By: Jonathan H. Mermin, MD, MPH
RADM and Assistant Surgeon General, USPHS
Director, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Centers for Disease Control and Prevention
Community Health Centers play a critical role in providing HIV services to communities throughout the United States. The COVID-19 pandemic has disrupted access to clinic-based care in many areas. Given the challenges and demands health care providers face, the Centers for Disease Control and Prevention (CDC) released a Dear Colleague Letter on May 15, 2020, with guidance to help you ensure continued access to critical HIV testing and prevention services in the communities you serve. The guidance includes the following:
Continue HIV testing including self-testing: CDC recommends that people at risk for HIV infection get tested in ways that comply with local orders and physical distancing practices, including self-testing. As providers of clinical HIV testing services, you can continue routine HIV screening and testing for patients who receive in-person clinical care, and expand support for HIV self-testing services by using the U.S. Food and Drug Administration (FDA)-approved self-test. HIV self-test kits can be shipped to residents’ homes or other locations, or provided directly to patients. If a patient’s test is positive, they should receive information on linkage to care that you provide or from the information included in the FDA approved kit.
Continue PrEP services: Consider the following guidance in the context of local resources and staff availability.
- Ensure the availability of PrEP for patients newly initiating PrEP and for patients continuing PrEP use.
- Provide a prescription for a 90-day supply of PrEP medication to minimize trips to the pharmacy and facilitate PrEP adherence.
- Continue quarterly HIV testing for patients taking PrEP, with lab-only visits. If lab visits are not available, consider:
- Home specimen collection kits for HIV and STDs. A kit is mailed to an individual to collect a specimen and return it to the lab.
- Oral swab-based HIV self-test kits. This is the least preferred method for detecting HIV in people on PrEP, but can be considered when other options are unavailable.
- Use telemedicine or refer patients to other clinics or pharmacies if you experience a suspension in services.
For additional HIV provider resources and updates, visit CDC’s HIV Nexus website.