Jen Chapman, Co-Chair of the Philadelphia HIV Prevention Planning Group (HPG) presented an update from the 10th annual International HIV Treatment, Prevention, and Adherence conference at the July 2015 HPG meeting.

1. PREP UPDATE
(PART 1)
FROM THE 10TH INTERNATIONAL HIV TREATMENT AND PREVENTION ADHERENCE CONFERENCE
MIAMI, FL  JUNE 2015

2. PREP USE IN THE U.S. 2014

4. STUDY OBJECTIVE
• EXPLORE THE INCREASE OF PREP UTILIZATION BETWEEN JANUARY 1, 2012 AND MARCH 31,
2015. AN ESTIMATED 39% OF TVD PRESCRIPTIONS WERE ANALYZED FROM A NATIONAL
PRESCRIPTION DATABASE. AN ALGORITHM WAS USED TO IDENTIFY TVD FOR PREP USE IN THIS
SAMPLE.
• DE-IDENTIFIED PATIENT DATA INCLUDED:
• PRESCRIPTION REFILLS
• MEDICAL CLAIMS
• PATIENT DEMOGRAPHICS

11. PREP EFFECTS ON PRIMARY CARE, INSURANCE
STATUS & MENTAL HEALTH

12. WHAT CAN PREP DO
(in addition to preventing HIV)

13. WHAT CAN PREP DO
(in addition to preventing HIV)

14. WHAT WE KNOW & WHAT WE NEED TO DO
WE NEED TO STOP WASTING TIME REHASHING WHAT WE ALREADY KNOW AND START WORKING ON
WHAT WE ACTUALLY NEED TO FIGURE OUT.
WHAT WE KNOW WHAT WE NEED TO FIGURE OUT
Implementation/having a
program access
HOW do we truly increase access for those
that need it the most?
(hint…it’s the people who are NOT knocking on
our doors)
Targeting perpetuates racism
and stigma
How to be targeted without
fueling/perpetuating myths
We have messed up
prevention messages
How to talk about HIV prevention in a way
that breeds empowerment and joy about
sexual expression.

15. WHAT WE KNOW & WHAT WE NEED TO DO
WE NEED TO STOP WASTING TIME REHASHING WHAT WE ALREADY KNOW AND START
WORKING ON WHAT WE ACTUALLY NEED TO FIGURE OUT.
WHAT WE KNOW WHAT WE NEED TO FIGURE OUT
We have messed up prevention messages How to talk about HIV prevention in a way that
breeds empowerment and joy about sexual
expression.

16. PRIMARY CARE & HIV
PROVIDERS’ KNOWLEDGE,
ATTITUDES, AWARENESS &
EXPERICENCE OF PREP
• CROSS SECTIONAL 177-ITEM ONLINE SURVEY
• PRIMARY CARE & HIV PROVIDERS FROM 10 US
CITIES (INCLUDING 50 FROM PHILADELPHIA)
• 515 TOTAL RESPONDENTS

17. DISCUSSING SEXUAL ORIENTATION & TYPES OF SEXUAL ACTIVITY
(significant differences btw groups (p<0.001)

18. SCREENING FOR HIV & ORDERING THE CORRECT HIV TEST
(significant differences btw groups (p<0.05 and p<0.001)

19. AWARENESS & FAMILIARITY WITH PREP
(significant differences btw groups (p<0.001)

20. AWARENESS & FAMILIARITY WITH PREP
(significant differences btw groups (p<0.001)

21. PREP KNOWLEDGE 8 items measured knowledge
TESTING
HIV testing
Baseline testing
Monitoring
ARVs
Number
Name
Dosing frequency
Contraindications
Cost

22. PREP EXPERIENCE

23. BARRIERS TO PRESCRIBING PREP
(% somewhat or very concerned)

24. IMPLICATIONS
PROVIDER INTERVENTIONS NEED CUSTOMIZATION
• PCP NEEDS INCLUDE KNOWLEDGE OF PREP PROCEDURES; NAVIGATING LOGISTICAL BARRIERS
• MAY BENEFIT FROM OPERATIONALIZATION MODELS
• UNCOMFORTABLE WITH ASPECTS OF SEXUAL HISTORY TAKING
• HIV PROVIDERS
• HIGH LEVELS OF PREP KNOWLEDGE AND EXPERIENCE
• CAPACITY NOT IDENTIFIED AS A BARRIER
FOR FUTURE CONSIDERATION
STUDY MODELS OF OPERATIONALIZING PREP IN VARYING SETTINGS
INCORPORATE SKILL-BUILDING INTO PREP EDUCATIONAL MATERIALS