ABSTRACTCynthia Denise Dalton. Integration of pre-exposure protocol in men who have sex with men. (Under the direction of DR. JUDY CORNELIUS).In the United States, men who have sex with men (MSM) remains the highest group infected with HIV. Truvada (PrEP) in combination with safer sex practices has shown efficacy in preventing HIV infection. Yet a PrEP protocol had not been initiated with MSM in an outpatient infectious disease clinic in North Carolina. The purpose of this study was to examine the effect of initiating a pilot PrEP protocol (brief educational intervention and 2 follow-up visits) on medication knowledge and adherence and sexually transmitted infection (STI) outcomes. The design of this study was case series. The sample consisted of 8 MSM who completed demographic and pre/post-test surveys, documented recall of pill usage, and provided blood and urine samples. The participants were primarily African American MSM, employed, and attended college. On the first visit, 63% of the participants demonstrated PrEP knowledge accuracy, on the post-test 100% demonstrated accuracy, and 38% reported no missed doses. None of the participants became infected with an STI compared to baseline and 63% reported consistent condom use. Despite the small sample size, there were trends in that data that the integration of a PrEP protocol with an educational intervention was associated with improvement in PrEP knowledge and medication adherence. Additionally, there were no new STI outcomes, from January 7 until March 7, 2019. We expected this project would demonstrate the importance of a PrEP protocol in the setting of an infectious disease clinic at Wake Forest Baptist Health. The findings suggest that knowledge of PrEP is considered essential to ensure effective PrEP implementation.