Get2PrEP2-A Provider Messaging Strategy to Improve PrEP Uptake: A Randomized Controlled Quality Improvement Project

Jason Zucker; Delivette Castor; Deborah Theodore; Caroline Carnevale; Eshiemomoh Osilama; Norman Archer; Lily Bonadonna; Elena Wadden; Nicholas Morley; Simian Huang; Kathrine Meyers; Alwyn Cohall; Peter Gordon; Magdalena E Sobieszczyk

doi:10.1093/ofid/ofae297

Get2PrEP2-A Provider Messaging Strategy to Improve PrEP Uptake: A Randomized Controlled Quality Improvement Project

Open Forum Infect Dis. 2024 Jun 20;11(6):ofae297. doi: 10.1093/ofid/ofae297. eCollection 2024 Jun.

Authors

Jason Zucker^{1

2

3}, Delivette Castor^{1

3

4}, Deborah Theodore^{1

2

3}, Caroline Carnevale², Eshiemomoh Osilama^{1

5}, Norman Archer^{1

6}, Lily Bonadonna^{1

7}, Elena Wadden³, Nicholas Morley³, Simian Huang¹, Kathrine Meyers¹, Alwyn Cohall^{1

2

8}, Peter Gordon^{1

2

3}, Magdalena E Sobieszczyk^{1

2

3}

Affiliations

¹ Department of Medicine, Division of Infectious Diseases, Columbia University Irving Medical Center, New York, New York, USA.
² HIV Prevention Program in the Comprehensive Health Program, Ambulatory Care Network West, NewYork-Presbyterian Hospital, New York, New York, USA.
³ Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.
⁴ Department of Epidemiology, Mailman School of Public Health, New York, New York, USA.
⁵ Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA.
⁶ UCSF School of Medicine, San Francisco, California, USA.
⁷ Wayne State University School of Medicine, Detroit, Michigan, USA.
⁸ Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA.

Abstract

Introduction: HIV preexposure prophylaxis (PrEP), a key strategy for preventing HIV transmission, requires awareness and access to PrEP services. Although all patients should be made aware of HIV PrEP; the diagnosis of bacterial sexually transmitted infections (STIs) is an important indicator of potential HIV PrEP need. In a previous evaluation of Get2PrEP (G2P), we found that an electronic medical record laboratory comments did not increase the frequency of PrEP discussions between patients and providers. In Get2PrEP2 (G2P2), we hypothesized that active, personalized messaging to providers about HIV PrEP would increase the documentation of PrEP discussions, referrals, and/or provision of HIV PrEP to individuals diagnosed with an STI.

Methods: G2P2 was a parallel 3-arm, unblinded, randomized controlled design. Participants were allocated 2:1 to intervention or control. Participants in the intervention arm were further allocated to receive provider messaging through the electronic medical record chat message or e-mail.

Results: The 191 randomized encounters resulted in a modest 7.8% (odds ratio, 1.078; confidence interval, 1.02-1.13) increase in documented PrEP discussions in intervention encounters versus none in the standard care group. There was no statistical difference by intervention modality. All documented discussions occurred in the outpatient or emergency department and were more frequent in women and those aged <25 years.

Discussion: An e-mail or electronic medical record chat message sent to providers of patients testing positive for an STI had a small but significant effect on documented patient-provider PrEP discussions. Further investigation is required to determine whether provider messaging can increase PrEP uptake among eligible patients and longer-term outcomes.

Keywords: HIV Pre-exposure prophylaxis (HIV PrEP); ending the HIV epidemic; provider feedback; sexual health; sexually transmitted infections.

Publication types

Clinical Trial

Abstract

Publication types

Grants and funding