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1291. Assessing Uptake of HIV Pre-Exposure Prophylaxis (PrEP) Among High-risk Demographics in a Community-Based Clinic in Brooklyn

BACKGROUND: PrEP is a proven, effective means of preventing HIV. Uptake in groups at highest risk of HIV, such as Black men who have sex with men (MSM) and Hispanics, has been disproportionately low nationwide. We analyzed the demographics of PrEP patients in the STAR Health Center in East Flatbush,...

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Autores principales: Marryshow, Terry, Ojeda-Martinez, Hector, Stefanov, Dimitre
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6252555/
http://dx.doi.org/10.1093/ofid/ofy210.1124
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author Marryshow, Terry
Ojeda-Martinez, Hector
Stefanov, Dimitre
author_facet Marryshow, Terry
Ojeda-Martinez, Hector
Stefanov, Dimitre
author_sort Marryshow, Terry
collection PubMed
description BACKGROUND: PrEP is a proven, effective means of preventing HIV. Uptake in groups at highest risk of HIV, such as Black men who have sex with men (MSM) and Hispanics, has been disproportionately low nationwide. We analyzed the demographics of PrEP patients in the STAR Health Center in East Flatbush, Brooklyn (BK) to assess our effectiveness in PrEP uptake and retention among at-risk groups. METHODS: We performed a retrospective analysis of 134 consecutive patients who enrolled in our clinic for PrEP between June 2016 and December 2017. We assessed risk factors, demographics, insurance status, location, and retention in care. Retention was defined as completing medical visits within 3 months of prior visit. We compared demographics, sexual practices, and locations of our patients to those among new HIV diagnoses in BK, as reported by NYC Department of Health’s 2016 surveillance report. Fisher’s exact test was used to detect differences in gender, race, and sexual practices. RESULTS: Only 11.94% of those enrolled in our clinic and prescribed PrEP were women, compared with 27.19% of BK new HIV diagnoses (P < 0.005). There was no statistically significant difference in race, and distributions were similar between the two groups. There was a higher proportion of MSM among those prescribed PrEP (71.64%) compared with BK new HIV diagnoses (46.64%) (P < 0.005). Retention rates were low, with female gender (6/16, 37.5%) and White race (12/32, 37.5%) having the lowest retention in care, compared with Hispanic patients (13/21, 61.90%) who had highest retention. 41.04% of PrEP patients were uninsured. ZIP codes with highest HIV incidence per NYC Department of Health surveillance report were well represented in our clinic for PrEP. CONCLUSION: In STAR, PrEP uptake was similar across race and location when compared with people who newly acquired HIV. There was a larger proportion of individuals known to be MSM among those prescribed PrEP. This study shows that STAR’s efforts at targeting at-risk groups are reaching the appropriate demographics. However, there was a detectable disparity in PrEP uptake in women. Research into further interventions to increase PrEP access for women and improve retention overall is needed. Nevertheless, STAR’s program presents a model to follow for other areas with disparities in PrEP uptake among at-risk groups. DISCLOSURES: All authors: No reported disclosures.
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spelling pubmed-62525552018-11-28 1291. Assessing Uptake of HIV Pre-Exposure Prophylaxis (PrEP) Among High-risk Demographics in a Community-Based Clinic in Brooklyn Marryshow, Terry Ojeda-Martinez, Hector Stefanov, Dimitre Open Forum Infect Dis Abstracts BACKGROUND: PrEP is a proven, effective means of preventing HIV. Uptake in groups at highest risk of HIV, such as Black men who have sex with men (MSM) and Hispanics, has been disproportionately low nationwide. We analyzed the demographics of PrEP patients in the STAR Health Center in East Flatbush, Brooklyn (BK) to assess our effectiveness in PrEP uptake and retention among at-risk groups. METHODS: We performed a retrospective analysis of 134 consecutive patients who enrolled in our clinic for PrEP between June 2016 and December 2017. We assessed risk factors, demographics, insurance status, location, and retention in care. Retention was defined as completing medical visits within 3 months of prior visit. We compared demographics, sexual practices, and locations of our patients to those among new HIV diagnoses in BK, as reported by NYC Department of Health’s 2016 surveillance report. Fisher’s exact test was used to detect differences in gender, race, and sexual practices. RESULTS: Only 11.94% of those enrolled in our clinic and prescribed PrEP were women, compared with 27.19% of BK new HIV diagnoses (P < 0.005). There was no statistically significant difference in race, and distributions were similar between the two groups. There was a higher proportion of MSM among those prescribed PrEP (71.64%) compared with BK new HIV diagnoses (46.64%) (P < 0.005). Retention rates were low, with female gender (6/16, 37.5%) and White race (12/32, 37.5%) having the lowest retention in care, compared with Hispanic patients (13/21, 61.90%) who had highest retention. 41.04% of PrEP patients were uninsured. ZIP codes with highest HIV incidence per NYC Department of Health surveillance report were well represented in our clinic for PrEP. CONCLUSION: In STAR, PrEP uptake was similar across race and location when compared with people who newly acquired HIV. There was a larger proportion of individuals known to be MSM among those prescribed PrEP. This study shows that STAR’s efforts at targeting at-risk groups are reaching the appropriate demographics. However, there was a detectable disparity in PrEP uptake in women. Research into further interventions to increase PrEP access for women and improve retention overall is needed. Nevertheless, STAR’s program presents a model to follow for other areas with disparities in PrEP uptake among at-risk groups. DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2018-11-26 /pmc/articles/PMC6252555/ http://dx.doi.org/10.1093/ofid/ofy210.1124 Text en © The Author(s) 2018. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Marryshow, Terry
Ojeda-Martinez, Hector
Stefanov, Dimitre
1291. Assessing Uptake of HIV Pre-Exposure Prophylaxis (PrEP) Among High-risk Demographics in a Community-Based Clinic in Brooklyn
title 1291. Assessing Uptake of HIV Pre-Exposure Prophylaxis (PrEP) Among High-risk Demographics in a Community-Based Clinic in Brooklyn
title_full 1291. Assessing Uptake of HIV Pre-Exposure Prophylaxis (PrEP) Among High-risk Demographics in a Community-Based Clinic in Brooklyn
title_fullStr 1291. Assessing Uptake of HIV Pre-Exposure Prophylaxis (PrEP) Among High-risk Demographics in a Community-Based Clinic in Brooklyn
title_full_unstemmed 1291. Assessing Uptake of HIV Pre-Exposure Prophylaxis (PrEP) Among High-risk Demographics in a Community-Based Clinic in Brooklyn
title_short 1291. Assessing Uptake of HIV Pre-Exposure Prophylaxis (PrEP) Among High-risk Demographics in a Community-Based Clinic in Brooklyn
title_sort 1291. assessing uptake of hiv pre-exposure prophylaxis (prep) among high-risk demographics in a community-based clinic in brooklyn
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6252555/
http://dx.doi.org/10.1093/ofid/ofy210.1124
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