A Randomized Study of Passive versus Active PrEP Patient Navigation for a Heterogeneous Population at Risk for HIV in South Florida. (23rd May 2019)

• Record Type: Journal Article
• Authors: Doblecki-Lewis, Susanne; Butts, Stefani; Botero, Valeria; Klose, Katherine; Cardenas, Gabriel; Feaster, Daniel
• Is Part Of: Journal of the International Association of Providers of AIDS Care. Volume 18(2019)
• Publication Date: 2019-05-23
• Subjects: pre-exposure prophylaxis -- HIV prevention -- access to care -- navigation; AIDS (Disease) -- Periodicals; 616.9792
• DOI: 10.1177/2325958219848848
• Languages: English
• ISSNs: 2325-9574

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.