Safety net family planning (FP) clinics provide vital care for women in high HIV-burden areas and may be ideal pre-exposure prophylaxis (PrEP) delivery sites. Yet, many FP providers lack knowledge about PrEP.
Four safety net FP clinics in Atlanta, Georgia.
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.
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.
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.
aRollins School of Public Health, Emory University, Atlanta, GA;
bDivision of Family Planning, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA; and
cDivision of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA.
Correspondence to: Jessica M. Sales, PhD, Department of Behavioral Sciences and Health Education, Emory University, Rollins School of Public Health, 1518 Clifton Road, Room 570, Atlanta, GA 30322 (e-mail: firstname.lastname@example.org).
Support for this research was provided to J. M. Sales by an Investigator Sponsored Grant from Gilead Sciences, Inc. (CO-US-276-4060). A. N. Sheth also receives grant funding from Gilead Sciences. A. N. Sheth receives funding from the National Institutes of Health (K23AI114407). L. B. Haddad's effort is supported by the National Institutes of Health (K23HD078153).
Presented in part at: International AIDS Conference; July 25, 2018; Amsterdam, the Netherlands. Forum on Family Planning; October 21, 2018; New Orleans, LA.
The authors have no conflicts of interest to disclose.
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Received November 08, 2018
Accepted March 18, 2019