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Improving the PrEP care continuum: a program evaluation
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Louis-Jacques, Carmel. Improving the PrEP care continuum: a program evaluation. Retrieved from https://doi.org/doi:10.7282/t3-1eae-4p02

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TitleImproving the PrEP care continuum: a program evaluation
NameLouis-Jacques, Carmel (author); Kwong, Jeffrey (chair); Rutgers University; School of Nursing - RBHS
Date Created2021
Other Date2021-05 (degree)
SubjectPrEP care, Family Nurse Practitioner
Extent1 online resource (68 pages)
DescriptionBackground: Nearly 30 years after the initial cases of human immunodeficiency virus in the United States, the Food and Drug Administration (FDA) approved the first drug for the prevention of sexually acquired HIV. Although robust evidence supports the use of Pre-exposure Prophylaxis (PrEP) in high-risk populations only 12% of this population have received PrEP (CDC, 2020).

Purpose: The overall aim of this quality improvement (QI) project was to evaluate the impact of a PrEP program in an urban community based sexual health clinic serving an ethnically diverse population.

Method: A retrospective chart review of all patients enrolled in the health center’s PrEP program between 2019-2020 was conducted. A total of 92 charts were reviewed. Data retrieved was analyzed using descriptive statistics. Findings identified barriers to care and recommendations to improve the efficacy of the program on the patient, provider and stakeholder level were offered to the clinic.

Results: Data analyzed found that of the 92 patients eligible for PrEP, 90 were enrolled in the PrEP program. Most participants were Hispanic males aged 31 to 40 years old. Adherence to the recommended follow-up visits decreased with time. At the 3-month visit, 72 of the original 90 patients kept their appointment. This number decreased to 58, 56 and 53 patients at the 6-,9-,12- month follow up appointment, respectively. Regarding sexually transmitted infections (STIs), 68 patients were diagnosed with other STIs. Discontinuation was relatively low, with 19% of participants discontinuing PrEP. One patient relocated and followed up at a different clinic and one patient declined PrEP. Reasons for discontinuing PrEP were not identified per the charts reviewed for the remaining patients.

Implication for practice: This project served as a benchmark for evaluating future PrEP programs. The findings of this QI project set forth recommendations to improve adherence to PrEP and in turn lessen the incidence of HIV. Such recommendations include expanding the demographic data to include patients, gender and preferred sexual orientation; the use of EMR or Patient Portal reminders; interactive text messages, and patient reminders; use of telehealth and telemedicine; and addressing patients where they are in terms of other life circumstances. It is imperative for stakeholders to have a thorough understanding of the facilitators and barriers to PrEP. By doing so, they will maximize its benefits while potential PrEP candidates will be enrolled and retained in care.
NoteDNP
NoteIncludes bibliographical references
Genretheses, ETD doctoral
Persistent URLhttps://doi.org/doi:10.7282/t3-1eae-4p02
LanguageEnglish
CollectionSchool of Nursing (RBHS) DNP Projects
Organization NameRutgers, The State University of New Jersey
RightsThe author owns the copyright to this work.
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