DOXY PrEP/PEP Experience within a Large Community Based Organization
Abstract
Background
Positive Impact Health Centers (PIHC) for FY 2023 cared for 7,152 PWH and 2,738 PWoH receiving HIV prevention and other services. 99% of PWH were prescribed ARVs with 91% viral suppression (VS). Services were provided through 3 clinics servicing 20 counties and supported through RW Funding Parts A/B. A Doxy-PrEP/PEP SOP was established in meeting the request of the population PIHC serves.
Methods
A Doxy-PrEP/PEP SOP was drafted April 2023 based on current literature and active utilization within the US and included Syphilis testing along with Gonorrhea/Chlamydia 3-site testing. A provider assessment was required prior to any Doxy refill and all materials were provided in English & Spanish. This SOP was created prior to the release of official CDC guidelines August, 2024. Data was collected from June 1, 2023 through May 31, 2024 for the 3 PIHC clinic sites and collected via the Cerner (EMR) Advanced Reporting System, which integrates data from the SPM-Specialty PM Application.
Results
- PWH were prescribed ART (100%) and PWoH were prescribed HIV-PrEP (99.22%)
- HIV-PrEP included Descovy™, Truvada™ or Apretude™
- Zero HIV-PrEP patients HIV seroconverted while on Doxy-PrEP
- 2 (1.2%) HIV-PrEP patients HIV seroconverted while on Doxy-PEP
- PWH viral suppression (VS) for Doxy-PrEP & PEP for the study period included:
Doxy-PrEP Doxy-PEP
Decatur 99.17% 97.76%
Duluth 79.43% 97.31%
Marietta 80.13% 97.50%
- Overall HIV VS for the last 3 study months for all sites included Doxy-PrEP: 95.1% & Doxy-PEP: 95.8%
- Overall, PWoH had fewer positive STI tests
Conclusions
- Need data on other preventative measures utilized by Doxy-PrEP/PEP clients as a part of a comprehensive sexual plan
- Need data on missed appointments and missed/late Doxy pharmacy pick-up
- Need to compare 2023/2024 study data with the next study period (2024/2025) in assessing STI case rates
- Need updated data on Gonorrhea Doxy resistance in the Atlanta metropolitan area
- PIHC had no resistant cases of gonorrhea during the review period
Keywords
DOXY, PrEP, PEP, HIV, STI, Care, Prevention
Conflict of Interest Form
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DOXY PrEP/PEP Experience within a Large Community Based Organization
Background
Positive Impact Health Centers (PIHC) for FY 2023 cared for 7,152 PWH and 2,738 PWoH receiving HIV prevention and other services. 99% of PWH were prescribed ARVs with 91% viral suppression (VS). Services were provided through 3 clinics servicing 20 counties and supported through RW Funding Parts A/B. A Doxy-PrEP/PEP SOP was established in meeting the request of the population PIHC serves.
Methods
A Doxy-PrEP/PEP SOP was drafted April 2023 based on current literature and active utilization within the US and included Syphilis testing along with Gonorrhea/Chlamydia 3-site testing. A provider assessment was required prior to any Doxy refill and all materials were provided in English & Spanish. This SOP was created prior to the release of official CDC guidelines August, 2024. Data was collected from June 1, 2023 through May 31, 2024 for the 3 PIHC clinic sites and collected via the Cerner (EMR) Advanced Reporting System, which integrates data from the SPM-Specialty PM Application.
Results
- PWH were prescribed ART (100%) and PWoH were prescribed HIV-PrEP (99.22%)
- HIV-PrEP included Descovy™, Truvada™ or Apretude™
- Zero HIV-PrEP patients HIV seroconverted while on Doxy-PrEP
- 2 (1.2%) HIV-PrEP patients HIV seroconverted while on Doxy-PEP
- PWH viral suppression (VS) for Doxy-PrEP & PEP for the study period included:
Doxy-PrEP Doxy-PEP
Decatur 99.17% 97.76%
Duluth 79.43% 97.31%
Marietta 80.13% 97.50%
- Overall HIV VS for the last 3 study months for all sites included Doxy-PrEP: 95.1% & Doxy-PEP: 95.8%
- Overall, PWoH had fewer positive STI tests
Conclusions
- Need data on other preventative measures utilized by Doxy-PrEP/PEP clients as a part of a comprehensive sexual plan
- Need data on missed appointments and missed/late Doxy pharmacy pick-up
- Need to compare 2023/2024 study data with the next study period (2024/2025) in assessing STI case rates
- Need updated data on Gonorrhea Doxy resistance in the Atlanta metropolitan area
- PIHC had no resistant cases of gonorrhea during the review period
