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

Susanne Doblecki-Lewis, Stefani Butts, Valeria Botero, Katherine Klose, Gabriel Cardenas, Daniel Feaster

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1 Citation (Scopus)

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.

Original languageEnglish (US)
JournalJournal of the International Association of Providers of AIDS Care
Volume18
DOIs
StatePublished - Jan 1 2019

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Patient Navigation
HIV
Case Management
Pre-Exposure Prophylaxis
Control Groups

Keywords

  • access to care
  • HIV prevention
  • navigation
  • pre-exposure prophylaxis

ASJC Scopus subject areas

  • Immunology
  • Dermatology
  • Infectious Diseases

Cite this

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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.",
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