Evaluation of an inner city HIV pre-exposure prophylaxis service tailored to the needs of people who inject drugs

Ceilidh Grimshaw*, Lynsey Boyd, Matt Smith, Claudia S. Estcourt, Rebecca Metcalfe

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)
1 Downloads (Pure)

Abstract

Objectives: HIV prevention strategies including pre- exposure prophylaxis (PrEP) must reach all in need to achieve elimination of transmission by 2030. Mainstream provision may inadvertently exclude key populations. Incidence of HIV in people who inject drugs (PWID) in Glasgow, Scotland's largest city, is increasing, partly due to sexual transmission. Scotland provides publicly funded oral PrEP for individuals at sexual risk of HIV through sexual health services; however, uptake by PWID has been negligible. We developed a tailored outreach PrEP service based in the local homeless health centre. We used active case finding, flexibility of assessment location, supervised community daily dispensing and active follow- up to optimise uptake and adherence. We describe a two- year service evaluation.
Methods: We reviewed the case records of all PWID identified by the outreach team as being at higher risk of sexual acquisition for whom PrEP was considered between November 2018 and November 2020. Evaluation focused on PrEP up-take, adherence and monitoring. We conducted a descriptive statistical analysis.
Results: Of 41 PWID assessed as eligible, 32 (78.0%) commenced PrEP. The proportion of PrEP- covered days was 3320/3400 days (97.6%); 31/32 (96.9%) had regular HIV serology monitoring. The service was feasible to run, but it relied on outreach provision and liaison with other services.
Discussion: Tailored PrEP services can reach PWID effectively. Uptake and adherence were high but the model was resource- intensive. Appropriately tailored PrEP delivery may be required to meet the needs of this and other key populations who experience barriers to accessing mainstream services.
Original languageEnglish
Pages (from-to)965-970
Number of pages6
JournalHIV Medicine
Volume22
Issue number10
Early online date28 Sep 2021
DOIs
Publication statusPublished - Nov 2021

Keywords

  • adherence
  • people who inject drugs
  • pre-exposure prophylaxis
  • service
  • uptake

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