TAMPA, Fla. – Screening and counseling for pre-exposure prophylaxis (PrEP) for people at risk for HIV may be more effective if education and access to the prevention protocols for sexually transmitted infection (STI) testing are provided.
It comes down to numbers, said Gabriela Brito, MSN, RN, ACRN, a research scientist at the nonprofit CAN Community Health, headquartered in Sarasota, Florida. More people seek STD screening compared to those who actively seek PrEP to prevent HIV.
“One in five people will be tested and diagnosed with an STD in 2021, so we can capture a large number of people just from STD testing and direct them to PrEP programs,” Brito said. Medscape Medical News during a poster presentation here at the AIDS Nurses Association (ANAC) 2022 annual meeting. “So our initiative is pretty much about capturing people” at the point of care.
Brito reported that as of September 30, 2022, 2174 patients received PrEP services through one of 40 CAN Community Health clinics. Almost a third, 32%, were initially seen for free STD screening.
Strive for a better following
In some cases, this is not the case start people on PrEP, that is keep then on treatment over time. The study found that 61% of people were still taking the medication after 6 months.
This number may have been even lower without CAN Community Health PrEP navigation. Of the 2174 patients, 63% work with a “PrEP navigator”. These guides help people access the medication and check in with them regularly to answer questions or reasons behind non-adherence.
“If we see someone missing their appointments, our PrEP guide will start reaching out to them to see what’s going on,” said study co-author Cheryl Netherly, BSW, LPN, ACLPN, Medscape Medical News.
“It could be that they’ve moved to another area or started a mutually monogamous relationship. They don’t realize that they can continue through telehealth if they need to, because sometimes it’s hard to get out of work to go [see] the doctor,” Netherly added. “So we find ways to break those barriers.”
Needs more education
Greater awareness of PrEP is another matter. “I think it’s really important to educate people and educate professionals. It can also help reduce the stigma around PrEP,” Brito said.
An analogy is when birth control pills first came out, and some providers wouldn’t prescribe them because they were worried about women becoming promiscuous, Netherly said.
“When PrEP first came out, there was a lot of the same mindset,” Netherly added. “But PrEP doesn’t change your behavior. It just adds a layer of protection to the behavior, so you can understand how to stay healthy.”
The policy of identifying potential PrEP candidates during STD screening is “very important,” Myra L. Rutland, CPN, DNP, FNP-BC, a family nurse practitioner and director of infectious disease and community services at Spectrum Community Health Center in Philadelphia, Pennsylvania, said. when asked to comment. Rutland did not participate in the CAN Community Health study.
“This is primary care at its most basic level. Primary care means you intervene before a problem occurs,” Rutland said.
“We have great drugs. Now if patients are compliant, they’re not just mildly effective – they’re between 95% and 99% effective at preventing HIV,” she added.
The goal is to raise awareness that “if you get something sexually transmitted…that means you may have come in contact with HIV,” Rutland said. “So why not offer PrEP? I do that with all my patients.”
AIDS Nurses Association (ANAC) Annual Meeting 2022. Abstract P-10. Introduced November 17, 2022.
The study was independently supported. Brito and Rutland report no relevant financial relationships.
Damian McNamara is a staff reporter based in Miami. He covers a wide range of medical specialties, including infectious diseases, gastroenterology and emergency medicine. Follow Damian on Twitter: @MedReporter.
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