Highlighting Georgia’s PrEP Story: Pre-exposure Prophylaxis Usage by Public Health District, 2015–2021
Abstract
Background:
Pre-exposure prophylaxis (PrEP) is a medication that effectively prevents HIV infection. As such, its usage patterns are to monitor. AIDSVu, a national project that visualizes HIV data, provides county-level PrEP estimates. However, data are suppressed for counties with fewer than three PrEP users, preventing the Georgia Department of Public Health (DPH) from calculating Public Health District (PHD)-level estimates. DPH partnered with AIDSVu to generate PHD-level PrEP data to understand how PrEP usage varied between PHDs from 2015–2021.
Methods:
DPH provided AIDSVu with a list of counties by PHDs and AIDSVu generated PHD-level PrEP counts. Using AIDSVu PrEP data, which come from a national prescription database, and new HIV diagnosis data, which come from DPH’s Enhanced HIV/AIDS Reporting System, we calculated state and PHD-level annual PrEP usage (counts and rates) and PrEP-to-Need Ratios (PNRs, number of PrEP users for every new HIV diagnosis) from 2015–2021. DPH compared PrEP rate and PNR changes between 2015–2021 to determine which PHDs experienced the largest and smallest increases.
Results:
In 2021, there were 110 PrEP users/100,000 population (11,895 total) in Georgia, a rate increase of +92 from 2015–2021. PHDs with the largest rate increases were Fulton (+301), DeKalb (+222) and East-Metro (+87). In 2021, Georgia’s PNR was five PrEP users for every new diagnosis, an increase of +4 from 2015–2021. PHDs with the largest PNR increases were Dalton (+10), Gainesville (+10), and Fulton (+6). Valdosta, Albany, and Waycross had the smallest increases (each +1).
Conclusion:
PrEP usage in Georgia has increased overtime, but disparities exist among PHDs. PHDs with the highest counts of new HIV diagnoses also had the highest PrEP rates. PNRs were lowest in central and southern PHDs, indicating higher unmet need. HIV programmatic partners may find PHD-level PrEP data useful to inform local planning and activities.
Keywords
HIV, PrEP, Epidemiology, AIDSVu, Equity, Prevention, Public-Health -District
Highlighting Georgia’s PrEP Story: Pre-exposure Prophylaxis Usage by Public Health District, 2015–2021
Background:
Pre-exposure prophylaxis (PrEP) is a medication that effectively prevents HIV infection. As such, its usage patterns are to monitor. AIDSVu, a national project that visualizes HIV data, provides county-level PrEP estimates. However, data are suppressed for counties with fewer than three PrEP users, preventing the Georgia Department of Public Health (DPH) from calculating Public Health District (PHD)-level estimates. DPH partnered with AIDSVu to generate PHD-level PrEP data to understand how PrEP usage varied between PHDs from 2015–2021.
Methods:
DPH provided AIDSVu with a list of counties by PHDs and AIDSVu generated PHD-level PrEP counts. Using AIDSVu PrEP data, which come from a national prescription database, and new HIV diagnosis data, which come from DPH’s Enhanced HIV/AIDS Reporting System, we calculated state and PHD-level annual PrEP usage (counts and rates) and PrEP-to-Need Ratios (PNRs, number of PrEP users for every new HIV diagnosis) from 2015–2021. DPH compared PrEP rate and PNR changes between 2015–2021 to determine which PHDs experienced the largest and smallest increases.
Results:
In 2021, there were 110 PrEP users/100,000 population (11,895 total) in Georgia, a rate increase of +92 from 2015–2021. PHDs with the largest rate increases were Fulton (+301), DeKalb (+222) and East-Metro (+87). In 2021, Georgia’s PNR was five PrEP users for every new diagnosis, an increase of +4 from 2015–2021. PHDs with the largest PNR increases were Dalton (+10), Gainesville (+10), and Fulton (+6). Valdosta, Albany, and Waycross had the smallest increases (each +1).
Conclusion:
PrEP usage in Georgia has increased overtime, but disparities exist among PHDs. PHDs with the highest counts of new HIV diagnoses also had the highest PrEP rates. PNRs were lowest in central and southern PHDs, indicating higher unmet need. HIV programmatic partners may find PHD-level PrEP data useful to inform local planning and activities.
