How Has COVID-19 Impacted PrEP Care in the LGBTQ Community?

PrEP initiations, discontinuations and lapses all increased among Latinx patients post shelter-in-place orders.

A recent study conducted by investigators from the University of California, San Francisco, in collaboration with the San Francisco AIDS Foundation and the San Francisco Department of Public Health, has found that pre-exposure prophylaxis (PrEP) initiations decreased when shelter-in-place mandates were implemented.

Results from the study were presented at this year’s 11th International AIDS Society Conference on HIV Science.

When the COVID-19 pandemic began, many states implemented shelter-in-place mandates to try and reduce the spread of the disease. Community-based LGBTQ sexual health and wellness centers had to quickly adapt to the restrictions, with many providing telehealth visits to allow for continued service.

The investigators in this study sought to identify how different phases of the COVID-19 pandemic impacted PrEP care at a San Francisco community-based sexual health clinic.

For the study, the team analyzed electronic medical records for patients with any active PrEP prescriptions.

They then examined PrEP initiations, PrEP lapses, PrEP discontinuations, and gonorrhea/chlamydia (GC/CT) testing during 3 separate periods. The 3 periods included: Before shelter-in-place orders began, during the orders and after the orders.

Findings from the study demonstrated that of the 3,616 participants, PrEP initiations decreased by 62.2% during the shelter-in-place orders. Initiations did rebound after the orders were lifted, but only up to 45.1% of prior levels.

Additionally, lapses of PrEP increased to 79% during the shelter-in-place orders and discontinuations increased by 21%, with the majority occurring in younger patients.

“PrEP initiations decreased post SIP, but without disparities in age or Black/Latinx ethnicity,” the authors wrote. “GC/CT testing and positivity decreased post-SIP. Further investigation is needed to evaluate the impact of lower HIV/STI prevention services on these syndemics.”