Objectives: Family planning clinics are well-suited to offer HIV pre-exposure prophylaxis (PrEP) care as a part of a sexually transmitted infection (STI) prevention strategy. We sought to evaluate implementation outcomes of a PrEP care strategy in a hospital-based academic abortion practice.
Methods: We employed a multifaceted implementation strategy directed towards abortion providers comprised of educational sessions, an electronic medical record-prompted verbal assessment of HIV risk, electronic medical record shortcuts for PrEP prescription, and support of a PrEP navigator. We assessed penetration of the intervention by calculating the proportion of patients who were screened for HIV risk, and the proportion of PrEP-eligible women who were offered a prescription for PrEP. We evaluated acceptability and appropriateness of the intervention using belief elicitation interviews with providers.
Results: In the year after initiation of the implementation strategy, the intervention's penetration was 91% across all abortion-related encounters. Providers found the intervention acceptable and appropriate, but reported barriers including time constraints, worry about patient stigmatization, and disappointment if patients did not adhere to PrEP. Providers liked that PrEP provision in abortion care settings felt innovative, and that they could contribute to HIV prevention.
Conclusions: Abortion providers in an academic center found HIV risk assessment and PrEP provision to be feasible, acceptable, and appropriate. Further research should evaluate implementation outcomes of PrEP care strategies in additional abortion care contexts, including clinics offering reproductive health care outside of academia.
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