The general flow for my follow-up appointments is that I have a conversation with my patients about any side effects, any issues that they’ve had with taking the PrEP. I do ask about missed tablets because a good opportunity to help reinforce ways that they can be more compliant with taking their medicines. It’s also a really great chance to just see how they’re going.
I ask if they’ve had any diagnosis with sexual infections, because sometimes people will go to other doctors with STIs and have them treated there. If this person has had a sexually transmitted infection, it’s a great time to document this in the chart.
I also ask if the person has any current symptoms of STIs. If they have any penile discharges or discharges through the vagina or cervix, it’s a really good chance to be able to make sure you get a swab of that discharge to find out exactly what is going on.
With the conversations done, I’ll produce a new script with the reinforcement of how to order the drugs online and reminding them that they do need a script every three months and that they are not to import more than 90 days worth of tablets at a time. Also, I like to document which version of generic Truvada the particular person is using, whether it be Ricovir-EM, Tenvir-EM, or Adco-Emtevir: the three main generics that I recommend.
Scripts aside, conversations aside, it’s now time to do a full sexual health screening. If they have any questions, you’ll be able to answer these quite efficiently. A lot can be done in a simple 15-minute appointment.