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. 2020 Dec;34(12):516-522.
doi: 10.1089/apc.2020.0228.

Targeted Screening for HIV Pre-Exposure Prophylaxis Eligibility in Two Emergency Departments in Washington, DC

Paige Kulie  1 , Amanda D Castel  2 , Zhaonian Zheng  3 , Natasha N Powell  1 , Aneil Srivastava  1 , Sandhya Chandar  1 , Melissa L McCarthy  1   3
Affiliations

Targeted Screening for HIV Pre-Exposure Prophylaxis Eligibility in Two Emergency Departments in Washington, DC

Paige Kulie et al. AIDS Patient Care STDS. 2020 Dec.

Abstract

Pre-exposure prophylaxis (PrEP) is an effective method to prevent HIV acquisition in high-risk individuals. This cross-sectional survey study estimated the proportion of patients who were PrEP eligible among a targeted sample of emergency department (ED) patients with chief complaints indicative of HIV risk. Research assistants screened a convenience sample of adult patients who presented to two hospital EDs in Washington, DC, during a 6-month period with genitourinary, substance use, or intentional injury-related complaints. Patients with these complaints who reported being sexually active within the past 6 months and HIV negative completed a computer-assisted survey that included questions on sexual practices and partners, substance use, and attitudes and knowledge about PrEP. We used the Centers for Disease Control and Prevention (CDC) clinical guidelines to determine whether PrEP use was indicated. We report differences in PrEP eligibility by demographic characteristics, knowledge, and attitudes. Of the 410 participants, the majority were black (85%), and heterosexual females (72%). PrEP use was indicated in 20% (N = 84), most commonly because of condomless sex with a person of unknown HIV status (82%) and/or a sexually transmitted infection (STI) diagnosis (41%). One-third (34%) of participants had heard of PrEP. Overall, 36% of the sample (N = 148) wanted to learn more about PrEP while in the ED. The percentage who wanted to learn more about PrEP was higher among PrEP-eligible patients (52%) compared with PrEP-ineligible patients (32%). Using CDC criteria, targeted screening identified that a substantial proportion of ED patients are PrEP eligible based on their self-reported behaviors.

Keywords: HIV; emergency medicine; pre-exposure prophylaxis; prevention; screening.

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Conflict of interest statement

No competing financial interests exist.

Figures

FIG. 1.
FIG. 1.
Derivation of study sample.
See this image and copyright information in PMC

References

    1. Shover CL, Shoptaw S, Javanbakht M, et al. . Mind the gaps: Prescription coverage and HIV incidence among patients receiving pre-exposure prophylaxis from a large federally qualified health center in Los Angeles, California [Mind the Gaps: Cobertura de recetas e incidencia de VIH entre pacientes recibiendo profilaxis pre-exposicion de un centro de salud grande y federalmente calificado en Los Angeles, CA]. AIDS Behav 2019;23:2730–2740 - PMC - PubMed
    1. Smith DK, Van Handel M, Wolitski RJ, et al. . Vital signs: Estimated percentages and numbers of adults with indications for preexposure prophylaxis to prevent HIV acquisition—United States, 2015. MMWR Morb Mortal Wkly Rep 2015;64:1291–1295 - PubMed
    1. PrEP Watch—United States 2019. Anonymous. Available at: https://www.prepwatch.org/country/united-states/ (Last accessed January30, 2020)
    1. District of Columbia Department of Health HIV/AIDS, Hepatitis, STD, and TB Administration (HAHSTA). Annual Epidemiology & Surveillance Report: Data Through December. 2018. 2019. Available at: https://dchealth.dc.gov/publication/hahsta-annual-epidemiology-surveilla... (Last accessed February29, 2020)
    1. DC Department of Health. PrEP Provider Handbook. Available at: https://doh.dc.gov/sites/default/files/dc/sites/doh/service_content/atta... (Last accessed February29, 2020)

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