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Integration of Oral HIV Pre-Exposure Prophylaxis into Ambulatory Reproductive Care for Cisgender Women: A Scoping Review and Development of an Evidence-Based Implementation Strategy

Butler, Sharlay K. (2021) Integration of Oral HIV Pre-Exposure Prophylaxis into Ambulatory Reproductive Care for Cisgender Women: A Scoping Review and Development of an Evidence-Based Implementation Strategy. Master Essay, University of Pittsburgh.

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Abstract

Public Health Significance:
Pre-Exposure Prophylaxis (PrEP) is a daily antiretroviral medication to prevent HIV. 20% of new US HIV diagnoses are among women. Although PrEP has been available since 2012, less than 5% of PrEP users are women. Barriers to PrEP use include poor risk assessment by women’s health providers, lack of PrEP knowledge among women, and lack of PrEP familiarity among women’s health providers. Obstetrician-gynecologists (OB/GYNs) are uniquely positioned to assess women’s HIV acquisition risk and increase PrEP utilization.

Objectives:
To describe the development of a clinical protocol and provider education series for PrEP delivery in an ambulatory OB/GYN setting.

Methods:
An implementation strategy for PrEP delivery was designed based on an informal institutional asset assessment. An evidence-based PrEP protocol was developed with stakeholder engagement. Provider knowledge/familiarity with PrEP was identified as a key barrier to PrEP access and a multi-modal, interactive lecture series was developed in partnership with local community and national HIV/AIDS organizations.

Results:
A clinical protocol was distributed. Women’s health provider education sessions were held. Studies monitoring the proportion of PrEP prescriptions filled before and after implementation are ongoing. Demographic data, including reason for initiating and/or discontinuing PrEP will be described.

Discussion:
There is little data on implementation of PrEP delivery among OB/GYNs. OB/GYNs are uniquely positioned to increase access and utilization of PrEP among women at risk for HIV acquisition. This evidence-based implementation strategy may provide a model that can be adapted to other women’s health ambulatory settings and reduce disparities in PrEP use among women.


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Details

Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Butler, Sharlay K.butlersk@upmc.edushb1190000-0002-3164-4592
Contributors:
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairFrank, Lindafrankie@pitt.edufrankieUNSPECIFIED
Committee MemberBunge, Katherinebungke@upmc.eduUNSPECIFIEDUNSPECIFIED
Date: 12 May 2021
Date Type: Completion
Submission Date: 30 April 2021
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 80
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Infectious Diseases and Microbiology
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Uncontrolled Keywords: HIV Pre-Exposure Prophylaxis; Obstetrics and Gynecology; PrEP Implementation strategy; HIV prevention
Date Deposited: 12 May 2021 15:52
Last Modified: 12 May 2021 15:52
URI: http://d-scholarship.pitt.edu/id/eprint/40977

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