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. 2020 Jan;34(1):1-6.
doi: 10.1089/apc.2019.0235.

A Pharmacist-Led, Same-Day, HIV Pre-Exposure Prophylaxis Initiation Program to Increase PrEP Uptake and Decrease Time to PrEP Initiation

Christine M Khosropour  1 , Kandis V Backus  2   3 , Arianna R Means  4 , Laura Beauchamps  2 , Kendra Johnson  5 , Matthew R Golden  1   6   7 , Leandro Mena  2   3
Affiliations

A Pharmacist-Led, Same-Day, HIV Pre-Exposure Prophylaxis Initiation Program to Increase PrEP Uptake and Decrease Time to PrEP Initiation

Christine M Khosropour et al. AIDS Patient Care STDS. 2020 Jan.

Abstract

Mississippi has one of the highest rates of HIV in the United States, but has low pre-exposure prophylaxis (PrEP) uptake, particularly among black men who have sex with men (MSM) and women. From November 2018 to May 2019, patients at high risk of HIV who tested negative for HIV at a nonclinical testing center in Jackson, Mississippi, were referred to an on-site clinical pharmacist for same-day PrEP initiation. The pharmacist evaluated patients for medical contraindications to PrEP, but no baseline labs were obtained. The pharmacist provided a PrEP prescription and scheduled a clinical appointment for patients within 6 weeks, at which time they were evaluated by a clinician and completed baseline labs. The pharmacist evaluated 69 patients for PrEP; 57% were MSM, 77% were black, and 65% were uninsured. All patients received a PrEP prescription; 83% received the prescription the same day and 97% received it within 5 days. Fifty-three (77%) of 69 clients filled the prescription; 87% of whom filled it within 1 week. Only 23 (43%) of 53 clients who filled their prescription attended their initial clinical appointment within 6 weeks of obtaining PrEP. There were no differences in PrEP initiation or retention by patient sex/gender. This pilot program suggests that an on-site pharmacist working in a nonclinical testing center in the southern United States can successfully initiate PrEP among predominately low-income black MSM. Future efforts should seek to better integrate laboratory testing into this demedicalized model of PrEP and to improve retention in care.

Keywords: HIV; pharmacist; pre-exposure prophylaxis.

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Conflict of interest statement

C.M.K. and M.R.G. have received donations of specimen collection kits and reagents from Hologic, Inc., unrelated to the submitted work. K.V.B. and L.M. have received honoraria as consultants to Gilead Sciences, and L.M. has received honoraria as a member of the Gilead Sciences speaker bureau. All other authors declare no conflicts of interest.

Figures

FIG. 1.
FIG. 1.
Number and percentage of patients retained along steps of the same-day, pre-exposure prophylaxis program (N = 69).
See this image and copyright information in PMC

References

    1. Centers for Disease Control and Prevention. HIV Surveillance Report, 2018, Vol. 30 2019. Available at: https://www.cdc.gov/hiv/library/reports/hiv-surveillance.html (Last accessed December19, 2019)
    1. Rosenberg ES, Grey JA, Sanchez TH, Sullivan PS. Rates of prevalent HIV infection, prevalent diagnoses, and new diagnoses among men who have sex with men in US states, metropolitan statistical areas, and counties, 2012–2013. JMIR Public Health Surveill 2016;2:e22. - PMC - PubMed
    1. AIDSVu. 2019. Available at: https://aidsvu.org (Last accessed 1June, 2019)
    1. Chan GA, Johnson KL, Mosca NG, et al. . Emerging regional and racial disparities in the lifetime risk of human immunodeficiency virus infection among men who have sex with men: A comparative life table analysis in King County, WA and Mississippi. Sex Transm Dis 2017;44:227–232 - PMC - PubMed
    1. Siegler AJ, Bratcher A, Weiss KM, Mouhanna F, Ahlschlager L, Sullivan PS. Location location location: an exploration of disparities in access to publicly listed pre-exposure prophylaxis clinics in the United States. Ann Epidemiol 2018;28:858–864 - PMC - PubMed

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