PREP UPDATE (PART 1) FROM THE 10 TH INTERNATIONAL HIV TREATMENT AND PREVENTION ADHERENCE CONFERENCE MIAMI, FL JUNE 2015
Jan 17, 2017
PREP UPDATE(PART 1)
FROM THE 10TH INTERNATIONAL HIV TREATMENT AND PREVENTION ADHERENCE CONFERENCE
MIAMI, FL JUNE 2015
PREP USE IN THE U.S. 2014
STUDY OBJECTIVE
• EXPLORE THE INCREASE OF PREP UTILIZATION BETWEEN JANUARY 1, 2012 AND MARCH 31, 2015. AN ESTIMATED 39% OF TVD PRESCRIPTIONS WERE ANALYZED FROM A NATIONAL PRESCRIPTION DATABASE. AN ALGORITHM WAS USED TO IDENTIFY TVD FOR PREP USE IN THIS SAMPLE.
• DE-IDENTIFIED PATIENT DATA INCLUDED: • PRESCRIPTION REFILLS • MEDICAL CLAIMS • PATIENT DEMOGRAPHICS
PREP EFFECTS ON PRIMARY CARE, INSURANCE STATUS & MENTAL HEALTH
WHAT CAN PREP DO (in addition to preventing HIV)
WHAT CAN PREP DO (in addition to preventing HIV)
WHAT WE KNOW & WHAT WE NEED TO DOWE NEED TO STOP WASTING TIME REHASHING WHAT WE ALREADY KNOW AND START WORKING ON WHAT WE ACTUALLY NEED TO FIGURE OUT.
WHAT WE KNOW WHAT WE NEED TO FIGURE OUT
Implementation/having a program access
HOW do we truly increase access for those that need it the most?
(hint…it’s the people who are NOT knocking on our doors)
Targeting perpetuates racism and stigma
How to be targeted without fueling/perpetuating myths
We have messed up prevention messages
How to talk about HIV prevention in a way that breeds empowerment and joy about sexual expression.
WHAT WE KNOW & WHAT WE NEED TO DOWE NEED TO STOP WASTING TIME REHASHING WHAT WE ALREADY KNOW AND START WORKING ON WHAT WE ACTUALLY NEED TO FIGURE OUT. WHAT WE KNOW WHAT WE NEED TO FIGURE OUTWe have messed up prevention messages
How to talk about HIV prevention in a way that breeds empowerment and joy about sexual expression.
PRIMARY CARE & HIV PROVIDERS’ KNOWLEDGE, ATTITUDES, AWARENESS & EXPERICENCE OF PREP• CROSS SECTIONAL 177-ITEM ONLINE
SURVEY• PRIMARY CARE & HIV PROVIDERS FROM
10 US CITIES (INCLUDING 50 FROM PHILADELPHIA)
• 515 TOTAL RESPONDENTS
DISCUSSING SEXUAL ORIENTATION & TYPES OF SEXUAL ACTIVITY
(significant differences btw groups (p<0.001)
SCREENING FOR HIV & ORDERING THE CORRECT HIV TEST
(significant differences btw groups (p<0.05 and p<0.001)
AWARENESS & FAMILIARITY WITH PREP
(significant differences btw groups (p<0.001)
AWARENESS & FAMILIARITY WITH PREP
(significant differences btw groups (p<0.001)
PREP KNOWLEDGE 8 items measured knowledge
TESTING
HIV testing Baseline testing Monitoring
ARVs Number Name Dosing frequency Contraindications Cost
PREP EXPERIENCE
BARRIERS TO PRESCRIBING PREP(% somewhat or very concerned)
IMPLICATIONS
PROVIDER INTERVENTIONS NEED CUSTOMIZATION • PCP NEEDS INCLUDE KNOWLEDGE OF PREP PROCEDURES; NAVIGATING
LOGISTICAL BARRIERS • MAY BENEFIT FROM OPERATIONALIZATION MODELS • UNCOMFORTABLE WITH ASPECTS OF SEXUAL HISTORY TAKING
• HIV PROVIDERS • HIGH LEVELS OF PREP KNOWLEDGE AND EXPERIENCE • CAPACITY NOT IDENTIFIED AS A BARRIER
FOR FUTURE CONSIDERATIONSTUDY MODELS OF OPERATIONALIZING PREP IN VARYING SETTINGS INCORPORATE SKILL-BUILDING INTO PREP EDUCATIONAL MATERIALS