Implementing Long-Acting PrEP in Primary Care: Workflow Lessons With Kevin Hatfield, MD

Long-acting injectable PrEP is often perceived as a significant operational hurdle for primary care practices, but real-world experience suggests that implementation may be more straightforward than many clinicians anticipate. In this video segment, family physician Kevin Hatfield, MD, outlines how his primary care practice integrated long-acting PrEP into routine workflows without disrupting clinic operations.

According to Hatfield, one of the most important early steps was recognizing that long-acting PrEP fits naturally into primary care environments that already administer vaccines and other injectable therapies. Because office staff were already trained in injection techniques, additional training requirements were minimal, and administration could be absorbed into existing clinical roles. “It ended up being much easier than we originally anticipated,” he noted.

Scheduling flexibility also played a central role. Patients are typically scheduled several injections in advance, allowing them to block appointments on their calendars well ahead of time. Built-in dosing windows—rather than fixed appointment dates—help accommodate travel, work obligations, and unexpected scheduling conflicts. From a practice perspective, injection visits are short and can often be accommodated even when physician schedules are full.

In addition, Hatfield emphasized the importance of proactive planning for patients who anticipate travel or extended absences. In these situations, a temporary oral PrEP bridge can be used to maintain HIV prevention coverage until injectable dosing resumes, preserving continuity of care without derailing the overall treatment plan.

From a workflow standpoint, staff engagement was key. Scheduling teams were trained on appropriate visit length and timing, while clinical staff were encouraged to surface patient questions or concerns during injection visits. Even when injections were administered without a physician present, this approach helped maintain a higher-touch clinical experience and ensured that patient issues were addressed promptly.

Overall, Hatfield described long-acting PrEP as a high-satisfaction addition to his practice—both for patients and staff. While any new therapy requires initial adjustment, he noted that long-acting PrEP quickly became routine and did not meaningfully disrupt clinic flow, reinforcing its feasibility in primary care settings.