1277. Retention Among Adolescents with Mental Health Diagnoses on Pre-Exposure Prophylaxis (RAMP) Study

Abstract

BackgroundThe CDC reported in 2017 that 21% of new HIV diagnoses were composed of persons 13–24 years old. New York State (NYS) is addressing this with the Ending the Epidemic initiative, started in 2014, which emphasized pre-exposure prophylaxis (PrEP) for persons at risk of acquiring HIV. Though PrEP can effectively prevent HIV transmission, NYS minors were only granted capacity to accept PrEP in 2017. The Adolescent Medicine Trials Network found clinicians had varying perceptions on whether mental health diagnoses (MHD) were a barrier to adolescent PrEP utilization. This study aims to test the hypothesis that patients with MHD do not differ in PrEP retention length when compared with adolescents without MHD.MethodsThis is a retrospective single-center study analyzing self-reported visit data for adolescent enrolled on PrEP (n = 27) in the Capital District, NY. MHD were confirmed with clinician notes and retention to PrEP was defined as attending appointments. Between-group differences were compared using Fisher’s Exact Test (FET). Kaplan–Meier curves were compared using the log-rank test.ResultsOf the 27 adolescents enrolled on PrEP between Sep 2015-March 2019, most self-identified as males (93%), MSM (85%), white (74%), and 13 (48%) had a MH diagnosis. Anxiety was the most common MHD (69%), followed by depression (38%). The mean age was 20.3 years (16–24). The average PrEP retention for patients with and without MHD were 262±136 and 292±138 days, respectively (P = 0.575). For patients with MHD, follow-up at 1-month, 3-months and 1-year was 10 (77%), 8 (62%), and 5 (39%), respectively. For patients without MHD, follow-up at 1-month, 3-months, and 1-year was 11 (79%), 10 (71%), 5 (36%), respectively. Follow-up between adolescents with and without MHD was compared at 1-month (P = 0.086, FET), 3-months (P = 0.695, FET), and 1-year (P = 1.0, FET). Adolescents’ retention on PrEP was depicted on Kaplan–Meier curves (Figure 1). Log-rank test indicated that PrEP retention is not significantly associated with MHD (χ2(1) = 0.1, P = 0.727).ConclusionAdolescents with and without MHD did not significantly differ in PrEP retention outcomes. The RAMP study elucidates a potentially incorrect provider bias regarding PrEP retention and MHD. Future investigation should be done prospectively with larger sample size. Disclosures All authors: No reported disclosures.