Maximizing HIV Prevention Strategies in Kansas Rural Health Resources

1. PrEP 101 Camille Cushinberry STI/HIV Prevention Coordinator Stephanie Green STI/HIV Section Chief Holly Harwood STI/HIV Disease Intervention Program Manager

2. Division of Public Health Navigating Rural Health Resources OBJECTIVES • Participants will be able to identify testing, treatment, and follow-up for HIV. • Participants will be able to identify the benefits of prescribing PrEP, recognize the steps to determine eligibility for PrEP, and how to request additional information from KDHE. To protect and improve the health and environment of all Kansans

3. Division of Public Health Navigating Rural Health Resources HIV • Human Immunodeficiency Virus • Stages 0,1,2,3 • More frequently involves neurological system • Transmitted: • Oral, anal or vaginal sex • Sharing needles/syringes • Babies born to infected mother • Breastmilk To protect and improve the health and environment of all Kansans

4. Division of Public Health Navigating Rural Health Resources HIV: Signs & Symptoms • May have flu-like symptoms during acute (Stage 0) infection To protect and improve the health and environment of all Kansans

5. Division of Public Health Navigating Rural Health Resources Testing for HIV • CDC Recommendations: • Everyone between the ages of 13 and 64 at least once. • Annual testing for those with specific risk factors: • MSM • Sex w/an HIV+ partner • More than 1 sex partner since your last HIV test • Injected drugs and shared needles or works • Exchanged sex for drugs/money/something needed • Been diagnosed w/an STI • Had sex w/someone who could answer yes to above questions or whose sexual history you don’t know To protect and improve the health and environment of all Kansans

6. Division of Public Health Navigating Rural Health Resources Follow-Up for HIV • Call your KDHE-assigned Disease Intervention Specialist for assistance. • DIS and Linkage to Care work hand-in-hand to ensure appropriate care is identified, engaged, and maintained. To protect and improve the health and environment of all Kansans

7. Division of Public Health Navigating Rural Health Resources To protect and improve the health and environment of all Kansans

8. Division of Public Health Navigating Rural Health Resources Linkage to Care Map • Sara Weckhorst • (Regions 3, 4, 5, 6, and 7) • 1000 SW Jackson, Suite 210 • Topeka, Kansas 66612-1274 • 785-213-6851 • Sara.weckhorst@ks.gov • April D Shilling • (Regions 8 and 9) • R.H. Garvey Building • 300 W. Douglas, Suite 700 • Wichita, KS 67202 • 316-213-2309 • April.shilling@ks.gov • Kenny Cochrane • Direct Care Coordinator • 11875 S Sunset Dr #300Olathe, KS 66061Cell: (785) 559-0004 • Fax: (785) 559-4229 • kenny.cochrane@ks.gov • Kansas City CARE Clinic • (Regions 1 and 2) • 3515 Broadway • Kansas City, Mo 64111 • 816-990-2411 To protect and improve the health and environment of all Kansans

9. Division of Public Health Navigating Rural Health Resources Linkage to Care Map To protect and improve the health and environment of all Kansans

10. Division of Public Health Navigating Rural Health Resources To protect and improve the health and environment of all Kansans

11. To protect and improve the health and environment of all Kansans

12. Division of Public Health Navigating Rural Health Resources What is PrEP? • PrEP, or pre-exposure prophylaxis, is a daily medicine that can reduce the chances of getting HIV. • Daily PrEP reduces the risk of getting HIV from sex by more than 90%. Among people who inject drugs, it reduces the risk by more than 70%. • PrEP should be used in combination with condoms and other prevention methods. To protect and improve the health and environment of all Kansans

13. Division of Public Health Navigating Rural Health Resources Truvada • A combination of two HIV medications (tenofovir-300 mg and emtricitabine-200 mg) • Studies have shown that PrEP is highly effective for preventing HIV if it is used as prescribed. PrEP is much less effective when it is not taken consistently. To protect and improve the health and environment of all Kansans

14. Division of Public Health Navigating Rural Health Resources Truvada Side Effects • Short-term: headaches, nausea, or weight loss. • Long-term: None • Safety: should not be prescribed to patients with current renal impairment To protect and improve the health and environment of all Kansans

15. Division of Public Health Navigating Rural Health Resources Paying for PrEP • Health Insurance • Medication assistance programs: • Gilead’s Medication Assistance Program • https://www.truvada.com/ • Gilead’s Co-Payment Assistance Program • https://www.gileadadvancingaccess.com/ • Patient Access Network Foundation • https://panfoundation.org/index.php/en/ • Patient Advocacy Foundation • https://www.patientadvocate.org/connect-with- services/copay-relief/ To protect and improve the health and environment of all Kansans

16. Division of Public Health Navigating Rural Health Resources PrEP Providers • Confirmed HIV negative HIV-1 • HBV Screening test • Not currently taking HIV-1 or HBV medication • Pregnancy • STI/HIV Testing every 3 months To protect and improve the health and environment of all Kansans

17. Division of Public Health Navigating Rural Health Resources PrEP and Kansas To protect and improve the health and environment of all Kansans

18. Division of Public Health Navigating Rural Health Resources Additional Information • If you are interested in becoming a PrEP Provider, please contact Camille Cushinberry at 785-296-7716 or Camille.Cushinberry@ks.gov • PrEP Provider Toolkit • Additional Resources: www.kdheks.gov/sti_hiv/PrEP.htm • Kansans Preps for PrEP – training available on KS-Train (Course #1078617) https://www.train.org/ks/home To protect and improve the health and environment of all Kansans