Clinical guidelines on pre-exposure prophylaxis (PrEP)
In December 2021, the Centers for Disease Control and Prevention published updated guidelines for PrEP: Pre-exposure Prophylaxis for the Prevention of HIV Infection in the United States—2021 Update (PDF). You can find these updated guidelines and other resources, including fact sheets and videos, on the Centers for Disease Control and Prevention website.
The updates reflect the latest science and are meant to help you effectively prescribe PrEP to patients. They’re also meant to help increase the use of the medicine by people at risk for getting HIV (human immunodeficiency virus).
Some of the new recommendations include:
- Letting all sexually active adults and teenagers know about PrEP.
- Prescribing bi-monthly intramuscular injections of cabotegravir for sexually active men and women at risk of getting HIV. This is pending Food and Drug Administration data review and potential regulatory action.
- Prescribing F/TAF (Descovy®) as a Food and Drug Administration-approved PrEP option for sexually active men and transgender women at risk of getting HIV.
- Prescribing PrEP to anyone who requests it, even if they don’t describe at-risk behaviors for HIV when you take their history.
- Requiring one of the following for people who have taken PrEP orally in the past three months or have received a cabotegravir injection in the past 12 months:
- A negative antigen/antibody test and an undetectable HIV-1 RNA test before confirming the absence of an HIV infection to continue prescribing PrEP.
- A positive antigen/antibody test and a detectable HIV-1 RNA test to confirm an HIV infection before switching the patient to HIV treatment.
Guide for Wisconsin PrEP providers
The Wisconsin Department of Health Services (DHS)—HIV Program, in collaboration with experienced, local HIV clinicians and other health care providers, compiled and reviewed this guide.
Case reporting of HIV infection and AIDS (acquired immunodeficiency syndrome)
Cases of AIDS and HIV should be reported to the state epidemiologist within 72 hours of a confirmed or suspected case:
- Centers for Disease Control and Prevention’s PrEP for clinicians website
- Communicable Disease Case Reporting and Investigation Protocol Human Immunodeficiency Virus (HIV), P-01988 (PDF)
- National HIV/AIDS Clinicians’ Consultation Center: Warmline, PEPline, Perinatal HIV hotline
- National Institutes of Health: HIV treatment and prevention guidelines
Combined HIV Infection and AIDS Case Report form
The Wisconsin HIV Infection and AIDS Case Report form collects important public health information about HIV and AIDS. This is critical to understanding the HIV epidemic and providing public health services to people living with HIV and those at risk:
HIV Partner Services
Through the HIV Partner Services program, public health professionals interview people with HIV to learn about their sex and drug use partners. They then notify these people of their potential exposure, and keep the patient’s name confidential:
- Letter to providers introducing the Partner Services for Persons with HIV Infection information sheet (PDF)
- Partner Services for Persons with HIV Infection, P-42114 (PDF)
Wisconsin statutes and administrative code related to HIV and AIDS
Read about the statutes and administrative code related to HIV and AIDS: HIV Related Wisconsin Statutes and Administrative Code, P-44295 (PDF).
Revision to Wisconsin HIV statutes related to Act 209
The 2009 Wisconsin Act 209 removed the requirement for written informed consent for HIV testing. It was replaced with a verbal consent process. This reduces the time and paperwork for HIV testing. It also encourages providers to routinely test in a variety of medical settings. In addition, Act 209 simplified legislative language and revised laws on the disclosure of:
- HIV case reporting.
- Significant exposure.
- Test results.
These resources summarize the changes, the related guidance for providers, and include sample HIV testing fact sheets:
HIV testing guidance and forms
- Centers for Disease Control and Prevention: Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings
- Common questions regarding testing, disclosure, and significant exposure in health care settings
- Sample Script for Clinicians Regarding Verbal Consent for HIV Testing (PDF)
Sample consent form for HIV testing
You can use the below form to record client consent for HIV testing. You don’t need permission to adapt it for your needs.
- Consent for HIV Testing, F-43018 (available in English, Hmong, and Spanish)
You can use the below fact sheet when testing people for HIV. It lets them know that biotin may interfere with certain lab results. It also reminds them to talk to their provider if they have questions.
Use the below form to authorize the release of patients’ HIV test results:
- Authorization for Release of Confidential HIV Test Results, F-42016 (available in English and Spanish)
Protocol and manuals
The below protocol was developed to give an overview of the Wisconsin HIV Counseling, Testing, and Referral (CTR) Program. The program’s sites must follow this protocol and the terms and conditions of contractual agreements and memorandum of understanding with the Division of Public Health.
The below manual gives an overview of a patient navigation program. It was developed as part of the federally funded Special Projects of National Significance Systems Linkages initiative. The manual includes program planning information for providers who want to create a similar patient navigation program for people living with HIV.
The below manual gives an overview of the Social Networks Testing (SNT) strategy. It’s part of Wisconsin’s federally funded Special Projects of National Significance Systems Linkages initiative. This strategy uses social networks to reach people who aren’t aware of their HIV status. It also provides them with testing and links to care.