Iowa leads nation in rural HIV prevention with launch of TelePrEP Program

Iowa is now a national leader in rural HIV and sexually transmitted infection (STI) prevention, with the launch of TelePrEP, an innovative telehealth program.

PrEP — Pre-Exposure Prophylaxis — refers to a daily medication regimen which prevents human immunodeficiency virus (HIV) infections for those without HIV who are at risk of contracting the virus. University of Iowa Health Care has been providing PrEP services to patients at the PrEP clinic in internal medicine at UI Health Care–Iowa River Landing. The new telehealth program combines secure video conferencing for in-home visits between patients and UI Health Care pharmacists and providers with medication delivery by mail to expand HIV prevention across the state of Iowa, especially in rural areas.

“We know that there are people in rural Iowa who are at risk for HIV. Approaches that work well for delivering PrEP in large cities don’t adapt to rural Iowa. We need to try different approaches such as this telehealth technology to make sure PrEP is available to those who need it, regardless of where they live,” said Michael Ohl, MD, a UI Health Care infectious disease specialist and medical director of the TelePrEP service.

The telehealth service involves pharmacists, physicians, and public health professionals from the Signal Center for Health Innovation, the Iowa Department of Public Health, Johnson County Public Health, and the UI Health Care Departments of Infectious Disease and Pharmaceutical Care. The pilot is funded by the Iowa Department of Public Health (IDPH).

“The collaborative partnership aims to significantly interrupt the chain of HIV transmission and reduce new infections across the state of Iowa, especially by increasing access for individuals living in rural Iowa through technology,” said Patricia Young, program manager of HIV and Hepatitis Prevention at the IDPH.

According to the IDPH, the number of new HIV diagnoses increased 11 percent from 2015 to 2016 in Iowa. In addition, STI rates, including chlamydia, gonorrhea, and syphilis, are rising.

The goals of the TelePrEP program are to reduce the number of new HIV infections throughout the state and decrease the cost of treating HIV infections over the next five years.

For more information about TelePrEP, please contact Angie Hoth at The Signal Center for Health Innovation at teleprep@healthcare.uiowa.edu, or visit thesignalcenter.com/teleprep-iowa or prepiowa.org/teleprep.

Fast Facts about TelePrEP and PrEP

The U.S. Public Health Service (USPHS) and the Centers for Disease Control and Prevention (CDC) report that daily use of PrEP can reduce the risk of HIV by more than 90 percent when used as part of a structured program of risk-reduction counseling and monitoring. According to the CDC, one in three primary care doctors and nurses haven’t heard about PrEP. Behaviors and circumstances that put a person at risk for STIs also increase the risk for HIV infection, according to the CDC.

At this time, Truvada® is the only PrEP medication approved by the U.S. Food and Drug Administration. The annual cost of Truvada® is $10,000 to $15,000 less than the cost of medications used to treat HIV infection. Truvada® is covered by Iowa Medicaid plans and most private insurance plans. Medication co-pay assistance is available to those who qualify. The TelePrEP service will assist individuals in identifying the most affordable avenues for obtaining the medication and associated lab monitoring.