P-308. Understanding Recruitment into a Long-acting Injectable Pre-exposure Prophylaxis Trial: Lessons Learned to Enhance Equity and Optimize Engagement of Underserved Groups

TL;DR

This study examines how to better recruit underserved groups into a trial for long-acting HIV prevention injections to improve equity in access.

Contribution

The paper provides insights into recruitment strategies and disparities in enrollment for LAI-PrEP among marginalized populations.

Findings

EquiPrEP achieved enrollment goals by race/ethnicity but underrepresented cisgender women and transgender/non-binary individuals.

Recruitment efforts disproportionately reached L/G/B and bisexual individuals compared to PrEP-eligible patients.

Barriers remain for equitable engagement of female/cisgender and TG/NB participants in LAI-PrEP trials.

Abstract

Inequitable uptake of pre-exposure prophylaxis (PrEP), including long-acting injectable PrEP (LAI-PrEP), persists among Black or Hispanic/Latine cisgender men who have sex with men (BLMSM) and cisgender women (BLCGW), and transgender or non-binary (TGNB) persons. Here we describe recruitment efforts and evaluate their success at optimizing representation of these groups in a LAI-PrEP implementation study.Figure 1:Comparison Patients Eligible for PrEP and Those Recruited for EquiPrEP, an Equity-based, LAI-PrEP Implementation project, NYC, NY, 2023-2024.

Comparison Patients Eligible for PrEP and Those Recruited for EquiPrEP, an Equity-based, LAI-PrEP Implementation project, NYC, NY, 2023-2024.

EquiPrEP is an implementation study of uptake and adherence to LAI-PrEP in BLMSM, BLCGW, and TGNB who were >/= 18yo and HIV-seronegative conducted at a municipal hospital in New York City. Hospital-based recruitment and enrollment was conducted between 2/2023-6/2024. Descriptive statistics were employed to compare EquiPrEP recruitment and enrollment to patients who were identified as PrEP-eligible during the same period, using CDC criteria for PrEP eligibility.

During the EquiPrEP study period, n=205 patients were screened for eligibility and n=129 were enrolled with the goal of equally enrolling one-third of participants in each group. A total of n=2856 patients were identified as PrEP-eligible during the same time-period. Comparisons of these eligible to those screened and enrolled in EquiPrEP identified differences by sexual orientation and gender identity. Specifically, participants screened for EquiPrEP consisted of a greater proportion of persons who identified as L/G/B (46.8% vs 5.6%), bisexual (18% vs. 2.2%), cisgender men (55.1% vs. 20.2%), TG (9.8% and 3.4% vs. 0.6% and 0.1%). Further, compared to those eligible (72.6%), only 26.8% of cisgender women were screened for EquiPrEP. Finally, the proportions of patients PrEP eligible compared to those enrolled were comparable across all race/ethnicities. Comparisons between those screened vs. enrolled indicate similar reach.

EquiPrEP enrollment goals for recruitment and enrollment by race/ethnicity were achieved, reflecting local demographic characteristics of this hospital setting. However, additional work to eliminate barriers to enrollment among female/cisgender and TG/NB are still required in order to optimize equitable engagement in LAI-PrEP for all people who can benefit from this HIV prevention strategy.

Emma Kaplan-Lewis, MD, gilead: Grant/Research Support Ofole Mgbako, MD, MS, Gilead Sciences: Advisor/Consultant Robert Pitts, MD MPH, Gilead Inc: Advisor/Consultant|ViiV: Advisor/Consultant

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