Akinbohun, Nicole

Flash, Charlene A.

Frost, Elizabeth L.

Giordano, Thomas P.

Rodriguez, Pete

Harvard University - DASH 

1526PrEP implementation in Houston, TXamong high-risk heterosexuals and MSMThe Harvard community has made thisarticle openly available.  Please share  howthis access benefits you. Your story mattersCitation Flash, Charlene A., Elizabeth L. Frost, Nicole Akinbohun,Pete Rodriguez, and Thomas P. Giordano. 2014. “1526PrEPimplementation in Houston, TX among high-risk heterosexualsand MSM.” Open Forum Infectious Diseases 1 (Suppl 1): S405.doi:10.1093/ofid/ofu052.1072. http://dx.doi.org/10.1093/ofid/ofu052.1072.Published Version doi:10.1093/ofid/ofu052.1072Citable link http://nrs.harvard.edu/urn-3:HUL.InstRepos:35982119Terms of Use This article was downloaded from Harvard University’s DASHrepository, and is made available under the terms and conditionsapplicable to Other Posted Material, as set forth at http://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#LAA1526. PrEP implementation in Houston, TX among high-risk heterosexualsand MSMCharlene A. Flash, MD, MPH1,2; Elizabeth L. Frost, BA1,3,4; Nicole Akinbohun5;Pete Rodriguez MD5; Thomas P. Giordano, MD, MPH6,7; 1Infectious Disease, BaylorCollege of Medicine, Houston, TX; 2Infectious Disease, Beth Israel DeaconessMedical Center/Harvard University, Boston, MA; 3Health Promotion and BehavioralSciences, University of Texas School of Public Health, Houston, TX; 4University ofHouston Graduate College of Social Work, Houston, TX; 5Harris Health System,Thomas Street Health Center, Houston, TX; 6Department of Medicine, Section ofInfectious Diseases, Baylor College of Medicine, Houston, TX; 7Health ServicesResearch and Development Center of Excellence, Michael E. Debakey VA MedicalCenter, Houston, TXSession: 196. HIV 1: Prevention StrategiesSaturday, October 11, 2014: 12:30 PMBackground. HIV pre-exposure prophylaxis (PrEP) has been proven to decreaserisk of HIV transmission; however, demonstration of effectiveness in clinical settings isneeded. A comprehensive HIV Prevention Clinic at Thomas Street Health Center(TSHC) in Houston, TX was established in July 2013, merging biomedical and behav-ioral prevention in a free-standing HIV clinic.Methods. Patients ≥18 years old presenting for conﬁdential walk-up rapid HIVtesting at TSHC who tested negative, were assessed for high-risk and, if appropriate,were invited to participate in the HIV prevention clinic, which provides counseling,condoms, and PrEP as appropriate. Retrospective chart review of clinic data assessedpatient acceptance, successful linkage to care in prevention services, and retention inpreventive services. Behavioral risk factors included sero-discordance, sexual orienta-tion, injection drug use, or having multiple sex partners.Results. Of the 477 HIV walk-up tests performed from July 2013 to May 2014, 52patients (10.9%) were deemed at the highest risk by the HIV tester, and agreed to anappointment in the HIV prevention clinic. Over half the patients (52%) were women.Twenty-three patients (44.2%) had multiple partners. Forty-ﬁve patients (86.5%) werein a serodiscordant relationship, 10 patients (19.2%) were MSM, and zero patients re-ported injection drug use. Most patients (55.8%) relied on Harris Health System pro-grams for subsidized cost of medical care and medication from pharmaceuticalassistance programs. Nine patients (17.3%) had Medicaid and 4 patients (7.7%) hadprivate insurance. Five patients (9.6%) eligible for PrEP declined the prescription.There were zero seroconversions. Two HIV positive patients were identiﬁed duringbaseline screening labs. Four patients were prescribed non occupational pre-exposureprophylaxis. In total, 36 patients (69%) attended their appointment, 19 patients (37%)completed at least one follow up appointment, and 12 patients (23%) started PrEP.Conclusion. PrEP implementation for MSM and high risk heterosexuals in con-text of comprehensive preventive services is feasible in an urban HIV clinic. Like thetreatment cascade, prevention efforts show a steep drop between patients initiallydeemed high-risk and those who are linked to and retained in care.Disclosures. C. A. Flash, Gilead Sciences: investigator initiated research grant andScientiﬁc Advisor, Consulting fee and Research grantPoster Abstracts • OFID 2014:1 (Suppl 1) • S369

1526PrEP implementation in Houston, TX among high-risk heterosexuals and MSM

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1526PrEP implementation in Houston, TX among high-risk heterosexuals and MSM

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