Page 47 - IMG JumpStart Employee Onboarding Manual. Draft 1_Neat

nPep Standard Operating Procedure (SOP)

Type of SOP: Guideline for Antiretroviral Postexposure Prophylaxis after Sexual, Injection Drug Use, or
Nonoccupational Exposure to HIV.

Purpose: To support Independent Medical Group (IMG) staff with the Center for Disease Control (CDC, 2016)
supported guidelines for the administration of medication prophylaxis for IMG patients who have incurred a
nonoccupational postexposure prophylaxis (nPep) through potential exposure to the Human Immunodeficiency
Virus (HIV) by way of blood, genital secretions, or any other potentially infectious body fluids that may

contain HIV.

Protocol/Procedure

Once IMG staff (outreach personnel, medical assistants, case managers, and or Nurse Practitioners) have
established potential exposure in persons who have sought IMG health clinic services less than 72 hours after a
possible post exposure to HIV, the following protocol will be followed:

rd
If Notified via 3 Party Entity by telephone:
1. Obtain all patient contact information and create an electronic health record on the IMG platform. (First
and Last name, DOB, BEST contact number, last 4 of social security number, and insurance information
if applicable)
2. If patient has insurance coverage contact your site’s Nurse Practitioner for ERx to be sent to the
pharmacy of patient’s choice within the hour. Per CDC guidelines the recommended nPep therapy is a
28-day two tablet oral combination therapy for healthy Adults and Adolescents:

Truvada Tenofovir Dispoproxil Fumarate (300 mg)/ Emtriitabine (200 mg) OR

Descovy Tenofovir Alafenamide (25 mg)/ Emtriitabine (200 mg)

And

Isentress Raltegravir (400 mg) twice daily OR Tivicay Dolutegravir (50 mg) daily

Site NP will use patient’s gender and medical history to determine effective nPep therapy.

3. If patient has NO INSURANCE arrange for patient to come to nearest clinic/site for Gilead approval
same day or within 48 hours. (i.e. If Clinic/Site receives call from third party on weekend hours,
schedule patient for the next open hours to obtain the following:
a. Perform rapid HIV and Hep C rapid testing
b. Obtain CBC, CMP, HIV, Hep B antigen and G/C; RPR phlebotomy labs, pregnancy test if
applicable.
c. Case Manager interview with 1628 DOH form.
d. Consultation with Prescribing NP to provide nPep medication same day and to discuss possible side
effects of nPep therapy which includes all of the following but not limited to: medication use side
effects from the short-term use of antiviral medications by otherwise healthy persons living without

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