Correlates of Linkage to HIV Preexposure Prophylaxis Among HIV-Testing Clients
BACKGROUND:Publicly funded HIV-testing sites can identify HIV preexposure prophylaxis (PrEP) candidates and provide PrEP linkage. SETTING:Harris Health Systemʼs HIV clinic, HIV-testing program, and HIV-prevention program (HPP) in Houston, TX, a high HIV-incidence city. METHODS:A prospective assessme...
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| Veröffentlicht in: | Journal of acquired immune deficiency syndromes (1999) 2018-04, Vol.77 (4), p.365-372 |
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| container_title | Journal of acquired immune deficiency syndromes (1999) |
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| creator | Flash, Charlene A Adegboyega, Oluwatobi O Yu, Xiaoying Avalos, Carmen Johnson, Syundai Mayer, Kenneth H Giordano, Thomas P |
| description | BACKGROUND:Publicly funded HIV-testing sites can identify HIV preexposure prophylaxis (PrEP) candidates and provide PrEP linkage.
SETTING:Harris Health Systemʼs HIV clinic, HIV-testing program, and HIV-prevention program (HPP) in Houston, TX, a high HIV-incidence city.
METHODS:A prospective assessment of individuals aged 18 years and older recruited from walk-in HIV testing from December 2013 to April 2015 included risk assessment, HIV testing, and self-administered survey, with follow-up surveys at 6 and 12 months and medical record review.
RESULTS:The mean age of our sample (n = 300) was 38.3 ± 11.7 years. Men constituted 63.1% of the sample and 53.7% were black non-Hispanic, 26.3% Hispanic, and 14.7% white non-Hispanic. Most were uninsured (63.5%). Only 27% always used condoms, although 67% perceived personal HIV risk. Of 300 participants, 64 (21.3%) linked to PrEP care and 49 (16.3%) took PrEP. In multivariable analysis, compared with heterosexual men, women [adjusted OR (aOR) 4.1, 95% CI1.5 to 11.1] and MSM (aOR 10.2, 95% CI3.4 to 31.0) were more likely to attend HPP and to take PrEP (aOR 3.0, 95% CI1.6 to 15.1 and 3.0, 95% CI1.1 to 8.3, respectively). Serodiscordance and PrEP interest correlated with program attendance (aOR 14.0, 95% CI6.1 to 32.3 and aOR 6.7, 95% CI1.8 to 25.4) and taking PrEP (aOR 13.1, 95% CI5.2 to 32.8 and 14.4, 95% CI1.8 to 166.9), respectively.
CONCLUSIONS:Preexposure prophylaxis interest, being female or MSM, and serodiscordance correlated with PrEP linkage. Safety-net health systems can facilitate PrEP access in marginalized populations, but the PrEP initiation rates remain low. |
| doi_str_mv | 10.1097/QAI.0000000000001605 |
| format | Article |
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SETTING:Harris Health Systemʼs HIV clinic, HIV-testing program, and HIV-prevention program (HPP) in Houston, TX, a high HIV-incidence city.
METHODS:A prospective assessment of individuals aged 18 years and older recruited from walk-in HIV testing from December 2013 to April 2015 included risk assessment, HIV testing, and self-administered survey, with follow-up surveys at 6 and 12 months and medical record review.
RESULTS:The mean age of our sample (n = 300) was 38.3 ± 11.7 years. Men constituted 63.1% of the sample and 53.7% were black non-Hispanic, 26.3% Hispanic, and 14.7% white non-Hispanic. Most were uninsured (63.5%). Only 27% always used condoms, although 67% perceived personal HIV risk. Of 300 participants, 64 (21.3%) linked to PrEP care and 49 (16.3%) took PrEP. In multivariable analysis, compared with heterosexual men, women [adjusted OR (aOR) 4.1, 95% CI1.5 to 11.1] and MSM (aOR 10.2, 95% CI3.4 to 31.0) were more likely to attend HPP and to take PrEP (aOR 3.0, 95% CI1.6 to 15.1 and 3.0, 95% CI1.1 to 8.3, respectively). Serodiscordance and PrEP interest correlated with program attendance (aOR 14.0, 95% CI6.1 to 32.3 and aOR 6.7, 95% CI1.8 to 25.4) and taking PrEP (aOR 13.1, 95% CI5.2 to 32.8 and 14.4, 95% CI1.8 to 166.9), respectively.
CONCLUSIONS:Preexposure prophylaxis interest, being female or MSM, and serodiscordance correlated with PrEP linkage. Safety-net health systems can facilitate PrEP access in marginalized populations, but the PrEP initiation rates remain low.</description><identifier>ISSN: 1525-4135</identifier><identifier>EISSN: 1944-7884</identifier><identifier>DOI: 10.1097/QAI.0000000000001605</identifier><identifier>PMID: 29474256</identifier><language>eng</language><publisher>United States: Copyright Wolters Kluwer Health, Inc. All rights reserved</publisher><subject>Adolescent ; Adult ; Aged ; Condoms ; Correlation ; Disease prevention ; Disease Transmission, Infectious - prevention & control ; Ethnicity ; Female ; Health Knowledge, Attitudes, Practice ; Health risk assessment ; Health risks ; HIV ; HIV Infections - prevention & control ; Human immunodeficiency virus ; Humans ; Male ; Medical tests ; Middle Aged ; Patient Acceptance of Health Care ; Polls & surveys ; Pre-Exposure Prophylaxis ; Prophylaxis ; Prospective Studies ; Risk assessment ; Risk perception ; Texas ; Young Adult</subject><ispartof>Journal of acquired immune deficiency syndromes (1999), 2018-04, Vol.77 (4), p.365-372</ispartof><rights>Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.</rights><rights>Copyright Lippincott Williams & Wilkins Ovid Technologies Apr 1, 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4264-c724569a392846df0f022ea6188a83cfb7b7c0c1cf8550d55aa63fbec9e4c0cf3</citedby><cites>FETCH-LOGICAL-c4264-c724569a392846df0f022ea6188a83cfb7b7c0c1cf8550d55aa63fbec9e4c0cf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf><![CDATA[$$Uhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&PDF=y&D=ovft&AN=00126334-201804010-00004$$EPDF$$P50$$Gwolterskluwer$$H]]></linktopdf><linktohtml>$$Uhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=n&CSC=Y&PAGE=fulltext&D=ovft&AN=00126334-201804010-00004$$EHTML$$P50$$Gwolterskluwer$$H</linktohtml><link.rule.ids>315,781,785,4610,27926,27927,64668,65463</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29474256$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Flash, Charlene A</creatorcontrib><creatorcontrib>Adegboyega, Oluwatobi O</creatorcontrib><creatorcontrib>Yu, Xiaoying</creatorcontrib><creatorcontrib>Avalos, Carmen</creatorcontrib><creatorcontrib>Johnson, Syundai</creatorcontrib><creatorcontrib>Mayer, Kenneth H</creatorcontrib><creatorcontrib>Giordano, Thomas P</creatorcontrib><title>Correlates of Linkage to HIV Preexposure Prophylaxis Among HIV-Testing Clients</title><title>Journal of acquired immune deficiency syndromes (1999)</title><addtitle>J Acquir Immune Defic Syndr</addtitle><description>BACKGROUND:Publicly funded HIV-testing sites can identify HIV preexposure prophylaxis (PrEP) candidates and provide PrEP linkage.
SETTING:Harris Health Systemʼs HIV clinic, HIV-testing program, and HIV-prevention program (HPP) in Houston, TX, a high HIV-incidence city.
METHODS:A prospective assessment of individuals aged 18 years and older recruited from walk-in HIV testing from December 2013 to April 2015 included risk assessment, HIV testing, and self-administered survey, with follow-up surveys at 6 and 12 months and medical record review.
RESULTS:The mean age of our sample (n = 300) was 38.3 ± 11.7 years. Men constituted 63.1% of the sample and 53.7% were black non-Hispanic, 26.3% Hispanic, and 14.7% white non-Hispanic. Most were uninsured (63.5%). Only 27% always used condoms, although 67% perceived personal HIV risk. Of 300 participants, 64 (21.3%) linked to PrEP care and 49 (16.3%) took PrEP. In multivariable analysis, compared with heterosexual men, women [adjusted OR (aOR) 4.1, 95% CI1.5 to 11.1] and MSM (aOR 10.2, 95% CI3.4 to 31.0) were more likely to attend HPP and to take PrEP (aOR 3.0, 95% CI1.6 to 15.1 and 3.0, 95% CI1.1 to 8.3, respectively). Serodiscordance and PrEP interest correlated with program attendance (aOR 14.0, 95% CI6.1 to 32.3 and aOR 6.7, 95% CI1.8 to 25.4) and taking PrEP (aOR 13.1, 95% CI5.2 to 32.8 and 14.4, 95% CI1.8 to 166.9), respectively.
CONCLUSIONS:Preexposure prophylaxis interest, being female or MSM, and serodiscordance correlated with PrEP linkage. Safety-net health systems can facilitate PrEP access in marginalized populations, but the PrEP initiation rates remain low.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Condoms</subject><subject>Correlation</subject><subject>Disease prevention</subject><subject>Disease Transmission, Infectious - prevention & control</subject><subject>Ethnicity</subject><subject>Female</subject><subject>Health Knowledge, Attitudes, Practice</subject><subject>Health risk assessment</subject><subject>Health risks</subject><subject>HIV</subject><subject>HIV Infections - prevention & control</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Male</subject><subject>Medical tests</subject><subject>Middle Aged</subject><subject>Patient Acceptance of Health Care</subject><subject>Polls & surveys</subject><subject>Pre-Exposure Prophylaxis</subject><subject>Prophylaxis</subject><subject>Prospective Studies</subject><subject>Risk assessment</subject><subject>Risk perception</subject><subject>Texas</subject><subject>Young Adult</subject><issn>1525-4135</issn><issn>1944-7884</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkF1rFDEUhoNY-mX_gciAN95MPUlOMpnLZal2YdEK1dshmz3pTpudrMkMbf-9WdqqNBDyEp7zcHgZe8_hnEPbfP4xW5zDf4drUG_YMW8R68YYfFuyEqpGLtURO8n5ds8gtofsSLTYoFD6mH2bx5Qo2JFyFX217Ic7e0PVGKvLxa_qKhE97GKeEpUcd5vHYB_6XM22cbjZE_U15bEveR56Gsb8jh14GzKdPb-n7OeXi-v5Zb38_nUxny1rh0Jj7RqBSrdWtsKgXnvwIARZzY2xRjq_alaNA8edN0rBWilrtfQrci1h-ffylH168u5S_D2VHbptnx2FYAeKU-4EQNOaRhss6MdX6G2c0lC2K5SQCFBuofCJcinmnMh3u9RvbXrsOHT7vrvSd_e67zL24Vk-rba0_jv0UvA_730MI6V8F6Z7St2GbBg3xceFlhJrAdwAAod6r0b5BwRsiQI</recordid><startdate>20180401</startdate><enddate>20180401</enddate><creator>Flash, Charlene A</creator><creator>Adegboyega, Oluwatobi O</creator><creator>Yu, Xiaoying</creator><creator>Avalos, Carmen</creator><creator>Johnson, Syundai</creator><creator>Mayer, Kenneth H</creator><creator>Giordano, Thomas P</creator><general>Copyright Wolters Kluwer Health, Inc. All rights reserved</general><general>Lippincott Williams & Wilkins Ovid Technologies</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T2</scope><scope>7T5</scope><scope>7TK</scope><scope>7U7</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20180401</creationdate><title>Correlates of Linkage to HIV Preexposure Prophylaxis Among HIV-Testing Clients</title><author>Flash, Charlene A ; Adegboyega, Oluwatobi O ; Yu, Xiaoying ; Avalos, Carmen ; Johnson, Syundai ; Mayer, Kenneth H ; Giordano, Thomas P</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4264-c724569a392846df0f022ea6188a83cfb7b7c0c1cf8550d55aa63fbec9e4c0cf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Condoms</topic><topic>Correlation</topic><topic>Disease prevention</topic><topic>Disease Transmission, Infectious - prevention & control</topic><topic>Ethnicity</topic><topic>Female</topic><topic>Health Knowledge, Attitudes, Practice</topic><topic>Health risk assessment</topic><topic>Health risks</topic><topic>HIV</topic><topic>HIV Infections - prevention & control</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Male</topic><topic>Medical tests</topic><topic>Middle Aged</topic><topic>Patient Acceptance of Health Care</topic><topic>Polls & surveys</topic><topic>Pre-Exposure Prophylaxis</topic><topic>Prophylaxis</topic><topic>Prospective Studies</topic><topic>Risk assessment</topic><topic>Risk perception</topic><topic>Texas</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Flash, Charlene A</creatorcontrib><creatorcontrib>Adegboyega, Oluwatobi O</creatorcontrib><creatorcontrib>Yu, Xiaoying</creatorcontrib><creatorcontrib>Avalos, Carmen</creatorcontrib><creatorcontrib>Johnson, Syundai</creatorcontrib><creatorcontrib>Mayer, Kenneth H</creatorcontrib><creatorcontrib>Giordano, Thomas P</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of acquired immune deficiency syndromes (1999)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Flash, Charlene A</au><au>Adegboyega, Oluwatobi O</au><au>Yu, Xiaoying</au><au>Avalos, Carmen</au><au>Johnson, Syundai</au><au>Mayer, Kenneth H</au><au>Giordano, Thomas P</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Correlates of Linkage to HIV Preexposure Prophylaxis Among HIV-Testing Clients</atitle><jtitle>Journal of acquired immune deficiency syndromes (1999)</jtitle><addtitle>J Acquir Immune Defic Syndr</addtitle><date>2018-04-01</date><risdate>2018</risdate><volume>77</volume><issue>4</issue><spage>365</spage><epage>372</epage><pages>365-372</pages><issn>1525-4135</issn><eissn>1944-7884</eissn><abstract>BACKGROUND:Publicly funded HIV-testing sites can identify HIV preexposure prophylaxis (PrEP) candidates and provide PrEP linkage.
SETTING:Harris Health Systemʼs HIV clinic, HIV-testing program, and HIV-prevention program (HPP) in Houston, TX, a high HIV-incidence city.
METHODS:A prospective assessment of individuals aged 18 years and older recruited from walk-in HIV testing from December 2013 to April 2015 included risk assessment, HIV testing, and self-administered survey, with follow-up surveys at 6 and 12 months and medical record review.
RESULTS:The mean age of our sample (n = 300) was 38.3 ± 11.7 years. Men constituted 63.1% of the sample and 53.7% were black non-Hispanic, 26.3% Hispanic, and 14.7% white non-Hispanic. Most were uninsured (63.5%). Only 27% always used condoms, although 67% perceived personal HIV risk. Of 300 participants, 64 (21.3%) linked to PrEP care and 49 (16.3%) took PrEP. In multivariable analysis, compared with heterosexual men, women [adjusted OR (aOR) 4.1, 95% CI1.5 to 11.1] and MSM (aOR 10.2, 95% CI3.4 to 31.0) were more likely to attend HPP and to take PrEP (aOR 3.0, 95% CI1.6 to 15.1 and 3.0, 95% CI1.1 to 8.3, respectively). Serodiscordance and PrEP interest correlated with program attendance (aOR 14.0, 95% CI6.1 to 32.3 and aOR 6.7, 95% CI1.8 to 25.4) and taking PrEP (aOR 13.1, 95% CI5.2 to 32.8 and 14.4, 95% CI1.8 to 166.9), respectively.
CONCLUSIONS:Preexposure prophylaxis interest, being female or MSM, and serodiscordance correlated with PrEP linkage. Safety-net health systems can facilitate PrEP access in marginalized populations, but the PrEP initiation rates remain low.</abstract><cop>United States</cop><pub>Copyright Wolters Kluwer Health, Inc. All rights reserved</pub><pmid>29474256</pmid><doi>10.1097/QAI.0000000000001605</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Aged Condoms Correlation Disease prevention Disease Transmission, Infectious - prevention & control Ethnicity Female Health Knowledge, Attitudes, Practice Health risk assessment Health risks HIV HIV Infections - prevention & control Human immunodeficiency virus Humans Male Medical tests Middle Aged Patient Acceptance of Health Care Polls & surveys Pre-Exposure Prophylaxis Prophylaxis Prospective Studies Risk assessment Risk perception Texas Young Adult |
| title | Correlates of Linkage to HIV Preexposure Prophylaxis Among HIV-Testing Clients |
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