Pre-exposure prophylaxis prescribing and retention in care among heterosexual women at a community-based comprehensive sexual health clinic

Oni J. Blackstock, Viraj V. Patel, Uriel R. Felsen, Connie Park, Sachin Jain

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

In the United States, heterosexual women account for 20% of new HIV infections. As a user-controlled HIV prevention method, pre-exposure prophylaxis (PrEP) has substantial potential to reduce new infections among women. However, among women, PrEP is vastly underutilized. To guide efforts to increase women-at-risk’s PrEP use, we sought to describe the characteristics of women prescribed PrEP as well as their retention in PrEP care. We conducted a chart review of women who received care at a comprehensive sexual health clinic within a large urban health care system. Referral sources included the health care system’s clinics and HIV testing program, as well as local community-based organizations. From 1 December 2014 to 5 August 2016, 554 women received care at the clinic. During this period, 21 heterosexual women (3.8%) received at least one prescription for daily oral PrEP. For women prescribed PrEP, median age was 35 years old (range: 20–52). The majority (66.7%) were either Latina or non-Latina Black and most (81.2%) had public health insurance. The most common PrEP indication was being in a known sero-discordant partnership (85.7%). Of women in such partnerships, 83.3% reported their male partner was currently taking antiretroviral medications (ARVs) and 16.7% reported trying to conceive with their partner (not mutually exclusive). Of women with ARV-using partners, 66.7% reported that their partners were virally suppressed. Retention in PrEP care at three months was 61.1% and, at six months, 37.5%. Further study is necessary to expand PrEP to women whose risk factors extend beyond being in a known sero-discordant partnership, and to understand the reasons for the observed drop-off in PrEP care visits in real-world settings.

Original languageEnglish (US)
Pages (from-to)866-869
Number of pages4
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Volume29
Issue number7
DOIs
StatePublished - Jul 3 2017

Fingerprint

prophylaxis
Heterosexuality
Reproductive Health
health
community
Pre-Exposure Prophylaxis
medication
HIV
health care
Urban Health
Delivery of Health Care
Health Insurance
Hispanic Americans
health insurance
HIV Infections
Prescriptions
indication
Referral and Consultation
Public Health
public health

Keywords

  • antiretroviral agents
  • HIV
  • PrEP
  • primary prevention
  • women

ASJC Scopus subject areas

  • Health(social science)
  • Social Psychology
  • Public Health, Environmental and Occupational Health

Cite this

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title = "Pre-exposure prophylaxis prescribing and retention in care among heterosexual women at a community-based comprehensive sexual health clinic",
abstract = "In the United States, heterosexual women account for 20{\%} of new HIV infections. As a user-controlled HIV prevention method, pre-exposure prophylaxis (PrEP) has substantial potential to reduce new infections among women. However, among women, PrEP is vastly underutilized. To guide efforts to increase women-at-risk’s PrEP use, we sought to describe the characteristics of women prescribed PrEP as well as their retention in PrEP care. We conducted a chart review of women who received care at a comprehensive sexual health clinic within a large urban health care system. Referral sources included the health care system’s clinics and HIV testing program, as well as local community-based organizations. From 1 December 2014 to 5 August 2016, 554 women received care at the clinic. During this period, 21 heterosexual women (3.8{\%}) received at least one prescription for daily oral PrEP. For women prescribed PrEP, median age was 35 years old (range: 20–52). The majority (66.7{\%}) were either Latina or non-Latina Black and most (81.2{\%}) had public health insurance. The most common PrEP indication was being in a known sero-discordant partnership (85.7{\%}). Of women in such partnerships, 83.3{\%} reported their male partner was currently taking antiretroviral medications (ARVs) and 16.7{\%} reported trying to conceive with their partner (not mutually exclusive). Of women with ARV-using partners, 66.7{\%} reported that their partners were virally suppressed. Retention in PrEP care at three months was 61.1{\%} and, at six months, 37.5{\%}. Further study is necessary to expand PrEP to women whose risk factors extend beyond being in a known sero-discordant partnership, and to understand the reasons for the observed drop-off in PrEP care visits in real-world settings.",
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