Table 2.

Recommendations for Providers

Interview findings	Examples of communication techniques to address finding
Need for providers to engage in open, non-judgmental conversations about sexuality and sexual history	Providers should take a sexual history for all patients.
	Be careful to avoid expressing surprise or judgment through body language and facial expressions.
	Avoid assumptions and use non-gendered language. For instance, ask, “Who are your sexual partners?” and “What sexual activities do you participate in? What body parts do you use?”
	At follow-up visits, ask, “Have there been any changes in your sexual history?” Then, ask specific questions about a few of the patient’s previous answers to confirm.
Lack of provider knowledge about PrEP and need for patients to educate providers	Providers should utilize clinical resources and engage in continuing education to learn about PrEP prescribing.
	One key resource is the clinical practice guidelines issued by the Centers for Disease Control and Prevention (CDC).8
	Additional information for providers, including resources for continuing education about PrEP, can be found on the CDC’s website (https://www.cdc.gov/hiv/risk/prep/index.html) and from the AIDS Education & Training Center (https://aidsetc.org/topic/pre-exposure-prophylaxis).
	If the patient requests PrEP but the provider is unable to prescribe, identify other local providers who are able to prescribe. The PrEP Locator created by Emory University and powered by the CDC’s National Prevention Information Network service provider database is one resource to find such providers (https://preplocator.org/).
Few providers initiate conversations about PrEP	Make the introduction of PrEP general. For instance, say, “PrEP is something that I like to talk to all my patients about. Do you know what PrEP is?” If no, give a brief description.
	If the patient expresses interest about PrEP: “I am glad you are interested in PrEP, and I am happy to discuss this with you. Do you have any questions first, before getting into the details?”
	Then, if the person meets the indications for PrEP: “Based on the sexual history we discussed, PrEP seems like it might be a good fit for you.”
	If PrEP is not indicated for the patient at this time, let them know that it is available if their sexual practices change in the future.
Concern about cost and lack of information about payment assistance options	Let patients know that PrEP can be affordable for most people.
	Give patients information about medication assistance programs, especially financial support available through the manufacturer (https://www.gileadadvancingaccess.com).
	If the clinic or health system has patient navigators, resource referral specialists, or other staff who can assist in applying for payment assistance, refer patients to these staff. If not, local AIDS service organizations may be able to assist patients to apply for insurance or PrEP financial assistance.