Integrating HIV Pre-Exposure Prophylaxis into Family Planning Care: A RE-AIM Framework Evaluation

Area of Science:

• Public Health
• Infectious Disease Prevention
• Reproductive Health

Background:

• Family planning settings are crucial for reaching women of reproductive age.
• Integrating HIV prevention services, such as pre-exposure prophylaxis (PrEP), into these settings can improve access.
• High HIV prevalence necessitates innovative service delivery models.

Purpose of the Study:

• To evaluate the feasibility of integrating HIV prevention services, including PrEP, into a family planning clinic.
• To assess the reach, adoption, implementation, and maintenance of PrEP services using the RE-AIM Framework.
• To identify facilitators and barriers to integrating PrEP into routine family planning care.

Main Methods:

• A 6-month pilot integration of HIV prevention services into a family planning clinic.
• Staff training on HIV PrEP and assessment of knowledge/comfort.
• Chart review to determine screening, eligibility, and initiation rates for PrEP.
• Qualitative interviews with staff to identify barriers and facilitators.
• RE-AIM Framework utilized for comprehensive evaluation.

Main Results:

• 50% of clinical encounters included HIV counseling and PrEP screening, increasing from 10% to 65% over 6 months.
• 98.4% of screened patients were eligible for PrEP, and 6% initiated PrEP.
• Staff knowledge and comfort discussing PrEP significantly improved post-training.

Conclusions:

• Embedding HIV prevention services, including PrEP, into family planning settings is feasible.
• The integration led to a rapid increase in PrEP screening and uptake.
• Addressing barriers like competing priorities and insurance issues is key for sustained implementation.