TY  - BOOK
AU  - Lotke, Pamela S
AU  - Scott, Rachel K
AU  - Ye, Peggy P
TI  - Integrating HIV Pre-Exposure Prophylaxis into Family Planning Care: A RE-AIM Framework Evaluation
SN  - 1087-2914
PY  - 2020///
KW  - *Anti-HIV Agents/ad [Administration & Dosage]
KW  - *Delivery of Health Care, Integrated/og [Organization & Administration]
KW  - *Family Planning Services/sn [Statistics & Numerical Data]
KW  - *HIV Infections/pc [Prevention & Control]
KW  - *Mass Screening/sn [Statistics & Numerical Data]
KW  - *Pre-Exposure Prophylaxis/mt [Methods]
KW  - Adult
KW  - Ambulatory Care Facilities
KW  - Anti-HIV Agents/tu [Therapeutic Use]
KW  - Cohort Studies
KW  - Counseling
KW  - Family Planning Services/og [Organization & Administration]
KW  - Female
KW  - HIV Infections/dt [Drug Therapy]
KW  - Humans
KW  - Prospective Studies
KW  - Sex Education
KW  - Sexual Partners
KW  - MedStar Health Research Institute
KW  - MedStar Washington Hospital Center
KW  - Obstetrics and Gynecology
KW  - Obstetrics and Gynecology/Family Planning
KW  - Journal Article
N2  - We aimed to systematically evaluate the feasibility of integrating HIV prevention services, including pre-exposure prophylaxis (PrEP), into a family  planning setting in a high-prevalence community. We used the RE-AIM Framework (Reach, Efficacy, Adoption, Implementation, Maintenance) to evaluate the  integration of HIV prevention services into a family planning clinic over 6 months. Before the integration, PrEP was not offered. We implemented a staff  training program on HIV PrEP. We determined the proportion of women presenting to the clinic who were screened, eligible for, and initiated PrEP through  chart review. We assessed staff comfort with PrEP pre- and post-integration. We compared planned and actual implementation, interviewed staff to determine  barriers and facilitators, and tracked systems adaptations. We assessed maintenance of PrEP after the study concluded. There were 640 clinical encounters  for 515 patients; the rate of HIV counseling and PrEP screening was 50%. The rate was 10% in month 1 and peaked to 65% in month 3. Nearly all screened  patients were eligible for PrEP (98.4%) and 15 patients (6%) initiated PrEP. Staff knowledge and comfort discussing PrEP improved after education.  Facilitators included partnering with local experts, continuing education, clinical tools for providers, and patient education materials. Barriers included  competing priorities during clinical encounters, limited woman-centered patient education materials, and insurance-related barriers. Embedding HIV  prevention services in the family planning setting was feasible in this pilot. The proportion of women screened for PrEP rapidly increased. In this high HIV  prevalence community, nearly all screened women were eligible and 6% initiated PrEP
UR  - https://dx.doi.org/10.1089/apc.2020.0004
ER  -