Low-Intensity Outreach to Increase Uptake of HIV Preexposure Prophylaxis Among Patients with Sexually Transmitted Infections

  • Ryan R. Guinness
  • Jonathan E. Volk
  • Leo B. Hurley
  • Tadd T. Tobias
  • Julia L. Marcus
Original Paper


We piloted a low-intensity outreach intervention to increase linkage to PrEP care among HIV-uninfected individuals with rectal sexually transmitted infections or syphilis. We sent a secure email message or letter with information about accessing PrEP. Of those sent an email, 12.4% were linked to PrEP care; linkage differed by race/ethnicity, ranging from 0% of Black individuals to 32% of Hispanic individuals (P = 0.019). No individuals sent letters were linked to PrEP care. A one-time secure email to high-risk patients is feasible to increase linkage to PrEP care. Studies are needed to evaluate scalable interventions to increase PrEP uptake in at-risk populations.


Human immunodeficiency virus (HIV) Preexposure prophylaxis (PrEP) Uptake Outreach Implementation research 



This work was supported by a Kaiser Permanente Northern California Community Benefit research grant, and by the National Institute of Allergy and Infectious Diseases (K01 122853).

Compliance with Ethical Standards

Conflicts of interest

RRG declares that he has no conflict of interest. JEV declares that he has no conflict of interest. LBH declares that he has no conflict of interest. TTT declares that he has no conflict of interest. JLM reports past research support from Merck.

Ethical Approval

All procedures performed in our study were in accordance with the ethical standards of Kaiser Permanente Northern California and with the 1964 Helsinki declaration and later its amendments or comparable ethical standards.

Informed Consent

An informed consent waiver was obtained for this project from the Kaiser Permanente Northern California Institutional Review Board.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Ryan R. Guinness
    • 1
  • Jonathan E. Volk
    • 1
  • Leo B. Hurley
    • 2
  • Tadd T. Tobias
    • 3
  • Julia L. Marcus
    • 4
  1. 1.Department of Adult and Family MedicineKaiser Permanente San Francisco Medical CenterSan FranciscoUSA
  2. 2.Kaiser Permanente Division of ResearchOaklandUSA
  3. 3.Department of Infectious DiseasesKaiser Permanente Oakland Medical CenterOaklandUSA
  4. 4.Department of Population MedicineHarvard Medical School and Harvard Pilgrim Health Care InstituteBostonUSA

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