Evaluating for health equity among a cluster of health departments implementing PrEP services

Carter, Jarvis W.; Salabarría-Peña, Yamir; Fields, Errol L.; Robinson, William T.

doi:10.1016/j.evalprogplan.2021.101981

Cited by 8 publications

(9 citation statements)

References 40 publications

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“…These assumptions may have underestimated the number of persons served in preceding steps or overestimated the percentages in subsequent steps. Third, some jurisdictions indicated difficulty in reporting linkage [38][39][40][41][42][43][44][45][46][47][48][49][50] Our findings show that PrIDE jurisdictions successfully demonstrated the feasibility of health department-supported programs in expanding PrEP services to MSM and transgender persons at risk for HIV infection. PrIDE jurisdictions exceeded their own targets in the number of persons reached to identify PrEP service needs, referred, and linked to providers, and eventually prescribed PrEP.…”

Section: Limitationsmentioning

confidence: 71%

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Expanding PrEP Services for Men Who Have Sex With Men and Transgender Persons Through Health Department Programs: Key Processes and Outcomes From Project PrIDE, 2015-2019

et al. 2022

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Objective: Pre-exposure prophylaxis (PrEP) Implementation, Data to Care, and Evaluation (PrIDE) was a demonstration project implemented by 12 state and local health departments during 2015-2019 to expand PrEP services for men who have sex with men (MSM) and transgender persons at risk for HIV infection. We describe findings from the cross-jurisdictional evaluation of the project. Methods: We analyzed work plans, annual progress reports, and aggregate quantitative program data submitted by funded health departments (n = 12) to identify key activities implemented and summarize key project outcomes. Results: PrIDE jurisdictions implemented multiple health equity–focused activities to expand PrEP services to priority populations, including building program capacity, conducting knowledge and awareness campaigns, providing PrEP support services, and addressing barriers to PrEP use. Overall, PrIDE jurisdictions identified 44 813 persons with PrEP indications. Of these, 74.8% (n = 33 500) were referred and 33.1% (n = 14 821) were linked to PrEP providers, and 25.3% (n = 11 356) were prescribed PrEP. Most persons prescribed PrEP were MSM or transgender persons (87.9%) and persons from racial and ethnic minority groups (65.6%). However, among persons with PrEP indications, non-Hispanic Black/African American persons (14.9% of 18 782) were less likely than non-Hispanic White persons (31.0% of 11 633) to be prescribed PrEP ( z = −33.57; P < .001). Conclusions: PrIDE jurisdictions successfully expanded PrEP services for MSM, transgender persons, and racial and ethnic minority groups by implementing health equity–focused activities that addressed barriers to PrEP services. However, PrEP prescription was generally low, with significant disparities by demographic characteristics. Additional targeted interventions are needed to expand PrEP services, achieve equity in PrEP use, and contribute to ending the HIV epidemic in the United States.

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Section: Limitationsmentioning

confidence: 71%

“…Detailed program-specific lessons from Project PrIDE are included in articles published in a special issue of Evaluation and Program Planning . 38-50…”

Section: Discussionmentioning

confidence: 99%

Expanding PrEP Services for Men Who Have Sex With Men and Transgender Persons Through Health Department Programs: Key Processes and Outcomes From Project PrIDE, 2015-2019

et al. 2022

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“…Having a usual health care source or a provider with whom the participant was comfortable discussing gender-related health issues was associated with improved HIV prevention and treatment outcomes, including HIV testing, preexposure prophylaxis (PrEP) use, and viral suppression. These findings illustrate the benefit of gender-affirming approaches used by health care providers ( 2 ), and highlight the challenging socioeconomic conditions faced by many transgender women. Ensuring access to gender-affirming health care approaches and addressing the socioeconomic challenges of many transgender women could improve access to and use of HIV prevention and care in this population and will help achieve the goals of the Ending the HIV Epidemic in the United States initiative ( 3 ).…”

mentioning

confidence: 58%

Factors Associated with Use of HIV Prevention and Health Care Among Transgender Women — Seven Urban Areas, 2019–2020

Lee¹,

Trujillo²,

Olansky³

et al. 2022

MMWR Morb. Mortal. Wkly. Rep.

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“…Intervention components were strategies and tactics that interventions used to reach populations and effect change. These included: (1) health education training, [22][23][24][25][26][27][28][29] (2) free/affordable care, [30][31][32][33][34][35][36] (3) social media/social networks, 37-42 (4) training providers, [43][44][45][46][47][48] (5) data-driven strategy, [49][50][51][52] (6) structural/policy change, [53][54][55][56] (7) phonebased interventions, [57][58][59] and (8) environmental change.-60 Some articles used multiple tactics to reach populations. However, for our analysis and Figure 1, we categorized each article using the primary strategy used in intervention; categories are mutually exclusive.…”

Section: Intervention Componentsmentioning

confidence: 99%

“…Preventing transmission (n = 12). 27,31,33,34,36,39,[41][42][43][44]52,53 Twelve interventions were focused on preventing transmission of infectious diseases, including HIV (n = 8), 33,34,39,[41][42][43][44]53 COVID-19 transmission (n = 3), 27,31,52 and TB (n = 1). 36 An example of an HIV intervention used incentivized social networks and direct recruitment to identify and connect out-ofcare persons living with HIV.…”

Section: Intervention Outcomesmentioning

confidence: 99%

A Scoping Review of Health Equity Interventions in Governmental Public Health

Martin,

Dill,

Demeritte

et al. 2024

Journal of Public Health Management &Amp; Practice

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Context: Despite major efforts in research, practice, and policy, racial and ethnic disparities in health and health care persist in the United States. Interventions in collaboration with governmental public health may provide ways to address these persistent racial and ethnic health and health care disparities and improve health outcomes. Objective: To conduct a comprehensive review of health equity interventions performed in collaboration with public health agencies. Design: This scoping review includes intervention studies from Ovid MEDLINE, PsycINFO, and Academic Search Premier, published between 2017 and 2023. The search strategy used terminology focused on 4 concepts: race/ethnicity, equity, health departments, and epidemiologic studies. Eligibility Criteria: The following inclusion criteria were determined a priori: (1) intervention tailored to reduce racial/ethnic health disparities, (2) public health department involvement, (3) health outcome measures, (4) use of epidemiologic study methods, (5) written in English, (6) implemented in the United States, (7) original data (not a commentary), and (8) published between January 2017 and January 2023. Main Outcome Measure(s): This review focused primarily on 4 dimensions of racial health equity interventions including intervention components, intervention settings, intervention delivery agents, and intervention outcomes. Results: This review indicated that health equity interventions involving public health agencies focused on the following categories: (1) access to care, (2) health behavior, (3) infectious disease testing, (4) preventing transmission, and (5) cancer screening. Critical strategies included in interventions for reaching racial/ethnic minoritized people included using community settings, mobile clinics, social media/social networks, phone-based interventions, community-based workers, health education, active public health department involvement, and structural/policy change. Conclusions: This scoping review aims to provide an evidence map to inform public health agencies, researchers, and funding agencies on gaps in knowledge and priority areas for future research and to identify existing health equity interventions that could be considered for implementation by public health leaders.

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Evaluating for health equity among a cluster of health departments implementing PrEP services

Cited by 8 publications

References 40 publications

Expanding PrEP Services for Men Who Have Sex With Men and Transgender Persons Through Health Department Programs: Key Processes and Outcomes From Project PrIDE, 2015-2019

Expanding PrEP Services for Men Who Have Sex With Men and Transgender Persons Through Health Department Programs: Key Processes and Outcomes From Project PrIDE, 2015-2019

Factors Associated with Use of HIV Prevention and Health Care Among Transgender Women — Seven Urban Areas, 2019–2020

A Scoping Review of Health Equity Interventions in Governmental Public Health

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