PrEP-Rx: Supporting Healthcare Providers in Prescribing PrEP

Scope

HIV Pre-Exposure Prophylaxis (PrEP) prevents patients from exposure to infection by way of a daily pill containing two medicines used to treat HIV. The prevention of new HIV infections is a public health priority, making PrEP an essential component in the HIV prevention toolkit.

To offer guidance for healthcare providers in optimizing and measuring the clinical impact of PrEP, we helped Parya Saberi (Assistant Professor at the Center for AIDS Prevention Studies (CAPS)) develop PrEP-Rx, a tool to:

  • Support and educate health care providers in
    • assessing the HIV risk of patients under their care,
    • prescribing PrEP to prevent HIV infection,
    • providing guidance on monitoring and adherence counseling, and
  • Coordinate an approach that reduces the risk of HIV acquisition.

Approach

Our smart project management system enabled us to refine PrEP-Rx as it was being developed.  

This iterative system comprised:

  • Developing a risk assessment survey for patients at risk of contracting HIV
  • Conducting a pilot study to assess the feasibility and acceptability of PrEP-Rx
  • Refining PrEP-RX through participant interviews with healthcare providers

Our familiarity with building systems within the UCSF ecosystem meant Parya could leave the technical details to us.

PrEP-RX

We had previously worked with Parya on developing a mobile app (WYZ) to help youth living with HIV become more engaged in their health care. Parya liked that, as an internal agency, we could use the university’s resources to keep costs low and also offer her cutting-edge technologies that fit medical guidelines.

Partners

Dr. Parya Saberi (CAPS) is an internal UCSF partner.

Solutions

Electronic tools that contain patient data must be HIPAA compliant.

The complexity of HIPAA can be a major drawback for clinicians interested in using electronic data systems. As specialists in developing applications to protect patient data, we understand the technical constraints of building HIPAA-compliant applications as well as accessing data from existing electronic records and lab databases. 

Screening potential candidates for HIV risk requires a sensitive approach.  

Parya and her research team developed a risk assessment survey for PrEP-Rx that uses a complex logic system that expands guidelines published by the Centers for Disease Control and Prevention (CDC). We communicated with potential PrEP-Rx users to refine this risk assessment survey to ensure that it is culturally sensitive, non-stigmatizing, and appropriate for all genders and sexual identities.

PrEP Journey Map

With clinicians, researchers and patients using PrEP-Rx, a user-friendly front- and back-end is essential.

We walked Parya through the available technologies before deciding on using Salesforce. The benefit of Salesforce is that it is HIPAA-compliant and user-friendly, allowing clinicians to customize their dashboards and enabling researchers to see visual representations of PrEP’s usage.

More information

PrEP-Rx has since been rolled out at one clinic,  with the goal of expanding it to more Department of Public Health clinics in San Francisco. Parya is currently awaiting further funding to expand PrEP-Rx’s use to other public health and low-resource clinics in San Francisco and Oakland.