Integrated Pharmacy and PrEP Navigation Services to Support PrEP Uptake: A Quality Improvement Project
JANAC-JOURNAL OF THE ASSOCIATION OF NURSES IN AIDS CARE
Authors: Coleman, Megan; Hodges, Ashley; Henn, Sarah; Lambert, Crystal Chapman
Preexposure prophylaxis (PrEP) is highly effective in preventing HIV among both men and women, with the reduction in risk directly linked to medication adherence. Navigation services and other adherence interventions have demonstrated efficacy in medication uptake; however, their use may not be fully integrated into clinic operations or their roles clearly defined. This quality improvement (QI) project developed an evidenced-based PrEP Navigation (PN) tool to identify patient-reported barriers to uptake and to support process improvement at a large community health center in Washington, DC. Outcomes related to patient-reported barriers, patient demographics, and time to medication pickup from the pharmacy were measured before and after implementation. A total of 198 patients were included in this analysis. Mean days from initial prescription to medication pickup was reduced by 1.42 days (p = .030) following PN tool implementation. The evidenced-based PN tool is modifiable to the needs of the individual clinic and the patients they care for to support wide-scale PrEP uptake and continuous system process improvements.
E-cigarette Perceptions among HIV-positive Smokers in a Switching Study
TOBACCO REGULATORY SCIENCE
Authors: Cioe, Patricia A.; Tidey, Jennifer W.; Mercurio, Alana N.; Costantino, Catherine; Kahler, Christopher W.
Objectives: Cigarette smoking is highly prevalent among persons with HIV (PWH), which is concerning due to their increased risk of developing smoking-related cancers compared to those without HIV. Smoking cessation rates are substantially lower among PWH compared to the general population and less than half report a goal of total abstinence. Given these factors, a switch to electronic cigarettes (ECs), as a form of tobacco harm reduction, may be a viable approach to decreasing tobacco-related morbidity and mortality in PWH. The US Food and Drug Administration has the authority to implement product standards for cigarettes, including ECs and flavors. Methods: This qualitative study enrolled 19 HIV-positive smokers into an EC switch study. At Week 12, qualitative interviews were conducted to examine EC perceptions and flavor preferences. Results: ECs were viewed as a less harmful, cost-effective method of reducing or eliminating CC smoking, and non-tobacco flavors were an essential part of EC appeal and use. Conclusions: Flavored EC liquid seems to enhance the user experience and may influence the user's ability to make a complete switch. Tobacco harm reduction, as a strategy, will only be effective if current evidence guides tobacco regulatory decisions.