Online Program

PrEP Implementation in a Community Health Setting: Challenges, Successes, Considerations

Wednesday, November 4, 2015 : 9:15 a.m. - 9:30 a.m.

Kristin Keglovitz-Baker, PA-C, AAHIVM, CHCF, Department of Clinical Care, Howard Brown Health Center, Chicago, IL

Individuals’ motivations for electing to take PrEP in real-world settings is unknown. Data on motivation/barriers to start PrEP and sexual histories are essential. Due to the ACA, many patients are accessing PrEP and healthcare for the first time.  Consequently, patients need insurance navigation, reminders about follow-up visits, and medication counseling.




HBHC implemented a PrEP community demonstration project in 2013 to increase awareness of and access to PrEP among Chicago men who have sex with men and transwomen.   HBHC’s unique program includes: 1. PrEP Case Management; 2. Electronic Health Record System (EHRS) forms for PEP/PrEP and sexual risk history; 3. PrEP social media campaign; 5. Active referral relationship with Chicago Department of Public Health for STI-positive patients; and 6. PEP/PrEP line for patients and providers to improve access for the community.

  Lessons Learned


Implementing a new program for a newly approved prevention approach takes time, partnership, and perseverance to implement it into common language and practice.  Resources to support patients’ navigation of insurance coverage, medication access, appointments, and medication adherence are key to a successful PrEP program.  Implementing PrEP in a community health center results in numerous benefits beyond HIV-prevention, including: 1. patient engagement in primary care; 2. increased testing frequency; 3. earlier identification and treatment of STIs. 


We will increase engagement efforts with communities including young MSM of color, women, and transgender women.  Strategies to reach historically hard to reach communities will include:  peer navigation,outreach, social media, and community forums to gain insight into barriers that remain.

Learning Areas:

Chronic disease management and prevention
Clinical medicine applied in public health
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Program planning
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Identify those patients for whom PrEP is most beneficial from a public health perspective Explain the challenges, successes, and considerations when attempting to implement PrEP in a Community Health Center setting Discuss ways in which the EHRS can be a beneficial tool for PrEP

Keyword(s): HIV/AIDS, Community Health Centers

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have years of experience conducting research in the realm of HIV and am a medical practitioner. I have been the principal or co-principal of multiple federal, state, and city funded grants focusing on HIV/STI prevention and treatment. Among my scientific interests has been the development of various programs for preventing HIV and STIs in the LGBT and community healthcare setting.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.