1287. PrEP-Engaged or PrEP Curious?: A Characterization and Comparison of Initial PrEP Appointment Attenders vs. Nonattenders

Abstract

BackgroundHuman immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP), with adequate adherence, is highly effective prevention of HIV-1 infection amongst high-risk individuals. While over 1 million individuals are PrEP-eligible in the U.S., those at highest risk for HIV, specifically young non-white men who have sex with men (MSM), represent some of the least penetrated groups to benefit from PrEP. No published data exists to characterize individuals with unattended initial PrEP appointments.MethodsOur program, a Ryan White funded HIV clinic that also provides Hepatitis C and PrEP care, prospectively collected demographic data on all patients with an attended initial PrEP appointment between November 2015 and March 2019. We retrospectively abstracted the same data for individuals with unattended initial PrEP appointments (including cancelations and no shows) during the same period. Descriptive statistical analyses used rank-sum tests for skewed data (age) and Chi-squared tests for categorical data (all other variables).Results33% (34/103) of all individuals did not attend an initial appointment (table). Younger age and nonprivate insurance were the 2 sociodemographic variables that were significantly associated with unattended vs. attended initial appointments. Amongst those whose HIV risk factors were known, MSM were more likely to attend their appointment compared with non-MSM. 77% (26/34) of individuals with unattended initial appointments did not reschedule (figure). Notably, 12% (4/34) PrEP-eligible individuals previously presented to the clinic yet did not re-present for dedicated PrEP evaluation.ConclusionA significant proportion of individuals schedule but do not attend initial PrEP appointments. This cohort, particularly younger patients and those with nonprivate insurance, represents a distinct population - with a “near” yet incomplete engagement in care – for whom HIV prevention efforts and concerted outreach should be focused. Same day, rapid PrEP starts deserve serious consideration in order to capitalize on patient engagement when the opportunity presents. The paucity of data highlights the need for research of those who are PrEP-interested but not fully PrEP-engaged. Disclosures All authors: No reported disclosures.