Healthcare Access and PrEP Continuation in San Francisco and Miami Following the U.S. PrEP Demo Project

Susanne Doblecki-Lewis, Albert Liu, Daniel J Feaster, Stephanie E. Cohen, Gabriel Cardenas, Oliver Bacon, Erin Andrew, Michael A Kolber

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28 Scopus citations

Abstract

ABSTRACT: Pre-exposure prophylaxis (PrEP) for prevention of HIV infection has demonstrated efficacy in randomized controlled trials as well as in demonstration projects. For PrEP implementation to result in significant reductions in HIV incidence for men who have sex with men (MSM) in the United States, sufficient access to PrEP care and continued engagement outside of demonstration projects is required. We report the results of a follow-up survey of 173 former participants from the Miami and San Francisco sites of the U.S. PrEP Demo Project, administered 4-6 months after study completion. Survey respondents continued to frequently access medical care and had a high incidence of sexually transmitted infections after completion of the Demo Project, indicating ongoing sexual risk behavior. Interest in continuing PrEP was high, with 70.8% indicating they were “very interested” in continuing PrEP. Among respondents, 39.9% reported continuation of PrEP following completion of the Demo Project, largely through their primary care providers and frequently at low or no cost. Variability in access and engagement was seen, with participants from the San Francisco site, those with medical insurance, and those with a primary care provider at the end of the Demo Project more likely to successfully obtain PrEP medication. Two respondents reported HIV seroconversion in the period between study completion and the follow-up survey. Additional effort to increase equitable access to PrEP outside of demonstration projects is needed to realize the potential impact of this evidence-based prevention intervention.

Original languageEnglish (US)
JournalJournal of Acquired Immune Deficiency Syndromes
DOIs
StateAccepted/In press - Nov 14 2016

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ASJC Scopus subject areas

  • Pharmacology (medical)
  • Infectious Diseases

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