Opportunities for PrEP in High Risk HIV Negative Patients
Abstract
Background:
Georgia maintains a high HIV incidence rate despite the implementation of multiple reduction strategies. Recent studies demonstrate the positive impact early initiation of PrEP has in HIV transmission reduction. Even though CDC recommends HIV prophylaxis discussion with patients, PrEP remains considerably underutilized in Southeast GA.
Methods:
A retrospective cohort analysis was performed on Family Medicine Clinic patients presenting from October 2020-October 2023. EMR identified demographics and high-risk variables, including STI test(s) and result(s), chief complaints, and HIV test results. An initial total of 8593 STI test results from patients’ ≥16 were identified. Of those, 339 positive tests results were evaluated for eligibility, yielding 133 patients meeting the inclusion criteria (≥1 positive Gonorrhea, Chlamydia, or Syphilis test result).
Results:
Out of the 133 patients meeting inclusion criteria, 123 reported sexual activity within prior 6 months and 75% of those reported no or intermittent condom use. 51 patients were found to have ≥2 positive tests and only 54 received STI prevention counseling during the initial positive test encounter. Ten patients received PrEP-specific counseling and two patients were placed on PrEP. Interestingly, 57% were found to have non-GU-related chief complaints, the majority of which were patients establishing care or receiving annual/well-child exams.
Conclusions:
This data supports the need for physicians to more actively engage patients in early risk reduction discussions to determine eligibility of PrEP services. Physicians often focus on the immediate chief complaint and overlook potential risk factors for future HIV infection. Utilizing the EMR to capture relevant data will facilitate easier identification of patients who are eligible for PrEP services, especially if the chief complaint is non-GU-related. Implementing curriculum to train physicians and better EMR utilization for early recognition and engagement of patients who would benefit from PrEP services will help to reduce incidence of HIV infection in southeast GA.
Keywords
high-risk HIV negative, PrEP, risk reduction
Opportunities for PrEP in High Risk HIV Negative Patients
Background:
Georgia maintains a high HIV incidence rate despite the implementation of multiple reduction strategies. Recent studies demonstrate the positive impact early initiation of PrEP has in HIV transmission reduction. Even though CDC recommends HIV prophylaxis discussion with patients, PrEP remains considerably underutilized in Southeast GA.
Methods:
A retrospective cohort analysis was performed on Family Medicine Clinic patients presenting from October 2020-October 2023. EMR identified demographics and high-risk variables, including STI test(s) and result(s), chief complaints, and HIV test results. An initial total of 8593 STI test results from patients’ ≥16 were identified. Of those, 339 positive tests results were evaluated for eligibility, yielding 133 patients meeting the inclusion criteria (≥1 positive Gonorrhea, Chlamydia, or Syphilis test result).
Results:
Out of the 133 patients meeting inclusion criteria, 123 reported sexual activity within prior 6 months and 75% of those reported no or intermittent condom use. 51 patients were found to have ≥2 positive tests and only 54 received STI prevention counseling during the initial positive test encounter. Ten patients received PrEP-specific counseling and two patients were placed on PrEP. Interestingly, 57% were found to have non-GU-related chief complaints, the majority of which were patients establishing care or receiving annual/well-child exams.
Conclusions:
This data supports the need for physicians to more actively engage patients in early risk reduction discussions to determine eligibility of PrEP services. Physicians often focus on the immediate chief complaint and overlook potential risk factors for future HIV infection. Utilizing the EMR to capture relevant data will facilitate easier identification of patients who are eligible for PrEP services, especially if the chief complaint is non-GU-related. Implementing curriculum to train physicians and better EMR utilization for early recognition and engagement of patients who would benefit from PrEP services will help to reduce incidence of HIV infection in southeast GA.
