Open AccessCapturing missed HIV pre-exposure prophylaxis opportunities—sexually transmitted infection diagnoses in the emergency department
Author(s) -
Stephanie E. McLaughlin,
Farzana Kapadia,
Richard E. Greene,
Robert F. Pitts
Publication year - 2021
Publication title -
international journal of std and aids
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.673
H-Index - 74
eISSN - 1758-1052
pISSN - 0956-4624
DOI - 10.1177/09564624211048671
Subject(s) - medicine , emergency department , gonorrhea , chlamydia , syphilis , sexually transmitted disease , human immunodeficiency virus (hiv) , emergency medicine , pre exposure prophylaxis , men who have sex with men , pediatrics , family medicine , immunology , psychiatry
The United States Centers for Disease Control and Prevention (CDC) recommends HIV pre-exposure prophylaxis (PrEP) be considered for all patients diagnosed with a sexually transmitted infection (STI). Emergency departments (EDs) are an important site for diagnosis and treatment of STIs for under-served populations. Consequently, we identified 377 patients diagnosed with a bacterial sexually transmitted infection (gonorrhea, chlamydia, and/or syphilis) at a major New York City emergency department between 1/1/2014 and 7/30/2017 to examine associations between key sociodemographic characteristics and missed opportunities for PrEP provision. In this sample, 299 (79%) emergency department patients missed their medical follow-up 90 days after STI diagnosis, as recommended. Results from adjusted generalized estimating equation regression models indicate that patients >45 yo (aOR = 2.2, 95% CI 1.2-3.9) and those with a primary care provider in the hospital system (aOR = 6.8, 95% CI 3.8-12.0) were more likely to return for follow-up visits, whereas Black patients (aOR = 0.44, 95% CI 0.25-0.77) were less likely to return for follow-up visits. These findings indicate that lack of STI treatment follow-up visits are significantly missed opportunities for PrEP provision and comprehensive human immunodeficiency virus prevention care.