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HIV PrEP implementation: A multi-level systems approach.

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This summary is machine-generated.

Payment assistance and co-located services significantly increased uptake of pre-exposure prophylaxis (PrEP) for men who have sex with men and transgender people. These findings highlight the need for comprehensive support systems in PrEP programs.

Keywords:
HIV preventionParticipatory evaluationPrEP

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Area of Science:

  • Public Health
  • HIV Prevention
  • Health Services Research

Background:

  • Pre-exposure prophylaxis (PrEP) is a critical tool for HIV prevention.
  • Access to PrEP can be limited by socioeconomic factors.
  • Demonstration projects are vital for understanding effective PrEP delivery models.

Purpose of the Study:

  • To evaluate the CO-PrIDE demonstration project aimed at increasing PrEP access for men who have sex with men and transgender individuals.
  • To identify key services and structural factors associated with PrEP uptake.
  • To understand barriers and facilitators to PrEP uptake in the Denver/Aurora area.

Main Methods:

  • A three-year demonstration project (CO-PrIDE) was implemented.
  • A participatory mixed-methods evaluation was conducted.
  • Analysis focused on services like payment assistance, insurance navigation, and healthcare navigation.

Main Results:

  • Clients receiving payment assistance were significantly more likely to accept a PrEP prescription (aPR = 3.52).
  • A co-located model, where clinical providers are situated with PrEP navigators, increased PrEP prescription likelihood (aPR = 3.78).
  • 10,129 clients were screened for PrEP between January 2016 and December 2018.

Conclusions:

  • Co-location of navigation and clinical services is a primary factor in increasing PrEP uptake.
  • Providing navigation to payment assistance programs significantly boosts PrEP acceptance.
  • Sustainable PrEP programs require a multi-level framework incorporating diverse support services.