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. 2018 Oct;108(10):1418-1420.
doi: 10.2105/AJPH.2018.304561. Epub 2018 Jul 19.

HIV Preexposure Prophylaxis as a Gateway to Primary Care

Julia L Marcus  1 , Kenneth Levine  1 , Chris Grasso  1 , Douglas S Krakower  1 , Victoria Powell  1 , Kyle T Bernstein  1 , Stephen Boswell  1 , Kenneth H Mayer  1
Affiliations

HIV Preexposure Prophylaxis as a Gateway to Primary Care

Julia L Marcus et al. Am J Public Health. 2018 Oct.

Abstract

Objectives: To determine whether HIV preexposure prophylaxis (PrEP) use is associated with use of non-HIV-related health care.

Methods: We conducted a cross-sectional study of potential PrEP candidates at a Boston, Massachusetts, community health clinic during 2012 to 2016, comparing the proportion of PrEP users and non-PrEP users receiving primary care.

Results: Of 5857 PrEP candidates, 2047 (35%) were prescribed PrEP. After adjustment for demographics and number of visits, more PrEP users received influenza vaccination (prevalence ratio [PR] = 1.28; 95% confidence interval [CI] = 1.20, 1.37), tobacco screening (PR = 1.06; 95% CI = 1.02, 1.09), and depression screening (PR = 1.07; 95% CI = 1.04, 1.11) compared with non-PrEP users. After additional adjustment for diabetes, hypertension, and overweight or obesity, more PrEP users received glucose testing (PR = 1.64; 95% CI = 1.56, 1.72) but fewer received hemoglobin A1c testing (PR = 0.81; 95% CI = 0.71, 0.93) compared with non-PrEP users.

Conclusions: PrEP use was associated with receipt of influenza vaccination, tobacco and depression screening, and glucose but not hemoglobin A1c testing. Among PrEP users receiving routine care, the benefits of PrEP may extend to behavioral health, mental health, and prevention and treatment of other infectious and chronic diseases.

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Comment in

  • HIV Preexposure Prophylaxis.
    Fernando D. Fernando D. Am J Public Health. 2018 Dec;108(12):e27. doi: 10.2105/AJPH.2018.304757. Am J Public Health. 2018. PMID: 30403514 Free PMC article. No abstract available.
  • Marcus et al. Respond.
    Marcus JL, Levine K, Grasso C, Krakower DS, Powell V, Mayer KH. Marcus JL, et al. Am J Public Health. 2018 Dec;108(12):e27-e28. doi: 10.2105/AJPH.2018.304758. Am J Public Health. 2018. PMID: 30403515 Free PMC article. No abstract available.

References

    1. Grant RM, Lama JR, Anderson PL et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010;363(27):2587–2599. - PMC - PubMed
    1. Volk JE, Marcus JL, Phengrasamy T et al. No new HIV infections with increasing use of HIV preexposure prophylaxis in a clinical practice setting. Clin Infect Dis. 2015;61(10):1601–1603. - PMC - PubMed
    1. Jenness SM, Weiss KM, Goodreau SM et al. Incidence of gonorrhea and chlamydia following human immunodeficiency virus preexposure prophylaxis among men who have sex with men: a modeling study. Clin Infect Dis. 2017;65(5):712–718. - PMC - PubMed
    1. Volk JE, Marcus JL, Phengrasamy T, Hare CB. Incident hepatitis C virus infections among users of HIV preexposure prophylaxis in a clinical practice setting. Clin Infect Dis. 2015;60(11):1728–1729. - PMC - PubMed
    1. Gold RB. The role of family planning centers as gateways to health coverage and care. Guttmacher Policy Rev. 2011;14(2):15–19.

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