Why is talking about sexual health important?
Sexual health is health. If knowing your patient is important, there's no better way to get to know them than to understand their intimate behavior. Sexual history is often a syndemic indicator, so if you really want to provide comprehensive care, it's time to start talking about sex.
We fully acknowledge that talking about sex can be awkward for you, and know that it's probably at least as awkward for you patient. Try to remember to use reaffirming language, have receptive body posture, and be open to a wide range of behaviors.
If your patient is sexually active, it's a good idea to screen them for HIV and other STIs. It's important to note that patients can get not only genital infections, but also pharyngeal and rectal infections. Additionally, consider talking to your sexually active patients about PrEP.
What is PrEP?
PrEP stands for Pre-Exposure Prophylaxis. It's a medication regimen to prevent infection in the event of exposure. The FDA has approved PrEP for HIV prevention. Truvada, a combination of emtricitabine and tenofovir, is the only drug currently approved for PrEP, but more are expected shortly.
Truvada 92-99% effective at preventing HIV when taken properly. Before prescribing, it's important to discuss that Truvada does not protect against other STIs and that other safer sex practices should be used in tandem.
Your patient wants PrEP. What next?
That's great news! Every patient protected from HIV is one step closer to ending the epidemic. When starting a patient on PrEP, you'll need to screen at-minimum for HIV, kidney function, and Hep B.
Here's what you need to screen for, and here's what you should screen for...
Don't let financial barriers put your patient at risk for HIV. Here are the possible ICD-10 codes to use:
- Z20.6 Contact with and (suspected) exposure to HIV
- Z20.2 Contact with and (suspected) exposure to infections with a predominantly sexual mode of transmission
- Z11.3 Encounter for screening for infections with a predominantly sexual mode of transmission
- Z11.4 Encounter for screening for human immunodeficiency virus
- Z11.59 Encounter for screening for other viral diseases
- Z20.5 Contact with and (suspected) exposure to viral hepatitis
- Z71.7 Encounter for HIV counseling
Keeping patients on PrEP
Strategies for persistence and adherence
Maximize patient satisfaction and increase your volume by adding self-collection screenings.
You manage your patients' care. We'll handle the logistics.
Interested in EMR integration?
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