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

  • Crystal Fuller LewisEmail author
  • Helen-Maria Lekas
  • Alexis Rivera
  • Sharifa Z. Williams
  • Natalie D. Crawford
  • Rafael E. Pérez-Figueroa
  • Adriana M. Joseph
  • Silvia Amesty
Original Paper

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.

Keywords

PEP Drug use Pharmacy Structural intervention Mixed-methods 

Notes

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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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2020

Authors and Affiliations

  • Crystal Fuller Lewis
    • 1
    • 2
    Email author
  • Helen-Maria Lekas
    • 1
    • 2
  • Alexis Rivera
    • 3
  • Sharifa Z. Williams
    • 2
  • Natalie D. Crawford
    • 4
  • Rafael E. Pérez-Figueroa
    • 2
  • Adriana M. Joseph
    • 2
  • Silvia Amesty
    • 5
    • 6
    • 7
  1. 1.Department of PsychiatryNew York University School of MedicineNew YorkUSA
  2. 2.Division of Social Solutions and Services ResearchNathan S. Kline Institute for Psychiatric ResearchOrangeburgUSA
  3. 3.Department of EpidemiologyColumbia University Mailman School of Public HealthNew YorkUSA
  4. 4.Department of Behavioral Sciences and Health EducationEmory University, Rollins School of Public HealthAtlantaUSA
  5. 5.Center for Family and Community Medicine, College of Physicians and SurgeonsColumbia University Medical CenterNew YorkUSA
  6. 6.Center for Global and Population Health, College of Physicians and SurgeonsColumbia University Medical CenterNew YorkUSA
  7. 7.Department of Population and Family HealthColumbia University Mailman School of Public HealthNew YorkUSA

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