Dr. Pooja Mittal works on the National Perinatal HIV Hotline, where she learned about PrEP. She is also a family physician and a civil surgeon. The Green Card Exam process requires a complete history, including that of previous STIs.  One day, she was talking to a 40-something year old man about why he left his country, and he told her he was persecuted because he is gay. Dr. Mittal was asking about his partners, to see if he was interested in PrEP. She says she found this amazing opportunity (to provide PrEP) through the green card application process, & the man got on PrEP.

Around the same time, a resident at the Family Health Center, Dr. Lauren Wolchok, told Dr. Mittal that she was interested in doing a project involving patients in her clinic. Dr. Wolchok is part of an HIV track (Family Medicine residents who receive specialized HIV training). This program is run by Dr. Monica Hahn. Dr. Mittal suggested that she do a PrEP project and partner with Dr. Bob Grant, and disseminate PrEP throughout the clinic. The first thing that Dr. Wolchok did was assemble her team, it included, Dr. Grant, Dr. Hahn. Dr. Mittal, and Dr. Pollock (Chief Resident, also part of the HIV track). The Family Health Center has 55,000 patients per year, and only some providers offer PrEP. The goal of the PrEP Pocket Card team is that PrEP should be offered by all providers. Drs. Mittal, Pollock, Grant, and Lauren Wolchok did trainings for all providers at the clinic. Drs. Grant & Wolchok had the idea to make to make the PrEP Pocket Card. Drs. Wolchok and Pollock presented at a provider meeting. Dr. Grant talked about how to prescribe PrEP, and Dr. Wolchok did a presentation to gauge providers’ interest in offering PrEP and introduced the Pocket Card to them. The group of providers were surveyed about how they felt about starting to offer PrEP, and that data is being processed now.

The PrEP Pocket Card team believes that PrEP belongs in primary care. It can be stigmatizing for HIV-negative patients to have to go to an HIV clinic to get the care they need. Primary care providers should be asking about their patients’ sexual histories anyway, and then the provider can offer PrEP if risk factors indicate that it’s appropriate.

 

 

Thanks to Drs. Bob Grant, Lauren Wolchok, Pooja Mittal, Lealah Pollock, and Monica Hahn