Getting to Implementation for HIV Pre-Exposure Prophylaxis (GTI-PrEP): A data-driven approach to PrEP prescribing

Area of Science:

• Implementation Science
• Public Health
• HIV Prevention

Background:

• Pre-Exposure Prophylaxis (PrEP) is highly effective in preventing HIV but remains under-prescribed, especially in high-incidence communities.
• Existing interventions have had limited success in addressing disparities in PrEP access and uptake.

Purpose of the Study:

• To identify implementation strategies associated with increased PrEP prescribing rates.
• To pilot a tailored intervention, the Getting to Implementation (GTI)-PrEP playbook, to improve PrEP uptake.

Main Methods:

• A survey of Veterans Affairs (VA) clinicians assessed implementation strategy use (2019-2021).
• Correlational analyses and interviews identified effective strategies, which were manualized into the GTI-PrEP playbook.
• The playbook was pilot-tested at a VA facility with high HIV incidence and low PrEP prescribing.

Main Results:

• Eight implementation strategies were significantly associated with higher PrEP prescribing.
• These include networking, clinician education, clinical support tools, telehealth, and pharmacist involvement.
• The pilot study resulted in a 363% increase in PrEP prescribing among Black Veterans within one year.

Conclusions:

• A core set of effective implementation strategies for increasing PrEP prescribing has been identified.
• The GTI-PrEP playbook offers a data-driven method to enhance PrEP prescribing and reduce racial disparities in HIV prevention.