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Immediate PrEP when accessing PEP: A service evaluation.

Beatrice Cockbain1, Gary Whitlock1,

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HIV Medicine
|March 30, 2022
PubMed
Summary
This summary is machine-generated.

Quick-start pre-exposure prophylaxis (PrEP) offered after post-exposure prophylaxis (PEP) significantly increased PrEP uptake among eligible individuals. This strategy proved acceptable and effective in a London sexual health clinic setting.

Keywords:
HIVPEPPrEPpost exposure prophylaxispre-exposure prophylaxis

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Area of Science:

  • Sexual Health
  • Infectious Disease Prevention
  • Public Health

Background:

  • Post-exposure prophylaxis (PEP) is a critical intervention for preventing HIV transmission.
  • Pre-exposure prophylaxis (PrEP) is highly effective in preventing HIV acquisition.
  • Integrating PrEP services into existing HIV prevention pathways can improve access.

Purpose of the Study:

  • To assess the uptake of quick-start opt-out pre-exposure prophylaxis (PrEP) among individuals attending for post-exposure prophylaxis (PEP).
  • To evaluate the impact of a new clinic policy offering immediate PrEP after PEP completion.
  • To compare PrEP uptake rates before and after the implementation of the quick-start opt-out PrEP strategy.

Main Methods:

  • A case note review was conducted at a London sexual health clinic.
  • Data from a 2-week period in February 2021 (after policy change) were compared to the same period in February 2020 (before policy change).
  • Service users receiving PEP were assessed for unmet PrEP need and PrEP eligibility and uptake.

Main Results:

  • While the number of PEP users decreased slightly in 2021, the proportion offered PrEP among those with unmet need increased significantly.
  • PrEP uptake among eligible individuals offered during their PEP consultation rose dramatically from 17.5% in 2020 to 53.1% in 2021 (p=0.0007).
  • The quick-start opt-out PrEP strategy demonstrated a substantial increase in service user uptake.

Conclusions:

  • The implementation of quick-start opt-out PrEP following PEP completion significantly enhanced PrEP uptake.
  • This integrated approach was found to be acceptable and effective in increasing PrEP coverage.
  • The strategy offers a promising model for improving HIV prevention service delivery.