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 uptake, 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.

AimsThe Child Death Reviews Working Group Report (Scottish Government, 2014) recommended that a national review system is implemented across Scotland. NHS Scotland does not currently have one system that captures data of all children who have died. The aim of the present study is to review childhood deaths, within one health board in Scotland, through analysing data from Electronic Health Records (EHR) and wider sources.MethodsA mixed-methods case series analyses approach was adopted within a constant comparison framework. EMIS is an EHR system implemented within this board three years ago. It captures health data of all patients 0–5 years and patients 6 years and over referred to Specialist Children’s Services. EMIS data of deceased patients (0–19 years old) within one Scottish health board, who died between July 2015 and September 2017, were analysed alongside data from wider sources including the Specialist Child Protection Service (SCPS).ResultsBetween July 2015 and September 2017, 156 children (m=87, f=69), aged between 0 and 19 years old were recorded as deceased within EMIS. 57.7% of the children died before their first birthday and 89.7% were known to at least one NHS service. None were known to the SCPS. Preliminary analyses suggest that an age ×environment interaction exists, with the highest death rates observed in infants who resided within decile 1: postcode areas of highest multiple deprivation (SIMD, 2016).ConclusionsThe study represents this health board’s first step in establishing a systematic and robust analytical process to review child deaths via EHR and wider data linkage. The findings demonstrate the potential that this approach offers in building a comprehensive understanding of why a child has died, what risk factors were known and how this knowledge can better protect children in the future. The analyses also suggest that gene ×environment vulnerabilities may exist and that particular age-groups require greater support to protect their survival outcomes. Limitations of the study are acknowledged and recommendations for future research proposed.