Pre-exposure prophylaxis (PrEP) has revolutionized the landscape of HIV transmission, effectively reducing the risk of acquisition for people considered high-risk. However, issues with uptake and access have prevented PrEP from taking off. Effective mobile PrEP services are needed to reach priority populations, such as Black and Hispanic/Latino men who have sex with men (MSM).
Researchers at the University of Miami evaluated a model involving the implementation of mobile PrEP, HIV prevention, cancer screening, and sexually transmitted infection (STI) services in four local areas with high HIV incidence where PrEP services were lacking. Their findings were presented at IDWeek 2019 .
Mobile services were offered via the Sylvester Gamechanger vehicle, staffed by a medical provider, an HIV/PrEP counselor, and a cancer educator, which returned to each site regularly. Patients were recruited through self-referrals, as well as through a campaign by Prevention305, a community organization that developed targeted patient recruitment via social media.
The data collected included normative demographics, risk behavior, STIs, and information on early maintenance care, and the services were provided free of charge.
The mobile unit served 229 clients from October 2018 to April 2019, 168 (73.7%) of whom sought PrEP. Of those PrEP clients, 125 (74.4%) identified as white/Hispanic, 6 (3.5%) as black/Hispanic, 6 (3.5%) as white/non-Hispanic, 11 (6.5%) as black/non-Hispanic, and 19 (11.3%) as other.
A total of 94.9% of PrEP clients were identified as MSM, and 6 of them (3.5%) were HIV positive at the start of the study.
“An initial PrEP prescription was completed by 166 (98.8%). Of the 77 clients seen within the first 3 months of operation and due to a follow-up evaluation, 55 (71.4%) completed a follow-up visit,” the researchers reported. “Overall, 45 (26.6%) PrEP clients had positive STI (gonorrhea, chlamydia, or syphilis) results at baseline. Nine (16.3%) clients had positive STI results at their follow-up visit.”
Researchers concluded that mobile HIV prevention services, including PrEP, are feasible and effective in engaging priority populations.
"There is a high demand for services and plans are underway to increase capacity and reach to other highly affected groups," the research team noted.
The study, PrEP On the Go! The Implementation of Mobile PrEP, STI, and HIV Prevention Services in South Florida, was presented at an oral abstract session on Saturday, October 5, 2019, at ID.
By: ALEXANDRA WARD