Capturing missed HIV pre-exposure prophylaxis opportunities—sexually transmitted infection diagnoses in the emergency department

Stephanie E. Mclaughlin, Farzana Kapadia, Richard E. Greene, Robert Pitts

Research output: Contribution to journalArticlepeer-review

Abstract

The United States Centers for Disease Control and Prevention (CDC) recommends HIV pre-exposure prophylaxis (PrEP) be considered for all patients diagnosed with a sexually transmitted infection (STI). Emergency departments (EDs) are an important site for diagnosis and treatment of STIs for under-served populations. Consequently, we identified 377 patients diagnosed with a bacterial sexually transmitted infection (gonorrhea, chlamydia, and/or syphilis) at a major New York City emergency department between 1/1/2014 and 7/30/2017 to examine associations between key sociodemographic characteristics and missed opportunities for PrEP provision. In this sample, 299 (79%) emergency department patients missed their medical follow-up 90 days after STI diagnosis, as recommended. Results from adjusted generalized estimating equation regression models indicate that patients >45 yo (aOR = 2.2, 95% CI 1.2–3.9) and those with a primary care provider in the hospital system (aOR = 6.8, 95% CI 3.8–12.0) were more likely to return for follow-up visits, whereas Black patients (aOR = 0.44, 95% CI 0.25–0.77) were less likely to return for follow-up visits. These findings indicate that lack of STI treatment follow-up visits are significantly missed opportunities for PrEP provision and comprehensive human immunodeficiency virus prevention care.

Original languageEnglish (US)
JournalInternational Journal of STD and AIDS
DOIs
StateAccepted/In press - 2021

Keywords

  • HIV (human immunodeficiency virus)
  • location
  • North America
  • other
  • prevention
  • viral disease

ASJC Scopus subject areas

  • Dermatology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases
  • Pharmacology (medical)

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