New Survey Shows Many Ceased PrEP During COVID-19 Pandemic Despite Provider Recommendations

New Survey Shows Many Ceased PrEP During COVID-19 Pandemic Despite Provider Recommendations

July 8, 2020: Data from an online survey presented this morning at the International AIDS Conference (AIDS 2020: Virtual) by the American Academy of HIV Medicine show that approximately 1/3 of respondents using pre-exposure prophylaxis (PrEP) and under a shelter-in-place order (SIPO) stopped taking their PrEP medication during the COVID-19 outbreak.  Of those stopping PrEP, 85% cited that they were not engaging in risk behaviors – mirroring the risk taking behaviors of the overall group.

The online survey, conducted in partnership with Gilead Sciences HIV Medical Affairs, sought to understand how SIPOs impacted PrEP access, use, and HIV risk behaviors among current PrEP users.  Of the 409 PrEP users surveyed, only 11 responded that an outside factor affected their ability to obtain PrEP (lost job/insurance, could not complete laboratory monitoring or HIV and STI testing, or provider was unable to refill).

When asked about their sexual behaviors during the SIPO, more than half of the respondents reported zero sexual events and zero sexual partners.  Further, 89% stated they have decreased the number of sex partners, 90% reported a decrease in the number of sex events and 88% reduced the frequency of using Apps to meet partners respectively.

The Academy also assessed the provision of care among 188 PrEP providers to understand how social distancing policies in healthcare may continue to impact PrEP delivery moving forward. Interestingly, 47% of providers reported that some of their patients had elected to stop PrEP during the SIPO, much higher than the self-reported numbers from the patient cohort. However, 89% of providers did not recommend that patients change their PrEP routines during shelter-in-place.

Considering that one in five healthcare providers encountered patients during a telehealth visit they believe to have an STI, providers believe that their patients are still engaging in risk behaviors, contrary to the patient survey where significant respondents indicated they had lowered or stopped virtually all risk activities.

Despite the closures and reduced hours of health facilities, the Centers for Disease Control and Prevention (CDC) issued a “dear colleague” letter in May 2020 stating that reducing the number of new HIV infections remains a public health priority.  They further detailed guidance on providing HIV-1 pre-exposure prophylaxis (PrEP) when facility-based services and in-person patient-clinician contact is limited.  This includes the necessity of practicing telehealth to ensure PrEP retention remains high.

“Reducing the number of new HIV transmissions and ensuring access to critical HIV prevention services must remain a public health priority during this challenging time,” said Bruce J. Packett, Executive Director of the American Academy of HIV Medicine.  “These data demonstrate the crucial role that technology-enabled care can play in helping facilitate the safe and timely delivery of critical public health services.  My hope is that clinics and HIV prevention providers can continue to adapt to changing circumstances by offering expanded use of telehealth services and other innovative tools to help meet the evolving needs of people at risk for HIV.”

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About the American Academy of HIV Medicine: The American Academy of HIV Medicine is the nation’s leading independent organization of healthcare professionals dedicated to providing excellence in HIV care and prevention. Our membership of practitioners and credentialed providers manage the health of the majority of people with and at risk for HIV in the United States.  The Academy’s mission is to ensure health care professionals have the resources needed to provide prevention, treatment and care for those living with or at risk for HIV and related conditions to achieve optimal health.

About the Surveys: Electronic convenience sample surveys of PrEP users and prescribers in the U.S. were simultaneously deployed across a 25-day period at the height of SIPO implementation. PrEP user survey link was sent via social media and PrEP advocates via snowball sample. Provider survey link was emailed to more than 2500 providers (MD/DO, PA, NP, PharmD) from the Academy’s database.