BACKGROUND: Clinics providing sexual health care pose unique opportunities to implement HIV pre-exposure prophylaxis (PrEP) programs. The PrEP program at New York City's Sexual Health Clinics provides intensive on-site navigation for linkage to PrEP care. We assessed uptake of this intervention. METHODS: We categorized men who have sex with men (MSM) without HIV hierarchically as having had (1) HIV post-exposure prophylaxis (PEP) use (past year); or (2) selected sexually transmitted infections (STI) (past year); or (3) HIV-diagnosed sex/needle-sharing partners (past 6 months); or (4) expressed interest in PrEP (day of clinic visit). We constructed PrEP cascades and used multivariable regression to examine acceptance of PrEP navigation, referral to a PrEP provider, linkage (<60 days), and PrEP prescription. RESULTS: One thousand three hundred one of 2106 PrEP (62%) patients accepted navigation. Of those, 55% (718/1301) were black or Hispanic MSM. STI and PEP patients had lowest navigation acceptance levels (35%-46%). Of navigated patients, 56% (628/1114) accepted referrals, 46% (288/628) linked to PrEP providers, and 82% (235/288) were prescribed PrEP; overall, 11% of those offered navigation (235/2106) received prescriptions. Navigated MSM with PEP history [adjusted prevalence ratio (aPR) 1.34, 95% confidence interval (CI): 1.16 to 1.56)], previous STI (aPR 1.28, 95% CI: 1.12 to 1.45), or HIV-diagnosed partners (aPR 1.18, 95% CI: 1.01 to 1.37) were more likely than those with PrEP interest to accept referrals. Probability of linkage varied by insurance status; prescription did not vary by patient factors. CONCLUSIONS: Although MSM in key priority groups (eg, previous STI) showed low navigation uptake, those who accepted navigation were likely to be referred for PrEP, suggesting a need for expanded up-front engagement.
BACKGROUND: Clinics providing sexual health care pose unique opportunities to implement HIV pre-exposure prophylaxis (PrEP) programs. The PrEP program at New York City's Sexual Health Clinics provides intensive on-site navigation for linkage to PrEP care. We assessed uptake of this intervention. METHODS: We categorized men who have sex with men (MSM) without HIV hierarchically as having had (1) HIV post-exposure prophylaxis (PEP) use (past year); or (2) selected sexually transmitted infections (STI) (past year); or (3) HIV-diagnosed sex/needle-sharing partners (past 6 months); or (4) expressed interest in PrEP (day of clinic visit). We constructed PrEP cascades and used multivariable regression to examine acceptance of PrEP navigation, referral to a PrEP provider, linkage (<60 days), and PrEP prescription. RESULTS: One thousand three hundred one of 2106 PrEP (62%) patients accepted navigation. Of those, 55% (718/1301) were black or Hispanic MSM. STI and PEPpatients had lowest navigation acceptance levels (35%-46%). Of navigated patients, 56% (628/1114) accepted referrals, 46% (288/628) linked to PrEP providers, and 82% (235/288) were prescribed PrEP; overall, 11% of those offered navigation (235/2106) received prescriptions. Navigated MSM with PEP history [adjusted prevalence ratio (aPR) 1.34, 95% confidence interval (CI): 1.16 to 1.56)], previous STI (aPR 1.28, 95% CI: 1.12 to 1.45), or HIV-diagnosed partners (aPR 1.18, 95% CI: 1.01 to 1.37) were more likely than those with PrEP interest to accept referrals. Probability of linkage varied by insurance status; prescription did not vary by patient factors. CONCLUSIONS: Although MSM in key priority groups (eg, previous STI) showed low navigation uptake, those who accepted navigation were likely to be referred for PrEP, suggesting a need for expanded up-front engagement.
Authors: Anthony Todd Fojo; Melissa Schnure; Parastu Kasaie; David W Dowdy; Maunank Shah Journal: Ann Intern Med Date: 2021-09-21 Impact factor: 25.391
Authors: Parya Saberi; Marie C D Stoner; Kristin Ming; Nadra E Lisha; J Carlo Hojilla; Hyman M Scott; Albert Y Liu; Wayne T Steward; Mallory O Johnson; Torsten B Neilands Journal: AIDS Date: 2022-06-22 Impact factor: 4.632
Authors: Rebecca Lillis; Jeremy Beckford; Joshua Fegley; Julia Siren; Bruce Hinton; Samuel Gomez; Stephanie N Taylor; Isolde Butler; Jason Halperin; Meredith Edwards Clement Journal: AIDS Patient Care STDS Date: 2021-08-26 Impact factor: 5.944
Authors: Pedro B Carneiro; Victoria Frye; Chloe Mirzayi; Viraj Patel; David Lounsbury; Terry T-K Huang; Nasim Sabounchi; Christian Grov Journal: AIDS Educ Prev Date: 2022-06
Authors: Cho-Hee Shrader; Justin Stoler; Juan Arroyo-Flores; Susanne Doblecki-Lewis; Adam Carrico; Steven Safren; Stephen Fallon; Mariano Kanamori Journal: J Immigr Minor Health Date: 2022-10-20
Authors: Zoe R Edelstein; Amanda Wahnich; Lawrence J Purpura; Paul M Salcuni; Benjamin W Tsoi; Paul H Kobrak; Paul A Santos; Adriana Andaluz; Jennifer H MacGregor; Jennifer D M Matsuki; David A Katz; Demetre C Daskalakis; Julie E Myers Journal: Sex Transm Dis Date: 2020-05 Impact factor: 2.830