Frank Leslie, Starzyk Erin, Hoxworth Tamara, Canon Megan, McGuinness Colleen, Watkins Anita, Deem Thomas, Orozco-Pacheco Gerardo
Colorado Department of Public Health and Environment 4300 Cherry Creek South Drive, Denver, CO, 80246, United States.
Vivent Health 5250 Leetsdale Drive, Suite #300, Denver, CO, 80246, United States.
Eval Program Plann. 2022 Feb;90:101966. doi: 10.1016/j.evalprogplan.2021.101966. Epub 2021 May 30.
CO-PrIDE was a three-year Pre-Exposure Prophylaxis (PrEP) demonstration project to increase access to PrEP for men who have sex with men and transgender people in the Denver/Aurora Metropolitan Statistical Area. CO-PrIDE implemented a multi-level framework featuring collaboration between health systems and community organizations to link clients to PrEP prescribers and provide support services intended to help clients overcome socioeconomic barriers to PrEP uptake. These services included payment assistance, insurance navigation, and healthcare navigation. CO-PrIDE implemented a participatory mixed-methods evaluation to understand the services associated with PrEP uptake.
From January 2016 to December 2018, navigators screened 10,129 clients for PrEP and offered supportive services. The results indicated that clients who received payment assistance were more likely to accept a PrEP prescription (aPR = 3.52, p < .0001). Additionally, clients were more likely to receive a PrEP prescription through a co-located health system model, meaning the clinical provider is located with the PrEP Navigator (aPR = 3.78, p < .001).
The primary factors associated with increased PrEP uptake included co-location of navigation and clinical PrEP services and providing navigation to payment assistance programs. The evaluation results suggest that a multi-level framework that includes diverse support services is needed to implement a sustainable PrEP program.
CO-PrIDE是一项为期三年的暴露前预防（PrEP）示范项目，旨在增加丹佛/奥罗拉大都市统计区男男性行为者和跨性别者获得PrEP的机会。CO-PrIDE实施了一个多层次框架，其特点是卫生系统与社区组织合作，将客户与PrEP开处方者联系起来，并提供旨在帮助客户克服PrEP使用的社会经济障碍的支持服务。这些服务包括支付援助、保险咨询和医疗保健咨询。CO-PrIDE实施了一项参与性混合方法评估，以了解与PrEP使用相关的服务。
2016年1月至2018年12月，咨询员对10129名客户进行了PrEP筛查并提供了支持服务。结果表明，获得支付援助的客户更有可能接受PrEP处方（调整后风险比[aPR]=3.52，p<.0001）。此外，客户通过同址卫生系统模式更有可能获得PrEP处方，即临床提供者与PrEP咨询员在同一地点（aPR=3.78，p<.001）。
与PrEP使用增加相关的主要因素包括咨询与临床PrEP服务同址以及提供支付援助项目咨询。评估结果表明，需要一个包括多种支持服务的多层次框架来实施可持续的PrEP项目。
