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All for All in HIV and Sexual Health
All for All in HIV and Sexual Health: How and Why I Offer All Patients All the Prevention Tools at My Disposal

Released: November 04, 2025

Tessa Rife-Pennington
Tessa Rife-Pennington, PharmD, BCGP
Activity Information

Activity

Key Takeaways
  • Don’t silo—bundle. Integrate HIV PrEP, DoxyPEP, STI screening, and preventive care into existing substance use disorder patient care visits and workflows.
  • Make it routine and stigma free. Incorporate universal service offering, person-first language, and brief sexual health history taking as standard of care.

As a substance use disorder (SUD) pharmacist, I recently spent more than 1 year completing training and working to expand my scope of practice. My goal was simple—I wanted to integrate low-barrier sexual health care, including HIV pre-exposure prophylaxis (PrEP) and doxycycline post-exposure prophylaxis (DoxyPEP) prescribing, into my clinical practice. Here, I discuss practical strategies that I learned along this journey.

Why SUD Pharmacists?
SUD pharmacists already practice harm reduction every day: We lower thresholds to care, use stigma-free language, and build trust with people who are too often told to “just stop” specific behaviors. Those same competencies translate seamlessly into HIV prevention. Offering HIV PrEP, DoxyPEP, sexual health history taking, routine sexually transmitted infection (STI) screening, and rapid treatment linkage does not require being an infectious diseases specialist; it requires patient-centered language and workflows, practice protocols, collaborative practice agreements or expanded scopes of practice, and a harm reduction framework. Training exists, and we do not have to deliver these services in silos.

Expanding Your Tool Kit With Free Training
A wealth of internet-based training resources (eg, HealthHIV, American Academy of HIV Medicine, AIDS Education and Training Center, CDC HIV Nexus), certificate training programs (eg, American Pharmacists Association), and state board of pharmacy trainings are available to equip SUD pharmacists with the knowledge and skills to expand practice. Core clinical topics cover the prevalence, microbiology, pathophysiology, clinical presentation, screening, prevention (including PrEP and DoxyPEP), diagnosis, and treatment linkage for HIV, viral hepatitis, and common STIs (chlamydia, gonorrhea, herpes simplex virus, human papillomavirus, syphilis).

Communication-based training centers on: 

  • Understanding implicit bias, social determinants of health, and common barriers to care 
  • Recognizing and avoiding stigma in HIV and sexual health care
  • Taking a sexual health history and talking to patients about sexual health
  • Using motivational interviewing strategies
  • Providing trauma-informed care
  • Incorporating diversity, equity, and inclusion to provide culturally competent care

How to Integrate Training Into Practice: A Practical Checklist

  • Ask ALL patients about sex. Avoid making assumptions about what kinds of sex people have, with whom they have sex, or that older adults are not having sex.
  • Integrate sexual health history taking into routine patient visits. Use the “6 Ps”—Partners, Practices, Protection, Past History of STIs, Pregnancy Intention, and Pleasure/Problems/Pride—as a quick guide.
  • Use a harm reduction framework for resource offering. Rather than preselecting which patients are offered which resources, offer ALL patients ALL prevention tools at your disposal: HIV PrEP, DoxyPEP, and prevention supplies (condoms, dental dams, lubricant, spermicidal gel, syringes, sharps containers, alcohol swabs, wound care, etc).
  • Incorporate stigma-free language in the context of HIV and sexual health care. Avoid words and phrases that are outdated and reframe with person-centered approaches.
  • Similarly, transition from a risks-based to reasons-based framework. Rather than focusing on risks for acquiring HIV and STIs, center patient conversations on reasons for PrEP, DoxyPEP, STI screening, and preventive care. 
  • Develop quick electronic medical record templates for screening, initiation, monitoring, and patient education—and have patient education materials ready to go.

If there is one lesson I have learned from practice, it is that patients will engage if you open the conversation. We do not necessarily need a new specialty clinic or referral to add new services. SUD pharmacists already deliver low-threshold, stigma-free care, and when we add universal sexual health education, screening, and preventive services, we create a one-stop shop for bundled care. Let’s use the skills we already have, paired with new skills that we can learn to make sexual health a standing offer for every patient we see.

Your Thoughts
Would you consider offering routine sexual health services within your setting? Why or why not? Leave a comment to join the discussion!