Implementation of an Educational Intervention to Improve HIV Pre-Exposure Prophylaxis Services for Women in an Urban Sexual Health Clinic

Authors

Rachel K. Scott, Department of Women's and Infants' Services, MedStar Washington Hospital Center, Division of Women's Health Research, MedStar Health Research Institute, Washington, District of Columbia, USA.
Megan Deyarmond, Georgetown University School of Medicine, Washington, District of Columbia, USA.
Shannon Marwitz, Georgetown University School of Medicine, Washington, District of Columbia, USA.
Jim C. Huang, Department of Business Management, National Sun Yat-sen University, Kaohsiung, Taiwan.
Patricia Moriarty, Division of Women's Health Research, MedStar Health Research Institute, Washington, District of Columbia, USA.
Adam J. Visconti, HIV/AIDS, Hepatitis, STD and TB Administration, DC Health, Washington, District of Columbia, USA.
Jason Beverley, HIV/AIDS, Hepatitis, STD and TB Administration, DC Health, Washington, District of Columbia, USA.
Rick Elion, HIV/AIDS, Hepatitis, STD and TB Administration, DC Health, Washington, District of Columbia, USA.
Megan Coleman, Whitman Walker Health, Washington, District of Columbia, USA.
Shawnika J. Hull, Department of Prevention and Community Medicine, George Washington University, Washington, District of Columbia, USA.

Document Type

Journal Article

Publication Date

9-1-2023

Journal

AIDS patient care and STDs

Volume

37

Issue

9

DOI

10.1089/apc.2023.0107

Keywords

HIV infections/prevention and control; PrEP; PrEP cascade; RE-AIM; anti-HIV agents; females; health services accessibility; implementation science; pre-exposure prophylaxis

Abstract

To test the hypothesis that implementation of a multicomponent, educational HIV pre-exposure prophylaxis (PrEP) intervention to promote universal PrEP services for cisgender women (subsequently "women") in sexual and reproductive health centers would improve the proportion of women screened, offered, and prescribed PrEP, we implemented a multicomponent, educational intervention in a Washington D.C. Department of Health-sponsored sexual health clinic. The clinic serves a patient population with high-potential exposure to HIV. The intervention included clinic-wide PrEP trainings, an electronic health record prompt for PrEP counseling by providers, and educational videos in the waiting room. We collected preimplementation data from March 22, 2018 to July 4, 2018, including 331 clinical encounters for 329 women. Between July 5, 2018 and July 1, 2019, there were 1733 clinical encounters for 1720 HIV-negative women. We used mixed methods to systematically assess intervention implementation using the Reach Effectiveness Adoption Implementation Maintenance framework. Additionally, we assessed the interventions' acceptability and feasibility among providers through semistructured interviews. The proportion of women screened by providers for PrEP (5.6% preimplementation to a mean of 89.2% of women during the implementation period,  < 0.01), offered (6.2 to 69.8%,  < 0.01), and prescribed PrEP (2.6 to 8.1%,  < 0.01) by providers increased significantly in the implementation period. Providers and clinic staff found the intervention both highly feasible and acceptable and demonstrated increased knowledge of PrEP and HIV prevention associated with the clinic-wide trainings. Our results demonstrate the effectiveness of a low-cost educational intervention to increase provision of integrated PrEP services in an urban sexual health clinic serving women with high-potential exposure to HIV. ClinicalTrials.gov ID NCT03705663.

APA Citation

Scott, Rachel K.; Deyarmond, Megan; Marwitz, Shannon; Huang, Jim C.; Moriarty, Patricia; Visconti, Adam J.; Beverley, Jason; Elion, Rick; Coleman, Megan; and Hull, Shawnika J., "Implementation of an Educational Intervention to Improve HIV Pre-Exposure Prophylaxis Services for Women in an Urban Sexual Health Clinic" (2023). GW Authored Works. Paper 3467.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/3467

Department

Prevention and Community Health