PrEP Is Underutilized in Emergency Department Settings

Despite approximately a third of patients who present to the emergency department (ED) being eligible for pre-exposure prophylaxis (PrEP) for HIV, few of these patients initiate treatment.

Researchers conducted a systematic review to identify PrEP eligibility in the ED and examined various outcomes along the PrEP care continuum. Among the outcomes measured were awareness of PrEP, interest in PrEP use, linkage to treatment, initiation of treatment, and retention of treatment.

Included were four databases, which included PrEP-related studies from January 1, 2013 to January 27, 2022. Study characteristics and outcomes identified 218 articles, of which 7 met inclusion criteria.

A modified quality assessment tool by the Effective Public Health Practice Project was used to examine study quality. Most studies identified patients who were eligible for PrEP based off the 2017 CDC PrEP guidelines; however, the number and time frame for each criterion varied between studies.

The results indicated that in the six studies that included these outcomes, there was a relatively high prevalence of awareness and interest in PrEP but a very low prevalence of linkage and uptake. Retention in PrEP treatment was not examined in any of the included studies.

“Although up to a third of patients in ED assessed in the current study were PrEP eligible, less than half of PrEP-eligible participants had prior knowledge of PrEP, and very few who expressed interest in the ED were ultimately linked to PrEP treatment or initiated,” the researchers concluded. “Future research is necessary to identify strategies to increase PrEP education, interest, and linkage to care from the ED.”

—Leigh Precopio

Reference:

Gormley MA, Nagy TR, Moschella P, Lu Z, Rodriguez J, Roth P. HIV preexposure prophylaxis in the emergency department: a systematic review. Ann Emerg Med. Published online September 15, 2022. https://www.annemergmed.com/article/S0196-0644(22)00516-9/fulltext