{'fraction_non_alphanumeric': 0.018268176835951774, 'fraction_numerical': 0.006211180124223602, 'mean_word_length': 5.503562945368171, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 2, 'profanity_word_list.json': 0, 'sexual_word_list.json': 1, 'zh_pornsignals.json': 0}}
Public Health-Seattle & King County and Washington State Department of Health Preexposure Prophylaxis Implementation Guidelines, 2015.

H IV preexposure prophylaxis (PrEP) is a central component of the US National HIV/AIDS strategy. In 2014, the US Public Health Service issued clinical practice guidelines defining how medical providers should prescribe andmonitor patients on PrEP. Those guidelines include recommendations defining high-risk patients for whom medical providers should consider prescribing PrEP. Among men who have sex with men (MSM), the guidelines specifically suggest that providers consider PrEP in patients who have condomless anal sex outside of long-term mutually monogamous relationships and MSM with a history of any sexually transmitted infection in the prior 6 months. The Infectious Diseases Society of America recommends that medical providers consider PrEP in patients with an estimated annual risk of HIVacquisition of 2% of more per year, whereas the World Health Organization recommends consideration of PrEP in populations with an annual risk of HIVof 3% or more. Existing guidelines are helpful as a starting point in defining candidate populations for PrEP. However, Infectious Diseases Society of America andWorldHealthOrganization guidelines require medical providers to know the approximate incidence of HIV in different populations of patients, information that clinicians often lack.Meanwhile, US Public Health Service Guidelines recommend that medical providers consider prescribing PrEP in a diverse populationwith widely variable levels of HIV risk. In large measure, the lack of specificity in existing guidelines reflects the heterogeneity of the HIVepidemic in the US and globally. In 2015, Public Health–Seattle & King County (PHSKC) and the Washington State Department of Health developed local PrEP implementation guidelines to help medical providers know when to recommend or discuss PrEP with patients. In developing these guidelines, wewere particularly interested in data that related risk factors ascertainable during a clinical encounter to the risk of future HIVacquisition. We sought to define a high-risk population in which local data suggest that the annual risk of HIV infection is 3% or more, and to advise providers to recommend PrEP to those patients. We also defined a larger population of patients at elevated risk for HIV compared with the general population, but with an estimated annual risk of HIV acquisition less than 3%, with whom medical providers should discuss PrEP. In both instances, we purposefully decided not to advise providers to “consider” PrEP because we wanted to promote a decision-making process that included both providers and patients. In some