P-312. Improving Utilization of PrEP Across Internal Medicine Resident Clinics

TL;DR

This study aimed to improve PrEP use and HIV screening in resident clinics through education, but PrEP prescriptions did not increase significantly.

Contribution

The study introduced targeted educational interventions to improve resident comfort and knowledge in discussing PrEP and sexual health.

Findings

Resident comfort with sexual history-taking increased from 37% to 50%.

Confidence in discussing or prescribing PrEP improved, with discomfort dropping from 69% to 28.6%.

Educational posters were found helpful by half of the residents in guiding sexual health conversations.

Abstract

The United States Preventive Services Task Force (USPSTF) recommends HIV screening for all adults and annual testing for those at higher risk, including men who have sex with men, individuals with STIs, injection drug users, and those engaging in transactional sex. Pre-exposure prophylaxis (PrEP), endorsed by the CDC, is a highly effective prevention method. Expanding PrEP education is crucial to reducing HIV transmission, improving health literacy, and addressing access disparities, especially among minorities and women. We aimed to increase HIV risk factor screening and appropriate PrEP prescription in the Internal Medicine resident clinic by 15% over a 3-month period.Image 1Educational posters in the clinic summarizing screening guidelinesFigure 1The pre- and post-intervention survey results (1)

Educational posters in the clinic summarizing screening guidelines

The pre- and post-intervention survey results (1)

We reviewed 60 patient charts in the clinic to identify PrEP eligibility and current PrEP use. A pre-intervention survey assessed residents’ baseline knowledge, comfort with sexual history-taking, and experience prescribing PrEP. Based on survey results and feedback from residents, social workers, and infectious disease specialists, we developed targeted interventions: educational posters in the clinic summarizing screening guidelines, PrEP options, labs, and follow-up needs; and a self-directed PowerPoint module with a post-module questionnaire to assess knowledge gains.Figure 2The pre- and post-intervention survey results (2)Figure 3The pre- and post-intervention survey results (3)

The pre- and post-intervention survey results (2)

The pre- and post-intervention survey results (3)

At baseline, 33.3% of eligible patients were offered PrEP. The pre-intervention survey noted that 37% felt comfortable taking a sexual history, 80% had never prescribed PrEP, and 69% lacked confidence in discussing or prescribing it. After the intervention, the rate of PrEP offers to eligible patients remained at 33.3%. However, resident-reported comfort with sexual history-taking rose to 50%, and 28.6% reported prescribing PrEP. Confidence in discussing or prescribing PrEP improved, with only 28.6% of residents still reporting discomfort. Half of the residents also found the posters helpful in guiding conversations around sexual health and PrEP.

There was not a significant increase in the rates of HIV PrEP prescription in the resident clinic over the course of a 3-month period. However, this project helped residents become comfortable discussing sexual health and PrEP in the clinic setting.

All Authors: No reported disclosures

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