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Randomized Controlled Trial
. 2019 Jan-Dec:18:2325958219848848.
doi: 10.1177/2325958219848848.

A Randomized Study of Passive versus Active PrEP Patient Navigation for a Heterogeneous Population at Risk for HIV in South Florida

Susanne Doblecki-Lewis  1 , Stefani Butts  1 , Valeria Botero  1 , Katherine Klose  1 , Gabriel Cardenas  2 , Daniel Feaster  2
Affiliations
Randomized Controlled Trial

A Randomized Study of Passive versus Active PrEP Patient Navigation for a Heterogeneous Population at Risk for HIV in South Florida

Susanne Doblecki-Lewis et al. J Int Assoc Provid AIDS Care. 2019 Jan-Dec.

Abstract

Effective approaches to promoting pre-exposure prophylaxis (PrEP) and linkage to PrEP care among those who may benefit the most from PrEP has proven to be a major challenge. We designed and pilot tested a strengths-based case management (SBCM) intervention for PrEP linkage. Adults interested in PrEP and meeting criteria (n = 61) were randomized to passive referral (control) or active SBCM (treatment). Outcomes measured were completion of provider visit, initiation of PrEP, and time to initiation of PrEP. Overall, 34% initiated PrEP by 12 weeks: 9 (29%) in the control group and 12 (40%) in the treatment group. The mean time to PrEP initiation was 13.1 weeks (95% confidence interval, 12.0-14.2) with no difference between groups ( P = .382). There was a 21% difference in achieving a provider visit between the treatment and control groups (53.3% versus 32.3%) by 12 weeks ( P = .096). Participants encountered financial, logistical, social, and provider-related barriers to PrEP access. Strengths-based case management-based patient navigation is a promising strategy for assisting PrEP seekers in obtaining a medical provider visit and initiating PrEP.

Keywords: HIV prevention; access to care; navigation; pre-exposure prophylaxis.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr. Doblecki-Lewis has served as on a scientific advisory board for Gilead Sciences.

Figures

Figure 1.
Figure 1.
CONSORT 2010 flow diagram.
Figure 2.
Figure 2.
Kaplan-Meier time-to-event analysis for receipt of pre-exposure prophylaxis (PrEP) medication, by study treatment group.
See this image and copyright information in PMC

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