- “One-Step PrEP®” – A community pharmacy-based PrEP clinic
- Target clients
- Building Blocks of One-Step PrEP®
- PrEP screening
- PrEP initiation
- PrEP initial follow-up
- PrEP continuation: PrEP refill
- PrEP continuation: Routine clinical follow-up
- COVID-19 related adaptations to model
- Building blocks of One-Step PrEP® – Post COVID-19
- More...
One-Step PrEP® is pharmacist-managed HIV PrEP clinic founded in 2015 and located at an independent pharmacy in Seattle, USA. Washington state law allows pharmacists to order laboratory tests and prescribe medication through the Collaborative Drug Therapy Agreement protocol, meaning that the team of clinical pharmacists can initiate and manage PrEP distribution as well as related administrative and pharmacy tasks.
Impact: Data presented in 2020 showed that 74% of clients started PrEP on the same day as initial screening, with a dropout rate of 19%. Eighty percent of clients reported not having a primary care provider.
Target clients
Populations at high risk of HIV acquisition in the USA
Building Blocks of One-Step PrEP®
PrEP screening
What
Coordination of care
When
Client requested
Where
Pharmacy
Who
Pharmacist
PrEP initiation
What
All laboratory tests
Client risk assessment
Client assistance
Risk reduction counselling
When
Client requested
Where
Pharmacy
Who
Pharmacist
PrEP initial follow-up
What
HIV testing
Adherence monitoring
Side effects assessment
When
1 month
Where
Pharmacy
Who
Pharmacist
PrEP continuation: PrEP refill
What
All monitoring labs
HIV risk assessment
Risk reduction counselling
Adherence counselling
When
Every 3 months
Where
Pharmacy
Who
Pharmacist
PrEP continuation: Routine clinical follow-up
What
All monitoring laboratory tests
HIV risk assessment
Risk reduction counselling
Adherence counselling
When
Every 3 months
Where
Pharmacy
Who
Pharmacist
COVID-19 related adaptations to model
In less than a week, services were moved from being pharmacy-based to a telehealth programme: One-Step TelePrEP ®. In the One-Step TelePrEP ® model, in-person testing for HIV and other STIs remains available at the pharmacy (pharmacist draws blood, client self-collects urine, rectal, vaginal or throat specimens), but clients can also opt for a home test kit or hybrid model with virtual consultations. For clients using the home test kit, all specimens, including finger stick for blood collection, are self-collected and mailed back to the pharmacy for laboratory testing, with results available in approximately one week. In the hybrid model, for clients uncomfortable with self-blood collection (finger-stick), clients go directly to a laboratory of their choice for blood draw (multiple locations available) while completing collection of the other samples via the home test kit. All consultations are conducted virtually, using a health insurance compliant consultation platform.
Building blocks of One-Step PrEP® – Post COVID-19
PrEP screening
What
Coordination of care
When
Client requested
Where
Virtual (Zoom); home sampling
Who
Pharmacist
PrEP initiation
What
All labs
Client risk assessment
Client assistance
Risk reduction counselling
When
Client requested
Where
Virtual (Zoom); Home sampling
Who
Pharmacist
PrEP initial follow-up
What
HIV testing
Adherence monitoring
Side effects assessment
When
1 month
Where
Virtual (Zoom); home sampling
Who
Pharmacist
PrEP continuation: PrEP refill
What
All monitoring labs
HIV risk assessment
Risk reduction counselling
Adherence counselling
When
Every 3 months
Where
Virtual (Zoom); home sampling
Who
Pharmacist
PrEP continuation: Routine clinical follow-up
What
All monitoring labs
HIV risk assessment
Risk reduction counselling
Adherence counselling
When
Every 3 months
Where
Virtual (Zoom); home sampling
Who
Pharmacist
