Purpose Pre‐exposure prophylaxis (PrEP) prevents HIV yet uptake remains suboptimal across the United States. This paper evaluates the impact of outreach activities led by nurse supervised community healthcare workers (CHWs) on the PrEP care cascade. Methods This is an observational programmatic evaluation of LGBTQ + community outreach between March 1, 2016, to March 31, 2020, as part of a public health initiative. Descriptive statistics are used to characterize the data by outreach type. Results 2,465 participants were reached. Overall, a PrEP appointment was scheduled for 94 (3.8%) with 70 (2.8%) confirmed to have completed a PrEP visit. Success for each type of community outreach activity was evaluated with virtual models outperforming face‐to‐face. Face‐to‐face outreach identified nine persons among 2,188 contacts (0.41%) completing an initial PrEP visit. The website prepmaryland.org identified 4 among 24 contacts (16.7%) and the PrEP telephone/text warm‐line identified 18 among 60 contacts (30%). The PrEPme smartphone application identified 39 among 168 contacts (23.2%). Conclusions Face‐to‐face community outreach efforts reached a large number of participants, yet had a lower yield in follow‐up and confirmed PrEP visits. All virtual platforms reached lower total numbers, but had greater success in attendance at PrEP visits, suggesting enhanced linkage to care.

Background: Despite clear evidence that pre-exposure prophylaxis (PrEP) prevents HIV, uptake remains suboptimal across the United States, particularly in populations at greatest risk of HIV infection, such as men who have sex with men (MSM) in Baltimore. This paper will evaluate awareness, engagement and linkage to care for PrEP activities through multiple outreach strategies. Methods: This is an observational evaluation of the impact of LGBTQ+ outreach on the PrEP cascade between March 1, 2016 to March 31, 2019. Descriptive statistics are used to characterize the data and the linkage cascade by outreach type. Results: Across all activities, our team had contact with 2,370 participants and scheduled a PrEP appointment for 84 (3.5%) with 58 (2.4%) who completed the intake visits. Among 54 venue-based activities, which focused on PrEP awareness messaging, 2,125 participants were reached with 11.4% (243/2125) interested in further discussion with a peer community-health worker (CHW). After 3 separate attempts to contact the individual, peer contact was successful in 66.2% (161/243); 11.2% (18/161) of those were interested in linkage to PrEP; 83.3% (15/18) had a PrEP appointment scheduled; and 53.3% (8/15) completed the PrEP visit. Online and telephone-based outreach resulted in 24 contacts through prepmaryland.org and 43 calls on the PrEP warm line, all of these indivduals reporting interest in further discussion with the peer CHW. Among prepmaryland.org users and warm line calls 54.2% (13/24) and 67.4% (29/43), respectively, were successfully contacted, while 100% (13/13) and 75.9% (22/29) of those reported interest in a PrEP referral. Among the referred, 61.5% (8/13) and 86.4% (19/22) had a PrEP appointment scheduled; and 50% (4/8) and 78.9% (15/19) completed the visit. The mobile app, PrEPme, yielded 178 unique downloads; 94.4% (168/178) had interest in further discussion with a peer CHW; follow-up contact was successful 64.3% (108/168); 41.6% (45/108) were interested in PrEP referral; 95.5% (43/45) had a PrEP appointment successfully scheduled; and 72.1% (31/43) completed the intake visit.Conclusions: Outreach efforts reached a large number of participants attending LGBTQ+ centric and health-based events, yet resulted in a relatively low total yield of engagement with peer CHWs and even lower documented PrEP initiations.