Provider Registration Form

Miami-Dade County is experiencing the highest incidence of new HIV infections nationwide at 47.0 new diagnoses per 100,00 population. The Ending the HIV Epidemic (EHE) initiative, proposed by the U.S. Department of Health and Human Services, has identified Miami-Dade County as one of the geographical hotspots to implement the four pillars for the initiative.

Pillar One: Diagnose all people with HIV as early as possible.

Pillar Two: Treat people with HIV rapidly and effectively to reach sustained viral suppression.

Pillar Three: Prevent new HIV transmissions using proven interventions, including pre-exposure prophylaxis (PrEP) and syringe services program (SSPs).

Pillar Four: Respond quickly to potential HIV outbreak to get needed prevention and treatment services to people who need them.

Therefore, as a clinical care provider, your participation in ongoing education activities, referrals or treatment services can make a significant difference in helping reduce new cases of HIV infections in Miami-Dade County.

I,

Authorized Signer:*

acknowledge that DOH Miami-Dade has visited our practice and provided resources regarding the ongoing effort to eliminate HIV transmission and reduce HIV-related deaths, including but not limited to, printed educational and informational materials for distribution to my patients at no cost. I also acknowledge that I have been explained how to make appropriate referrals for any services I do not provide in my practice

Date:*

Name of Practice (If Applicable):*

Address:*

City:*

Zip Code:*

Email Address:*

Website:*

Phone Number:*

Alternative Phone Number:*

Contact Person:*

Title:*

Which activities would your clinical care site agree to implement? Please see below for further details on each activity:*

Routine HIV testing as per statute 381.004.  
Provide PrEP/nPEP clinical care.  
Refer PrEP/nPEP service inquiries to https://preplocator.org/.  
Provide immediate antiretroviral therapy for patients who test positive for HIV.  
Alternatively, refer patients who test positive for HIV to https://www.testmiami.org/get-treated.  
Distribute condoms and lubricant to interested patients.  
I am not yet ready to commit to any of the above, but I will accept a follow-up email and /or follow-up visit in 6 months.  

1. Routine HIV testing as per statute 381.004. The CDC recommends that individuals between the ages of 13 to 64 get tested for HIV at least once as part of routine health care and that those with risk factors get tested more frequently. Patients who may be at high risk for HIV should be screened at least annually. Testing for HIV is the only way to determine if a person is living with the virus. Increasing the number of persons who are aware of their status and receiving appropriate antiretroviral treatment is an essential part of the strategy to reduce new HIV infections.

In July 2015, the Florida HIV testing law was amended (section 381.004, Florida Statutes) to allow opt-out testing. The amendment to statute 381.004 removed the need for separate informed consent prior to HIV testing in health care settings. Patients must be notified either orally or in writing that they will be tested for HIV unless they decline testing. Notification must include information that a positive HIV test result, along with identifying information, will be reported to the county health department and of the availability and location of sites at which anonymous testing is performed.

The Florida Department of Health recommends including a fourth-generation antigen/antibody test on all routine lab testing for clients that are sexually active.

2. PrEP/nPEP clinical care. PrEP (pre-exposure prophylaxis) and nPEP (non-occupational post-exposure prophylaxis) are biomedical interventions that are designed to prevent HIV infection. Both interventions are highly effective, with 98% effectiveness for PrEP and up to 96% for nPEP with proper adherence.

PrEP: Patients should be screened for PrEP eligibility. A sexual history should be taken for all sexually active patients, and HIV risk factors discussed. Those exhibiting one or more HIV risk factors and who are HIV-negative (excluding other contraindications) are eligible for PrEP. Treatment should be started as soon as possible. Factors to consider completing prior to beginning PrEP:

• Physical exam
• Discuss medication history
• Review clinical signs and symptoms of HIV infection
• Refer patient to a Ryan White Service Provider to discuss funding options
• Reproductive and contraceptive assessment for PrEP users assigned female at birth, inclusive of trans men, and pregnancy test if applicable
• Documented negative HIV test(s) within one to two weeks of starting PrEP (antibody-antigen and/or viral load, depending upon recent exposures)
• Screening for sexually transmitted infections, such as urine tests (chlamydia, gonorrhea), blood tests (herpes, syphilis), or rectal, vaginal or throat swabs (chlamydia, gonorrhea)
• blood work for hepatitis A, B and C (vaccines recommended if not immune to HAV or HBV, treatment options discussed if current hepatitis disease)
• Urinalysis of creatinine levels for kidney health
• Prescription for a 30-day supply of PrEP (perhaps w/o refill to assess adherence and side effects before first refill)

For further guidance on PrEP, please see the Florida Department of Health’s HIV Pre-Exposure Prophylaxis Clinical Guidelines.

nPEP: Patients who present as having experienced a high-risk HIV exposure in the last 72 hours are eligible for PEP. Eligible patients must start on medication within 72 hours of exposure. All persons considered for nPEP should undergo HIV testing to determine HIV status, preferably with rapid combined Ag/Ab, or antibody blood tests. If rapid HIV blood test results are unavailable and nPEP is otherwise indicated, it should be initiated without delay and can be discontinued if the patient is later determined to be HIV-positive already or the source is found to be HIV-negative. For further guidance on nPEP clinical implementation, please see the Florida Department of Health’s HIV Non-Occupational Post-Exposure Prophylaxis Clinical Guidelines.

3. PrEP/nPEP referrals. If a provider determines not to offer PrEP/nPEP clinical care, they may refer PrEP/nPEP clients to the Florida Department of Health by filling out a PrEP Referral Form, scanning it and emailing it to PrEPLink@flhealth.gov or by calling 305-643-7420.

4. Test & Treat. Also known as Test and Treat Rapid Access, this is the standard of care for all patients who have been newly diagnosed as HIV positive or was previously diagnosed as HIV positive and is not currently in care.  Within 7 days of receiving an HIV positive diagnosis, the patient should:

1. 1. Visit the clinician for a physical exam.
   2. Receive a 30-day supply of antiretroviral therapy
   3. Obtain base line lab results; can be ordered prior to visit or on same day that ART is started.
   4. Be linked to an HIV primary care provider.
   5. Be referred to a Ryan White care agency for assistance with Ryan White eligibility/health insurance coverage and case management services.

For further details, please refer to the Florida Department of Health’s HIV Test and Treat and Re-engage in Care Guidance (Dec 2020).

 

5. Distribute condoms and lubricant to interested patients. If you are interested in applying to be a Condom Distribution site, please fill out the Condom Distribution Application on TestMiami.org here:https://www.testmiami.org/condom-distribution-application. If you have any questions, please contact Erika Coello at Erika.Coello@flhealth.gov

6. I am not yet ready to commit to any of the above, but I will accept a follow-up email and/or follow-up visit in 6 months. If you are not yet ready to commit to any of the activities detailed above, we understand. If you are open to implementing some of these activities into your practice in the future, please consider accepting a follow-up visit in 6 months, along with a follow-up email.

Confirm Website ID (don 't touch):Website ID:

Cancel