Assessing an Implementation Science Strategy to Improve PrEP Primary Care Serving Black and Latino Communities

We examined the impact of a PrEP navigation implementation strategy on care engagement at nine New York City Federally Qualified Health Centers (FQHCs) in an Ending the HIV Epidemic (EHE) jurisdiction. Between March 2021 and April 2022, FQHCs implemented the strategy, which consisted of five distinct navigation activities conducted by the Navigator (e.g., PrEP refill). We extracted electronic medical record (EMR) data on navigation services attempted/delivered, HIV prevention service delivery (e.g., HIV testing), and demographic characteristics for 303 patients prescribed PrEP and identified as eligible for navigation (27.4% Black, 48.8% Latino). We analyzed differences in HIV prevention service delivery by navigation success. Out of 303 patients, 95 (31.4%) were reached for navigation and 208 (68.6%) were not. Patients who were successfully navigated had significantly greater care engagement during the study period. In addition, patients who were successfully navigated were more likely to have had timely care engagement. There were no differences in navigation success by characteristics examined (e.g., sex in EMR, race/ethnicity, insurance coverage). The navigation service most utilized was medical appointment assistance (77.9%). Navigation appeared effective in enhancing PrEP care engagement. Although additional strategies may be needed to reach patients not successfully navigated through this implementation strategy, our work may inform researchers, policymakers, and practitioners focused on enhancing PrEP care about evaluating implementation strategies.