Impact of PrEP Training for Family Planning Providers on HIV Prevention Counseling and Patient Interest in PrEP in Atlanta, Georgia

• Type of Material: Article
• Authors: Jessica Sales, Emory University; Carrie Cwiak, Emory University; Lisa Haddad, Emory University; Ashley Phillips, Emory University; Leah Powell, Emory University; Ilyssa Tamler, Emory University; Anandi Sheth, Emory University
• Language: English
• Date: 2019-08-01
• Publisher: Lippincott Williams & Wilkins
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2019 Wolters Kluwer Health, Inc. All rights reserved.
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1097/QAI.0000000000002057
• Title of Journal or Parent Work: JAIDS-Journal of Acquired Immune Deficiency Syndromes
• Volume: 81
• Issue: 4
• Start Page: 414
• End Page: 418
• Grant/Funding Information: A. N. Sheth receives funding from the National Institutes of Health (K23AI114407).; A. N. Sheth also receives grant funding from Gilead Sciences.; L. B. Haddad’s effort is supported by the National Institutes of Health (K23HD078153).; Support for this research was provided to J. M. Sales by an Investigator Sponsored Grant from Gilead Sciences, Inc. (CO-US-276-4060).
• Keywords: Awareness; implementation; Life Sciences & Biomedicine; Science & Technology; Risk; PrEP; Acceptability; family planning; women; Attitudes; United States; Knowledge; Infectious Diseases; Womens health-care; Immunology; southern United States
• Research Categories: Sociology, Public and Social Welfare; Health Sciences, Health Care Management; Health Sciences, Public Health; Health Sciences, Immunology

Abstract

Background: Safety net family planning (FP) clinics provide vital care for women in high HIV-burden areas and may be ideal preexposure prophylaxis (PrEP) delivery sites. Yet, many FP providers lack knowledge about PrEP. Setting: Four safety net FP clinics in Atlanta, Georgia. Methods: We provided a 1.5-hour PrEP informational training for 28 providers working in these sites. To assess the training’s impact on PrEP counseling, we enrolled 500 female patients after training (47% ≤ 28 years; 69% black; 12% Hispanic) and determined their PrEP indication based on CDC guidelines. We conducted a postvisit survey to assess provider counseling and patients’ interest in PrEP and acceptance of off-site PrEP referral. Results: From pre-training to post-training, provider PrEP knowledge and confidence to identify women who may benefit from PrEP significantly increased. Only 19% of women knew about PrEP before the visit. Among 376 sexually active women, 29% had risk consistent with PrEP indication. Among PrEP-indicated women, 66% reported the provider discussed PrEP, 29% were interested in taking PrEP, but only 18% accepted off-site PrEP referral. Most (76%) were more willing to take PrEP if provided by the FP clinic. Conclusions: After a brief PrEP training, most women with HIV-risk indicators received PrEP counseling during their visits. Once counseled, women expressed interest if it were offered at the FP clinic rather than through off-site referral. Findings highlight the potential impact that PrEP capacity building within safety net FP clinics in high HIV-burden areas may have on PrEP scale-up for women.