Survey: Non-Occupational Post-Exposure Prophylaxis

Does your healthcare organization/institution currently have an up-to-date (based on CDC guidelines) policy and procedure(s) for care of patients reporting recent sexual exposure (assaultive AND non-assaultive)? *

Yes

No

Unsure

Not Applicable

If "yes," does this policy and procedure(s) include:

Select all that apply

If "no," are you or your healthcare organization/institution currently in discussions/drafting a policy/procedure(s)?

Do you have the FIRST dose of nPEP available to provide on-site? (e.g., Truvada + rilpivirine OR Truvada + dolutegravir) available to provide on-site?

Yes

No

Unsure

Not Applicable

Do you have a 1-5 day supply of nPEP to provide to the patient until they can get the prescription filled?

Yes

No

Unsure

Not Applicable

If "yes," # of days dose provided

If you work in an emergency department or urgent care setting, do you have a designated clinic or provider to refer patients to for nPEP follow-up?

Yes

No

Unsure

Not Applicable

If yes, what type(s) of provider(s) do you refer to for follow-up?

Select all that apply

Infectious disease clinic

Infectious disease private practice

Primary care clinic/health center

Primary care private practice

Hospital based follow-up clinic

Department of Health clinic (STD, HIV)

Other

Other referral

Are you aware of resources to help you obtain nPEP for uninsured or underinsured patients?

Yes

No

If "yes" which of the following

Select all that apply

Pharmaceutical company patient assistance programs

Pharmacist assistance – knowledge of other programs to pay for nPEP

Other

Other resources

Have you ever had difficulty getting a patient's nPEP prescription filled?

Yes

No

Unsure

Not Applicable

If “yes”, what barriers were encountered?

Select all that apply

Patient uninsured

Pharmacy does not have medication available

Pharmacy will not dispense less than 30-day supply

No close-proximity pharmacy available for patient to get prescription filled in timely matter

Other

Other barriers encountered

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nPEP = Non-Occupational Post-Exposure Prophylaxis