EquiPrEP: An implementation science protocol for promoting equitable access and uptake of long-acting injectable HIV pre-exposure prophylaxis (LAI-PrEP)

• Published in: PloS one Vol. 18; no. 9; p. e0291657
• Main Authors: Kaul, Christina M, Moore, Brandi E, Kaplan-Lewis, Emma, Casey, Eunice, Pitts, Robert A, Pagan Pirallo, Patricia, Lim, Sahnah, Kapadia, Farzana, Cohen, Gabriel M, Khan, Maria, Mgbako, Ofole
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 19-09-2023; Public Library of Science (PLoS)
• Subjects: Biology and Life Sciences; Clinics; Community; Disease prevention; Drug approval; Epidemics; Gender identity; Hispanic Americans; HIV; HIV (Viruses); Hospital systems; Hospitals; Human immunodeficiency virus; Indigent care; Leadership; Medicine and health sciences; Men; Patients; People and places; Pharmacy; Populations; Prevention; Primary care; Prophylaxis; Research and Analysis Methods; Retention; Sexually transmitted diseases; STD; Study Protocol; Transgender people; Transgender persons; Uninsured people; Verbal communication; Women; United States; New York; United States > US
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0291657

Background Long-acting injectable HIV pre-exposure prophylaxis (LAI-PrEP) was approved by the U.S. Food and Drug Administration in December 2021. This initial phase of implementation represents a prime opportunity to ensure equitable LAI-PrEP provision to communities often underrepresented in PrEP care before disparities in access and uptake emerge. Herein, we describe the EquiPrEP Project which utilizes an equity-oriented implementation science framework to optimize LAI-PrEP rollout in an urban safety-net clinic in New York City. Methods The primary objectives of this project are to: (1) increase LAI-PrEP initiation overall; (2) increase uptake among groups disproportionately impacted by the HIV epidemic; (3) preserve high PrEP retention while expanding use; and (4) identify barriers and facilitators to LAI-PrEP use. EquiPrEP will enroll 210 PrEP-eligible participants into LAI-PrEP care with planned follow-up for one year. We will recruit from the following priority populations: Black and/or Latine men who have sex with men, Black and/or Latine cisgender women, and transgender women and nonbinary individuals. To evaluate implementation of LAI-PrEP, we will utilize equity-focused iterations of the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework and the Consolidated Framework for Implementation Research (CFIR), in addition to longitudinal surveys and qualitative interviews. Discussion Novel LAI-PrEP formulations carry tremendous potential to revolutionize the field of HIV prevention. Implementation strategies rooted in equity are needed to ensure that marginalized populations have access to LAI-PrEP and to address the structural factors that hinder initiation and retention in care.