"Let's get PrEP'd" - A pilot service evaluation of the LVNDR health digital pre-exposure prophylaxis pathway for HIV prevention.

Abstract

Background: Despite the availability of PrEP, 2023 data have demonstrated an increase in new HIV diagnoses. LGBTQ + individuals are disproportionately affected by HIV. PrEP access is crucial but limited due to high demand on sexual health services. Additional modalities of PrEP access may help to address this unmet need. LVNDR Health, a digital solution for LGBTQ + care, sought to evaluate its PrEP pathway.

Methods: We conducted a retrospective cross-sectional service evaluation of users accessing the LVNDR digital PrEP pathway between December 2022-April 2023. Operational data (e.g., appointment attendance) were derived from the clinical dashboard. Service-user feedback (e.g., service experience) was sought using a bespoke questionnaire. Descriptive statistics are reported for socio-demographic information. Non-parametric between-group analyses are reported.

Results: In total, 90 users completed the end-to-end pathway and received PrEP. Average time for pathway completion was 2.7 weeks. A survey response rate of 71.0% was achieved. Users reported significantly higher service satisfaction, inclusivity, and accessibility, compared to their most recent experience accessing PrEP (p < .01). Up to 89% of users strongly agreed they would switch to a digital PrEP service if made available.

Conclusion: Digital PrEP shows acceptability among LGBTQ + populations. More research is needed to assess scalability, digital equity, and cost-effectiveness.