Updated December 2022

Author: HIV/STD/Hepatitis program, Vermont Department of Health

After the first quarter of 2020 some HIV testing options were suspended during the COVID-19 pandemic. Additionally, the Centers for Disease Control and Prevention (CDC) changed the methodology for this measure and no longer uses scoring of the Risk Assessment as a criteria for offering PrEP Care services. This measure will soon be adjusted for future reporting. 

PrEP Care includes a range of procedures (medical assessment, prescriptions, follow up visits) to help people at highest risk for HIV acquisition access medication that prevents infection. PrEP is Truvada or Descovey (two of the medications used to treat HIV infection) taken daily, that prevents infection from high-risk exposures. When taken as prescribed, PrEP, is highly effective at preventing, particularly, the sexual transmission of HIV.

Scoring a ten or higher on the CDC Risk Assessment tool indicates the individual is at high risk for HIV acquisition who might benefit from accessing PrEP care. PrEP treatment is about preventing HIV. In the absence of a cure for HIV, PrEP, in tandem with condom use, is proving to be an effective HIV prevention strategy for those at highest risk of infection.

In Vermont, the population at highest risk for HIV transmission/acquisition are MSM. CDC recommends that 25% of MSM being tested for HIV who score a ten or higher on their PrEP assessment tool be referred and linked to PrEP care services. This is a new strategy and we are in the early stages of implementation in Vermont. Thus far, we know that of the MSM who are currently taking PrEP in Vermont, no new HIV infections have been identified.

Due to the COVID-19 pandemic, data is not available to update this measure.

In the absence of a cure for HIV, PrEP care decreases the chance of acquiring HIV.

University of Vermont Medical Center – Comprehensive Care Clinic

Vermont CARES

Pride Center of Vermont

People at High Risk for HIV (Patients)

Medical Providers (Planned Parenthood of Northertn New England)

HIV Testing, Referral and Linkage (TRL) is designed to help individuals at the highest risk for acquiring HIV find out their status. Individuals who screen positive are immediately referred to confirmatory testing. All individuals with a confirmed HIV infection are linked to appropriate treatment.

Our TRL protocol directs our funded providers to ensure that MSM who test HIV negative will be evaluated as to whether they would benefit from referral and linkage to PrEP Care. Our test sites utilize the CDC PrEP assessment tool, specific to MSM, developed and distributed by the Centers for Disease Control and Prevention (CDC).

The Health Department strives to reduce barriers that individuals at high risk for HIV infection may face in accessing testing. It offers free, confidential HIV testing services at a wide variety of organizations using targeted campaigns, outreach, and social networks to engage individuals at increased risk for HIV.  Relationships between TRL providers and PrEP Care providers facilitate seamless client linkages to these services. Using the CDC’s PrEP assessment tool as part of the testing session helps identify those at highest risk for whom a PrEP referral is most appropriate.

The Health Department will continue to invest in targeted recruitment of high risk MSM for Testing, Linkage and Referral services. We will continue support of our TRL providers to perform PrEP Assessment of all MSM who access the HIV testing services we fund. Funded TRL service providers will focus on connecting MSM at high risk for infection to PrEP Care services.