(P302) Improved PrEP delivery among all populations during the COVID 19 pandemic in a traditional sexual health clinic

Background: The COVID-19 pandemic necessitated changes in health care delivery, including for vulnerable populations receiving pre-exposure prophylaxis (PrEP), an effective tool for HIV prevention. The traditional health department sexual health clinic delivers STI care at minimal cost and is underutilized for PrEP delivery. We hypothesized an increase in filled initial prescriptions for PrEP in one sexual health clinic setting because of pandemic related changes in care that included reducing the number of visits need to start PrEP.

Methods: We conducted a retrospective review of encounters from 8/2017 to 12/2021 where paperwork to start PrEP was initiated in the St. Louis County Sexual Health clinic. We defined encounters prior to 3/2020 as pre-pandemic and afterwards as peri-pandemic. We described patient data (age, race, gender identity, sex of sex partners, and insurance status) and analyzed encounters with the outcome of a filled prescription for PrEP pre- versus peri-pandemic using bivariate and multivariate analyses.

Results: A total of 150 patients were seen at the clinic. The mean age was 29 (IQR 25, 33) with mostly male (n=127; 84.7%), Black (n=83; 55.3%), men who have sex with men (n=79; 78.2%), uninsured (n= 82; 54.7%) patients and with overall similar findings pre- and peri-pandemic. Of the pre-pandemic PrEP encounters, 50.6% (n= 42) had initial prescriptions filled and 88.1% (n= 59) during the peri-pandemic encounters. There were no significant associations between demographic factors and filled PrEP prescriptions.

Conclusions: More encounters resulted in initial filled PrEP prescriptions peri-pandemic versus pre-pandemic (88.1% vs 50.6%). This supports the hypothesis that implementing PrEP directly in the STI clinic with reduced visits addresses the barriers of time and transportation. However, no specific population subset was more affected than others. Study limitations include small sample size and other factors concurrently affecting our population during the COVID-19 pandemic.