Skye McGregor

This session focused on PrEP service delivery across a range of settings, including differentiated direct-to-pharmacy PrEP refill visits (Kenya), sociodemographic and behavioural characteristics of people initiating PrEP (Brazil), PrEP use and service utilization among sexual and gender minority youth (USA), and event driven PrEP use during COVID (Australia)

Zewdie examined differentiated direct-to-pharmacy PrEP refill visits and HIV self-testing in adults, Kenya. Clients enrolled in 2 clinics (standard of care, intervention). The intervention reduced by 35% total time spent at the clinic, increased PrEP continuation (23% vs 16% at 6-months) but didn’t diminish adherence. Intervention feasible and acceptable. Soares examined sociodemographic and behavioural characteristics of adolescent men who have sex with men and transgender women initiating oral PrEP, in Brazil (PrEP1519), across four PrEP initiation groups. Same-day PrEP initiation was high (93.3%). PrEP users had higher risk behaviours or perceived risk. PrEP refusers had less sex partners. A four-arm factorial RCT (Rotheram, USA) determined improvement in uptake of PrEP and service utilization, among sexual and gender diverse youth. Interventions included automated text messaging and monitoring, online peer support, strengths-based telehealth coaching. The intensive combination intervention group doubled and sustained PrEP use. Chan assessed trends in event driven PrEP (ED PrEP) use between 2019 and 2022 using national Gay Community Periodic Survey data (n=9,367). ED PrEP use increased from 7.8% in 2019 to 24.7% in 2022. ED PrEP users were less likely to identify as gay, have a lower risk profile (condomless sex or STI diagnosis), and report COVID-19 impact.

This session focused on a person-centred approach to PrEP use, across a range of settings, by providing support and interventions, to enable individuals at risk of HIV to make decisions that best suit their needs. As PrEP modalities and technologies change and evolve there is a need to ensure people are informed about PrEP options, adherence is appropriately conceptualised, and studies are designed to capture both interventions and uptake. Further strategies are required to avoid missed opportunities for initiating and sustaining PrEP use, including ensuring research builds on existing knowledge to design nuanced interventions.