Hospital and Laboratory Practice in an Integrated Medical System for HIV Infection Prevention Interventions at a Veteran Affairs Medical Center

Abstract

Objective: The impact of sexually transmitted infection (STI) results on prompting clinicians to consider pre-exposure prophylaxis (PrEP) indication is sparse in the literature, particularly for veterans. Methods: A retrospective search from June 2018 to February 2020 was performed to identify all patients who were HIV-negative at a regional Veteran Affairs Medical Center with a positive STI test result and review the medical chart of these patients. Results: We identified 220 veterans who were HIV-negative with a positive STI test result. Of these 220 veterans, 51 unique patients were identified by the clinicians. In a provider-initiated discussion, PrEP was discussed with all 51 patients. In the end, 27 of these 51 patients started PrEP after discussion with their clinical providers. Conclusion: Prior positive STI results successfully helped identify patients who may benefit from PrEP. Quality assurance studies on clinician reactions to test result reporting, particularly regarding highly effective preventive therapies, are important.