P062 Accessing the prep population: what is the best service model?

Abstract

IntroductionPre-Exposure Prophylaxis (PrEP) is effective to prevent HIV infections. Optimal service models for delivering this intervention are as yet unclear. We looked at our dedicated PrEP clinic in East London to identify who was accessing our service.MethodsRetrospective case note review collected demographics, PrEP use, STI rates and ‘chem’ use from January to November 2016. Data was analysed with STATA.Results116 visits from 54 patients were returned with a median age 42 years (IQR 32 – 44.5). 90% were white. Of these 54 patients, only 27 started PrEP and engaged in care. For our population, there were lower than expected rates of STI’s (6% for CT and 9% for GC – any site) and a median of 4 partners in the preceding 90 days; much lower than encountered in the PROUD trial. 40% (21/54) had used ‘chems’ at some point, with 21% (4/21) of those ‘slamming’ (using intravenously) in the last 3 months. Routine urinalysis showed 30% abnormalities, but no subsequent abnormal uPCR.DiscussionAs the interest and use of PrEP grows, new service models may have to be developed to accommodate this population. We saw varying levels of engagement with patients who were predominantly white with low sexual risk. Young MSM were also underrepresented. Engagement with BME and MSM communities, along with drug services, may be needed to inform effective delivery of this intervention to those most at risk.