Gaps in Preexposure Prophylaxis Uptake for HIV Prevention in the Veterans Health Administration

Overview

Journal Am J Public Health

Specialty Public Health

Date 2018 Nov 2

PMID 30383417

Citations 12

Authors

Will Garner

Brigid M Wilson

Lauren Beste

Marissa Maier

Michael E Ohl

Puja Van Epps

Affiliations

Soon will be listed here.

Abstract

Objectives: To report demographics, regional variations, and indications for preexposure prophylaxis (PrEP) use for HIV prevention in the Veterans Health Administration (VHA).

Methods: We identified persons initiating tenofovir/emtricitabine for the PrEP indication in the United States between July 2012 and April 2016 in a VHA national database. We stratified PrEP use by provider type and VHA region. We calculated PrEP initiation rate for each region with VHA population data.

Results: Of the 825 persons who initiated PrEP during the observation period, 67% were White and 76% were men who have sex with men. People who inject drugs and transgender persons represented less than 1% each of the cohort. The majority of PrEP initiations were clustered in 3 states, leading with California (28%) followed by Florida (9%) and Texas (8%). The Southeast had one of the lowest PrEP rates at 10 PrEP initiations per 100 000 persons in care. Infectious disease specialists issued more than two thirds of index PrEP prescriptions.

Conclusions: Uptake of PrEP in the VHA is uneven along geographic and risk categories. Understanding the reasons behind these gaps will be key in expanding the use of this important prevention tool.

Citing Articles

"I Heard of PrEP-I Didn't Think I Needed it." Understanding the Formation of HIV Risk Perception Among People Who Inject Drugs.

Mars S, Ondocsin J, Koester K, Mars V, Mars G, Ciccarone D Cult Med Psychiatry. 2024; 48(4):747-767.

PMID: 39007986 PMC: 11570555. DOI: 10.1007/s11013-024-09870-8.

'The High Five Club': Social Relations and Perspectives on HIV-Related Stigma During an HIV Outbreak in West Virginia.

Mars S, Koester K, Ondocsin J, Mars V, Mars G, Ciccarone D Cult Med Psychiatry. 2022; 47(2):329-349.

PMID: 35199277 PMC: 8865492. DOI: 10.1007/s11013-022-09769-2.

Pharmacy-Based Interventions to Increase Use of HIV Pre-exposure Prophylaxis in the United States: A Scoping Review.

Zhao A, Dangerfield 2nd D, Nunn A, Patel R, Farley J, Ugoji C AIDS Behav. 2021; 26(5):1377-1392.

PMID: 34669062 PMC: 8527816. DOI: 10.1007/s10461-021-03494-4.

Association between HIV PrEP indications and use in a national sexual network study of US men who have sex with men.

Weiss K, Prasad P, Sanchez T, Goodreau S, Jenness S J Int AIDS Soc. 2021; 24(10):e25826.

PMID: 34605174 PMC: 8488229. DOI: 10.1002/jia2.25826.

Discussion and Initiation of HIV Pre-exposure Prophylaxis Were Rare Following Diagnoses of Sexually Transmitted Infections Among Veterans.

Kobayashi T, Van Epps P, Maier M, Beste L, Beck B, Alexander B J Gen Intern Med. 2021; 37(10):2482-2488.

PMID: 34341917 PMC: 9360206. DOI: 10.1007/s11606-021-07034-7.

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