A Pilot Study of a Patient Navigation Intervention to Improve HIV Pre-exposure Prophylaxis Persistence among Black/African American Men Who Have Sex with Men

Authors

• William C. Goedel, Brown University
• Cassandra Sutten Coats, Center for Health Promotion and Health Equity
• Philip A. Chan, The Warren Alpert Medical School
• Courtney E. Sims-Gomillia, University of Mississippi Medical Center
• James B. Brock, University of Mississippi School of Medicine
• Lori M. Ward, University of Mississippi Medical Center
• Leandro A. Mena, University of Mississippi Medical Center
• Amy S. Nunn, Center for Health Promotion and Health Equity

Abstract

Background:Suboptimal HIV pre-exposure prophylaxis (PrEP) care outcomes among Black/African American men who have sex with men (MSM) limits its population-level effects on HIV incidence. We conducted a pilot study of a brief patient navigation intervention aimed at improving PrEP initiation and persistence among Black/African American MSM in the Southern United States.Setting:Community health center in Jackson, MS.Methods:We recruited 60 Black/African American MSM aged 18-34 years who were newly prescribed PrEP. Participants were randomized to receive the clinic's current standard of care or an intervention condition including a single patient navigation session to discuss and address perceived barriers to initiating and maintaining access to PrEP and biweekly check-ins. Participants were followed over 6 months using survey assessments, medical chart review, and pharmacy purchase records to ascertain PrEP initiation and persistence.Results:Participants in the intervention condition were more likely to pick up their initial PrEP prescription [RR: 1.47; 95% confidence interval (CI): 1.10 to 1.97], be retained in PrEP care at 3 months (RR: 1.62; 95% CI: 1.01 to 2.59) and 6 months (RR: 1.38; 95% CI: 0.64 to 2.93), and have access to PrEP medications greater than 80% of all study days based on pharmacy fill records (RR: 3.00; 95% CI: 1.50 to 5.98).Conclusion:A brief patient navigation intervention demonstrated proof-of-concept in improving PrEP initiation and persistence among Black/African American MSM in the Southern United States.

Publication Title

Journal of Acquired Immune Deficiency Syndromes

Recommended Citation

Goedel, W., Coats, C., Chan, P., Sims-Gomillia, C., Brock, J., Ward, L., Mena, L., & Nunn, A. (2022). A Pilot Study of a Patient Navigation Intervention to Improve HIV Pre-exposure Prophylaxis Persistence among Black/African American Men Who Have Sex with Men. Journal of Acquired Immune Deficiency Syndromes, 90 (3), 276-282. https://doi.org/10.1097/QAI.0000000000002954