Purpose

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.

Results

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).

Conclusions

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.

中文翻译：

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HIV PrEP 实施：多层次系统方法

目的

CO-PrIDE 是一个为期三年的暴露前预防 (PrEP) 示范项目，旨在增加丹佛/奥罗拉都会统计区男男性行为者和跨性别者获得 PrEP 的机会。CO-PrIDE 实施了一个多层次的框架，以卫生系统和社区组织之间的合作为特色，将客户与 PrEP 处方者联系起来，并提供旨在帮助客户克服社会经济障碍的支持服务。这些服务包括支付协助、保险导航和医疗保健导航。CO-PrIDE 实施了参与式混合方法评估，以了解与 PrEP 吸收相关的服务。

结果

从 2016 年 1 月到 2018 年 12 月，导航员筛选了 10,129 名客户进行 PrEP 并提供支持服务。结果表明，接受付款援助的客户更有可能接受 PrEP 处方（aPR = 3.52，p < .0001）。此外，客户更有可能通过同地卫生系统模型获得 PrEP 处方，这意味着临床提供者位于 PrEP Navigator (aPR = 3.78, p < .001)。

结论

与 PrEP 吸收增加相关的主要因素包括导航和临床 PrEP 服务的协同定位以及为支付援助计划提供导航。评估结果表明，需要一个包含多种支持服务的多层次框架来实施可持续的 PrEP 计划。