July 09, 2019
3 min read

Same-day PrEP initiation a favorable option for patients at risk for HIV

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Same-day initiation of pre-exposure prophylaxis, or PrEP, for HIV prevention was found to be safe, feasible and well-received among patients at a walk-in STD clinic, according to a recently published study.

During the study, which was conducted at a clinic in Denver, a high proportion of the participants were linked to ongoing PrEP care, researchers reported.

“HIV remains a critical public health priority with almost 40,000 new diagnoses in the U.S. in 2017. PrEP ... has demonstrated effectiveness in the prevention of HIV acquisition among men who have sex with men and transgender women, heterosexual individuals, and people who inject drugs,” Kevin F. Kamis, MPH, health programs specialist at Denver Public Health, and colleagues wrote.

“More than 1.2 million persons in the U.S. are estimated to have indications for PrEP, yet fewer than 50,000 individuals initiated PrEP between 2013 and 2015, underscoring the vital need for new strategies to increase PrEP uptake.”

PrEP pill 
A high proportion of at-risk patients were linked to ongoing PrEP care at a walk-in STD clinic in Denver.
Source: Adobe Stock.

To assess same-day PrEP initiation as a means to increase PrEP uptake, Kamis and colleagues enrolled 100 individuals aged 18 years or older, giving them a free 30-day PrEP starter pack and assigning them a patient navigator to establish ongoing care. They compared individuals who did and did not attend at least one PrEP follow-up appointment within 180 days of enrollment, and conducted client satisfaction surveys after 3 months.

Overall, 78% of participants completed at least one PrEP follow-up appointment and 57% attended at least two follow-up appointments, Kamis and colleagues reported. When they adjusted the findings for race or ethnicity, age, health insurance status and income, they found that only income was positively associated with follow-up appointment attendance, according to the study. Specifically, for each additional $10,000 of income, there was a 1.7-fold increase in attendance odds (95% CI, 1.07-2.66), according to Kamis and colleagues.

The researchers also reported that, among the 54% of participants who completed the satisfaction survey, all of them said they liked the same-day PrEP option.

“Our study suggests STD clinic-based same-day PrEP initiation models are a highly acceptable, feasible, and safe means of PrEP initiation, and a high proportion of individuals initiated via such models link to ongoing care,” the authors concluded. “STD clinics positioned to initiate but not longitudinally manage individuals on PrEP can utilize patient navigation to support PrEP retention at outside clinics. Rapid PrEP start models are promising approaches to addressing the gap between PrEP need and utilization. More research is needed to assess long-term retention among individuals initiating PrEP under rapid initiation models.” – by Caitlyn Stulpin

Disclosures: Kamis reports receiving grant support from Gilead Sciences. Please see the study for all other authors’ relevant financial disclosures.