Immediate PrEP when accessing PEP: A service evaluation

Abstract

Objectives In January 2021, 56 Dean Street, a London sexual health clinic, changed clinic policy so that all those attending for post‐exposure prophylaxis (PEP) were offered quick‐start opt‐out pre‐exposure prophylaxis (PrEP) following completion of the 28‐day PEP course. We assessed the uptake of this quick‐start PrEP in service users attending for PEP. Methods We undertook a case note review of those who received PEP during the 2‐week period from 17 February to 1 March 2021, assessing the data and comparing them to those from the same period in 2020 (15 February–28 February 2020) before quick‐start opt‐out PrEP was introduced. Results The number of service users receiving PEP was 82 in 2020 and 42 in 2021, of which an unmet PrEP need was demonstrated in 81.7% (67/82) in 2020 and 78.6% (33/42) in 2021 (p = 0.8106). Of those with an unmet need, a higher proportion (97.0% [32/33]) were offered PrEP in 2021 following the introduction of opt‐out PrEP compared with the 85.1% (57/67) in 2020 (p = 0.0953). Of those eligible for PrEP who were offered it during their PEP consultation, 53.1% (17/32) in 2021 were dispensed PrEP compared with 17.5% (10/57) in 2020 (p = 0.0007). Conclusion Since the introduction of quick‐start opt‐out PrEP, uptake in eligible candidates increased from 17.5% to 53.1%. This suggests that this strategy was acceptable to service users.

Predictors of starting and stopping chemsex in men who have sex with men in England: findings from the AURAH2 prospective study

“…An association was not present with PrEP use (although it should be noted the period of this study is before widespread PrEP use 23 ), suggestive that healthcare providers may have scope to provide useful advice and strategy regarding PrEP use, such as rapid transition to PrEP post PEP use. 24 …”

“…healthcare providers may have scope to provide useful advice and strategy regarding PrEP use, such as rapid transition to PrEP post PEP use. 24 There was a clear link between younger age (<40) and increased likelihood of both starting and stopping chemsex. It seems that older service users may be more fixed in their behaviours, while our findings tally with developmental neuroscience understanding that younger people are more open to novel experiences and more likely to engage in risky behaviours, 25 making them possibly a more suitable group for intervention.…”