A Pilot Study of a Patient Navigation Intervention to Improve HIV Pre-Exposure Prophylaxis Persistence Among Black/African American Men Who Have Sex with Men

Abstract

Background: 

Suboptimal HIV pre-exposure prophylaxis (PrEP) care outcomes among Black/African American men who have sex with men (MSM) limits its population-level effects on HIV incidence. We conducted a pilot study of a brief patient navigation intervention aimed at improving PrEP initiation and persistence among Black/African American MSM in the Southern United States.

Setting: 

Community health center in Jackson, Mississippi

Methods: 

We recruited 60 Black/African American MSM aged 18 to 34 years old who were newly prescribed PrEP. Participants were randomized to receive the clinic’s current standard of care, or an intervention condition including a single patient navigation session to discuss and address perceived barriers to initiating and maintaining access to PrEP and biweekly check-ins. Participants were followed over six months using survey assessments, medical chart review, and pharmacy purchase records to ascertain PrEP initiation and persistence.

Results: 

Participants in the intervention condition were more likely to pick up their initial PrEP prescription (RR: 1.47; 95% CI: 1.10–1.97), be retained in PrEP care at three months (RR: 1.62; 95% CI: 1.01–2.59) and six months (RR: 1.38; 95% CI: 0.64–2.93), and have access to PrEP medications greater than 80% of all study days based on pharmacy fill records (RR: 3.00; 95% CI: 1.50–5.98).

Conclusion: 

A brief patient navigation intervention demonstrated proof-of-concept in improving PrEP initiation and persistence among Black/African American MSM in the Southern United States.