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Pharmacy PEP Access Intervention Among Persons Who Use Drugs in New York City: iPEPcare Study—Rethinking Biomedical HIV Prevention Strategies

Abstract

Biomedical HIV prevention uptake has not taken hold among Black and Latinx populations who use street-marketed drugs. A pilot intervention providing a PEP informational video and direct pharmacy access to a PEP starter dose was conducted among this population. Four study pharmacies were selected to help facilitate syringe customer recruitment (2012–2016). Baseline, post-video, and 3-month ACASI captured demographic, risk behavior, and psychosocial factors associated with PEP willingness, and willingness to access PEP in a pharmacy. A non-experimental study design revealed baseline PEP willingness to be associated with PEP awareness, health insurance, being female, and having a high-risk partner (n = 454). Three-month PEP willingness was associated with lower HIV stigma (APR = 0.95). Using a pre-post approach, PEP knowledge (p < 0.001) and willingness (p < 0.001) increased overtime; however, only three participants requested PEP during the study. In-depth interviews (n = 15) identified lack of a deeper understanding of PEP, and contextualized perceptions of HIV risk as PEP access barriers. Pharmacy PEP access shows promise but further research on perceived risk and HIV stigma is warranted.

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Acknowledgements

We would like to thank the study participants for sharing their experiences, and the study staff for their hard work. This research was sponsored by the National Institute on Drug Abuse, R01DA030253. The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the funders.

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Correspondence to Crystal Fuller Lewis.

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Lewis, C.F., Lekas, H., Rivera, A. et al. Pharmacy PEP Access Intervention Among Persons Who Use Drugs in New York City: iPEPcare Study—Rethinking Biomedical HIV Prevention Strategies. AIDS Behav (2020). https://doi.org/10.1007/s10461-019-02775-3

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Keywords

  • PEP
  • Drug use
  • Pharmacy
  • Structural intervention
  • Mixed-methods