Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Sep 19;18(9):e0291657.
doi: 10.1371/journal.pone.0291657. eCollection 2023.

EquiPrEP: An implementation science protocol for promoting equitable access and uptake of long-acting injectable HIV pre-exposure prophylaxis (LAI-PrEP)

Christina M Kaul  1   2 , Brandi E Moore  3 , Emma Kaplan-Lewis  1 , Eunice Casey  1 , Robert A Pitts  2   4 , Patricia Pagan Pirallo  2 , Sahnah Lim  5 , Farzana Kapadia  3 , Gabriel M Cohen  1   2   4 , Maria Khan  5 , Ofole Mgbako  2   4   5   6
Affiliations

EquiPrEP: An implementation science protocol for promoting equitable access and uptake of long-acting injectable HIV pre-exposure prophylaxis (LAI-PrEP)

Christina M Kaul et al. PLoS One. .

Abstract

Background: Long-acting injectable HIV pre-exposure prophylaxis (LAI-PrEP) was approved by the U.S. Food and Drug Administration in December 2021. This initial phase of implementation represents a prime opportunity to ensure equitable LAI-PrEP provision to communities often underrepresented in PrEP care before disparities in access and uptake emerge. Herein, we describe the EquiPrEP Project which utilizes an equity-oriented implementation science framework to optimize LAI-PrEP rollout in an urban safety-net clinic in New York City.

Methods: The primary objectives of this project are to: (1) increase LAI-PrEP initiation overall; (2) increase uptake among groups disproportionately impacted by the HIV epidemic; (3) preserve high PrEP retention while expanding use; and (4) identify barriers and facilitators to LAI-PrEP use. EquiPrEP will enroll 210 PrEP-eligible participants into LAI-PrEP care with planned follow-up for one year. We will recruit from the following priority populations: Black and/or Latine men who have sex with men, Black and/or Latine cisgender women, and transgender women and nonbinary individuals. To evaluate implementation of LAI-PrEP, we will utilize equity-focused iterations of the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework and the Consolidated Framework for Implementation Research (CFIR), in addition to longitudinal surveys and qualitative interviews.

Discussion: Novel LAI-PrEP formulations carry tremendous potential to revolutionize the field of HIV prevention. Implementation strategies rooted in equity are needed to ensure that marginalized populations have access to LAI-PrEP and to address the structural factors that hinder initiation and retention in care.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Timeline of participant visits and study activities.
Fig 2
Fig 2. An implementation research logic model for the EquiPrEP study.
See this image and copyright information in PMC

References

    1. Sullivan P.S.; Giler R.M.; Mouhanna F., et al.. Trends in the use of oral emtricitabine/tenofovir disoproxil fumarate for pre-exposure prophylaxis against HIV infection, United States, 2012–2017. Ann Epidemiol. 2018, 28(12), 833–840. doi: 10.1016/j.annepidem.2018.06.009 - DOI - PMC - PubMed
    1. Tuller D. HIV Prevention drug’s slow uptake undercuts its early promise. Health Aff (Millwood). 2018,37(2),178–180. doi: 10.1377/hlthaff.2017.1650 - DOI - PubMed
    1. Norwood A.; Zuniga J.A. Knowledge and attitude about pre-exposure prophylaxis among primary care clinicians at a federally qualified health center in central Texas: a cross-sectional study. J Assoc Nurses AIDS Care. 2022, 34(1), 24–30. doi: 10.1097/JNC.0000000000000353 - DOI - PubMed
    1. Deeper Look: HIV in Black Communities. AIDSVu. Available online: https://aidsvu.org/resources/deeper-look-hiv-in-black-communities/ (Accessed 3 February 2023).
    1. Andriano T.M.; Arnsten J.; Patel V.V. Social determinants of health and HIV pre-exposure prophylaxis (PrEP) interest and use among young Black and Latinx sexual minority men. PLoS One. 2022, 17(4):e0267031. doi: 10.1371/journal.pone.0267031 - DOI - PMC - PubMed

Publication types