NIH Grant Funds Novel Test-to-PrEP, HIV Outreach Strategies
Article Summary
- The Mobile PrEP Clinic is using an NIH grant to further implement its “Test-to-PrEP” strategy aimed at increasing HIV testing.
- HIV rates in Miami are amongst the highest in the nation.
- Miller School researchers asked clinic patients to distribute HIV self-tests to members of their social network to increase community knowledge of pre-exposure prophylaxis (PrEP).
The National Institutes of Health recently awarded a $3.6 million grant to the Mobile PrEP Clinic at the University of Miami Miller School of Medicine to further implement its Test-to-PrEP strategy aimed at increasing HIV testing and the use of pre-exposure prophylaxis (PrEP).
With Miami-Dade County’s HIV rates amongst the highest in the nation, new efforts to increase HIV testing are imperative, especially in marginalized communities. The Mobile PrEP Clinic has partnered with the Florida Department of Health (FDOH) to use patients already enrolled in the clinic to distribute HIV self-tests to people in their social circle and raise awareness of PrEP.
“We are using these kits not only for HIV testing but also to inform people about PrEP,” said Susanne Doblecki-Lewis, M.D., chief of the Division of Infectious Diseases and director of HIV Prevention at the Miller School. “We realized that people often hear about PrEP or medical interventions from trusted friends with personal experience. This approach could encourage more people to test for HIV and consider if they might be good candidates for PrEP.”
Changing HIV Testing Strategies
Distribution kits were first made available through FDOH as a new way to engage people in HIV testing. Most recently, the FDOH distributed HIV test kits by request online. Despite some participation, the department wanted to increase its outreach. It selected Dr. Doblecki-Lewis for a solution based on their past successful collaborations.
“We began with a pilot distribution from the nearly 100 kits sent to us by the FDOH,” Dr. Doblecki-Lewis said. “Through a brief survey, we asked people enrolled in our testing programs if they were interested in distributing HIV self-test kits and if they thought they would be useful. The results were overwhelmingly enthusiastic, resulting in us giving out up to four kits to each willing patient in our clinic.”
Test-to-PrEP will follow a model of familiarity and trust. The participants handing out the kits are patients of the mobile clinic who are using PrEP and familiar with HIV testing. People who complete the test and survey receive a $15 gift card for their participation.
“This method will provide faster access in HIV testing,” said one of the clinic participants. “Not only will it be an effective option, but the social aspect will also help alleviate nerves and the gift card further boosts encouragement.”
Effective Solutions in HIV Care
During the first rollout of tests, 50 of 81 participants accepted kits. Follow-up data showed 77% of the distributors gave out at least one kit and 77% of those had meaningful discussions with thier social network while handing out the kits. Most patients involved were Latino men who have sex with men (86%). Fourteen percent were Black. Cisgender women, individuals at risk for HIV who have multiple sexual partners and people with a history of sexually transmitted infections also participated.
“Our participants liked being part of this public health initiative to try to spread HIV testing and PrEP information,” Dr. Doblecki-Lewis said. “This was a good opportunity to get that added reach into a community that doesn’t always have this access to care and let them know we are here to help.”
A Larger, Second Rollout of Kits
A second rollout soon followed, as 100 participants distributed nearly 300 kits. The clinic used a more strategic approach, asking eventual distributors about their social networks and to whom they planned to give the kits, which had QR codes that allowed the clinic to survey participants. Study outcomes will be calculated in a more formal NIH supplement study.
Forty-seven of the 100 participants in the second rollout distributed at least one kit. Of those who responded to the survey, 16.2% reported no previous HIV test and 38.5% reported no prior knowledge of PrEP.
“I thought this was an inspiring effort to reach out to these communities,” Dr. Doblecki-Lewis said. “For those who tested positive, immediate action was provided for follow-up testing and access to medication, usually on the same day. Many that received the kits ended up going on PrEP and enrolling in our clinics to continue their health journey.”
Tags: Division of Infectious Diseases, Dr. Susanne Doblecki-Lewis, HIV, HIV PrEP, HIV prevention, Infectious diseases, NIH grant