1296. Potential use of Sexually Transmitted Infection (STI) Testing for Expanding HIV Pre-Exposure Prophylaxis (PrEP) at an Urban Hospital Center
Session: Poster Abstract Session: HIV: Prevention
Friday, October 5, 2018
Room: S Poster Hall
Posters
  • id week.pdf (1017.8 kB)
  • Background:

    Despite the high efficacy of PrEP, it continues to be underutilized. We examined the extent to which patients with a documented positive test for STIs were provided PrEP at an urban municipal medical center.

    Methods:

    We reviewed data of all patients seen between 1/1/14 and 7/30/17 who were > 18 years old and had an initial HIV negative test and ≥1 positive test for Chlamydia, Gonorrhea or Syphilis. We examined PrEP prescription data by gender, race/ethnicity, and clinic location. Differences between groups were compared using Chi-squared analysis and logistic regression.

    Results:

    Of 1,142 initially HIV- patients who were identified as having a positive STI result, 52% were female, 89% either Black or Hispanic, with a median age of 40 years (quartiles 30, 47). 58% had Medicare/Medicaid and 34% were self-pay or uninsured (Table 1). Only 25 (2.1%) of 1,142 patients who had ≥1 STI test positive were prescribed PrEP. No women received PrEP. Whites (aOR: 21.7 [95% CI:4.4, 107, p<0.001] and Hispanics (aOR:6.64 [95%CI:1.35, 32.8, p=0.02] were both more likely to receive PrEP than Blacks, after adjusting for age, sex, marital status, and insurance. All PrEP prescriptions originated from the Medicine, Emergency, or HIV specialty clinics although most STI testing was obtained in Emergency and Obstetrical/Gynecological clinics (Table 2).

    Conclusion:

    There were significant missed opportunities for HIV prevention among patients with STIs within the medical center, particularly among Hispanic and Black patients. Enrichment programs to educate providers and increase PrEP prescriptions may have a major impact on expanding HIV prevention, especially for women.

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    Robert Pitts, MD1, Robert Holzman, MD, FIDSA, FSHEA2, Richard Greene, MD3, Emily Lam, BS1, Ellie Carmody, MD, MPH4 and Scott Braithwaite, MD5, (1)Infectious Diseases, New York University, New York, NY, (2)NYU Medical Center, New York, NY, (3)Medicine, New York University, New York, NY, (4)Division of Infectious Diseases and Immunology, New York University School of Medicine, New York, NY, (5)Department of Population Health, New York University, New York, NY

    Disclosures:

    R. Pitts, None

    R. Holzman, None

    R. Greene, None

    E. Lam, None

    E. Carmody, None

    S. Braithwaite, None

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