Feasibility of Emergency Department-Initiated HIV Pre-Exposure Prophylaxis

Area of Science:

• Public Health
• Infectious Diseases
• Health Equity

Background:

• Pre-exposure prophylaxis (PrEP) is crucial for HIV prevention but faces challenges in uptake and racial disparities.
• The emergency department (ED) presents a potential setting for PrEP delivery to high-risk populations.
• Previous ED PrEP initiatives have been limited by cost or success.

Purpose of the Study:

• To explore the needs and views of multidisciplinary clinicians regarding the feasibility of initiating PrEP in the ED.
• To identify operational and patient-level considerations for an ED-based PrEP program.
• To assess clinician perspectives on the potential impact of ED-initiated PrEP.

Main Methods:

• Conducted 22 semi-structured interviews with clinicians from an urban, safety-net ED and an on-site HIV clinic.
• Utilized thematic analysis to identify challenges and solutions for ED PrEP workflows.

Main Results:

• Clinicians identified operational challenges in busy EDs and highlighted the need for support.
• Patient-level considerations included complex psychosocial needs of individuals eligible for PrEP.
• Participants anticipated positive impacts of ED-based PrEP initiation on individual and public health.

Conclusions:

• Multidisciplinary clinician input is vital for designing effective ED-initiated PrEP workflows.
• Enthusiasm from both ED and HIV clinicians suggests potential for successful implementation.
• Leveraging the ED can create an innovative entry point for HIV prevention services.