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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

Community health center in Jackson, Mississippi.

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.

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.

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).

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.

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