Utilization of an Off-Site Patient Navigator to Facilitate HIV Pre-Exposure Prophylaxis Referrals in Patients with Sexually Transmitted Infections in the Emergency Department.

Abstract

The emergency department (ED) is an important setting to identify people at increased risk of HIV infection who may benefit from HIV pre-exposure prophylaxis (PrEP). However, prescribing or referral for PrEP in the ED is not widespread. The purpose of this study is to evaluate the use of an off-site HIV PrEP patient navigator to facilitate PrEP access for patients who seek care for sexually transmitted infections (STIs) in the ED. Between January 1, 2023 and June 30, 2023, patients who tested positive for a bacterial STI in the ED were eligible for outreach by an off-site PrEP patient navigator. Interested patients were scheduled for telehealth appointments for PrEP. Demographic, clinical information and outcomes were obtained. During the study period, there were 160 patients eligible for PrEP outreach. Outreach was completed in 75 (47%) of patients, with 46/75 (61%) agreeable to scheduling a PrEP appointment. Of these 46 patients, median age was 30 years old [IQR 23, 35], 25 (54%) were male, 40 (87%) were Black/African American and 6 (13%) identified as men who have sex with men (MSM). Forty three of 46 interested patients (93%) scheduled an appointment and 35/46 (76%) completed an appointment. Thirteen of 35 (37%) patients who completed an appointment were prescribed PrEP, with 6/13 (46%) and 2/13 (15%) remaining on PrEP at 3 and 6 months, respectively. Use of an off-site patient navigator can facilitate referrals for HIV PrEP for patients who are diagnosed with bacterial STIs in the ED.