PREP UPDATE(PART 1)

FROM THE 10TH INTERNATIONAL HIV TREATMENT AND PREVENTION ADHERENCE CONFERENCE

MIAMI, FL JUNE 2015

PREP USE IN THE U.S. 2014

STUDY OBJECTIVE

• EXPLORE THE INCREASE OF PREP UTILIZATION BETWEEN JANUARY 1, 2012 AND MARCH 31, 2015. AN ESTIMATED 39% OF TVD PRESCRIPTIONS WERE ANALYZED FROM A NATIONAL PRESCRIPTION DATABASE. AN ALGORITHM WAS USED TO IDENTIFY TVD FOR PREP USE IN THIS SAMPLE.

• DE-IDENTIFIED PATIENT DATA INCLUDED: • PRESCRIPTION REFILLS • MEDICAL CLAIMS • PATIENT DEMOGRAPHICS

PREP EFFECTS ON PRIMARY CARE, INSURANCE STATUS & MENTAL HEALTH

WHAT CAN PREP DO (in addition to preventing HIV)

WHAT CAN PREP DO (in addition to preventing HIV)

WHAT WE KNOW & WHAT WE NEED TO DOWE NEED TO STOP WASTING TIME REHASHING WHAT WE ALREADY KNOW AND START WORKING ON WHAT WE ACTUALLY NEED TO FIGURE OUT.

WHAT WE KNOW WHAT WE NEED TO FIGURE OUT

Implementation/having a program access

HOW do we truly increase access for those that need it the most?

(hint…it’s the people who are NOT knocking on our doors)

Targeting perpetuates racism and stigma

How to be targeted without fueling/perpetuating myths

We have messed up prevention messages

How to talk about HIV prevention in a way that breeds empowerment and joy about sexual expression.

WHAT WE KNOW & WHAT WE NEED TO DOWE NEED TO STOP WASTING TIME REHASHING WHAT WE ALREADY KNOW AND START WORKING ON WHAT WE ACTUALLY NEED TO FIGURE OUT. WHAT WE KNOW WHAT WE NEED TO FIGURE OUTWe have messed up prevention messages

How to talk about HIV prevention in a way that breeds empowerment and joy about sexual expression.

PRIMARY CARE & HIV PROVIDERS’ KNOWLEDGE, ATTITUDES, AWARENESS & EXPERICENCE OF PREP• CROSS SECTIONAL 177-ITEM ONLINE

SURVEY• PRIMARY CARE & HIV PROVIDERS FROM

10 US CITIES (INCLUDING 50 FROM PHILADELPHIA)

• 515 TOTAL RESPONDENTS

DISCUSSING SEXUAL ORIENTATION & TYPES OF SEXUAL ACTIVITY

(significant differences btw groups (p<0.001)

SCREENING FOR HIV & ORDERING THE CORRECT HIV TEST

(significant differences btw groups (p<0.05 and p<0.001)

AWARENESS & FAMILIARITY WITH PREP

(significant differences btw groups (p<0.001)

AWARENESS & FAMILIARITY WITH PREP

(significant differences btw groups (p<0.001)

PREP KNOWLEDGE 8 items measured knowledge

TESTING

HIV testing Baseline testing Monitoring

ARVs Number Name Dosing frequency Contraindications Cost

PREP EXPERIENCE

BARRIERS TO PRESCRIBING PREP(% somewhat or very concerned)

IMPLICATIONS

PROVIDER INTERVENTIONS NEED CUSTOMIZATION • PCP NEEDS INCLUDE KNOWLEDGE OF PREP PROCEDURES; NAVIGATING

LOGISTICAL BARRIERS • MAY BENEFIT FROM OPERATIONALIZATION MODELS • UNCOMFORTABLE WITH ASPECTS OF SEXUAL HISTORY TAKING

• HIV PROVIDERS • HIGH LEVELS OF PREP KNOWLEDGE AND EXPERIENCE • CAPACITY NOT IDENTIFIED AS A BARRIER

FOR FUTURE CONSIDERATIONSTUDY MODELS OF OPERATIONALIZING PREP IN VARYING SETTINGS INCORPORATE SKILL-BUILDING INTO PREP EDUCATIONAL MATERIALS