prevention services because of social stigma, distance, or ease of access—has caused noticeable differences for providers in their digital interactions. Angie Hoth, PharmD, MPH, one of the two pharmacists on the program, described how comfortable people seem in conversation with her. “They’re in the home, on the couch, sometimes they’ve got a pet on their lap,” Dr. Hoth said. “I think they tend to open up more.”

As STI rates, including HIV infections, continue to rise around the state of Iowa and nationally, gaining patient trust can be an important factor in reversing that trend. Though Dr. Hoth admitted that quantifiable data for measurable impact may be a few years off, the TelePrEP program is diagnosing and treating STIs in addition to its delivery and monitoring of Truvada use. In the meantime, the funds from the CDC will allow the program to grow and improve. Dr. Ohl hopes that other programs will find useful lessons in their work. “TelePrEP is an example of how academic medical centers can apply technology and partner with public health departments to improve population health in a rural state,” he said.

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