Feasibility and Acceptability of Home-Collected Samples for Human Immunodeficiency Virus Preexposure Prophylaxis and Severe Acute Respiratory Syndrome Coronavirus 2 Laboratory Tests in San Francisco Primary Care Clinics

Parya Saberi, Kristin Ming, Isha Shrestha, Hyman Scott, Brad Thorson, Albert Liu, Parya Saberi, Kristin Ming, Isha Shrestha, Hyman Scott, Brad Thorson, Albert Liu

Abstract

Background: Due to the difficulty of conducting laboratory testing during the pandemic shelter-in-place orders, the objective of this study was to examine the feasibility and acceptability of conducting home-collected samples for preexposure prophylaxis (PrEP) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) laboratory tests.

Methods: We conducted a pilot study among patients on PrEP in San Francisco primary care clinics. Individuals on PrEP provided home-collected laboratory samples using dried blood spot for fourth-generation human immunodeficiency virus antigen/antibody test, serum creatinine, syphilis antibody, and hepatitis C antibody, as needed; 3-site (oropharyngeal, rectal, and urine) swabbing for sexually transmitted infections; and nasopharyngeal swabbing for SARS-CoV-2 polymerase chain reaction. We examined feasibility and acceptability of collecting these laboratory samples using predefined benchmarks to determine feasibility or acceptability.

Results: Of 92 individuals who consented to participate, 73 (79.3%) mailed back their home-collected kit. Nearly 87.7% noted being extremely to moderately satisfied with the ability to complete the laboratory tests without having to come into a clinic. Approximately 49.3% of participants chose this home-collection method as their first choice for providing laboratory samples. Mean time from collection of samples by the participant to receipt of test results was reduced from the first quarter of the study (17 days) to the last quarter of the study (5 days).

Conclusions: We report high levels of feasibility and acceptability with the use of home-collected laboratory samples for patients on PrEP. Our results indicate that home-collected laboratory samples for patients on PrEP is a viable option that should be offered as an alternative to clinic-collected laboratory samples.

Keywords: HIV; SARS-CoV-2; home collection; pandemic; preexposure prophylaxis; self-test.

Published by Oxford University Press on behalf of Infectious Diseases Society of America 2022.

References

    1. Grant RM, Lama JR, Anderson PL, et al. . Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med 2010; 363:2587–99.
    1. Thigpen MC, Kebaabetswe PM, Paxton LA, et al. . Antiretroviral preexposure prophylaxis for heterosexual HIV transmission in Botswana. N Engl J Med 2012; 367:423–34.
    1. Baeten JM, Donnell D, Ndase P, et al. . Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. N Engl J Med 2012; 367:399–410.
    1. Choopanya K, Martin M, Suntharasamai P, et al. . Antiretroviral prophylaxis for HIV infection in injecting drug users in Bangkok, Thailand (the Bangkok Tenofovir Study): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet 2013; 381:2083–90.
    1. Molina JM, Capitant C, Spire B, et al. . On-demand preexposure prophylaxis in men at high risk for HIV-1 infection. N Engl J Med 2015; 373:2237–46.
    1. McCormack S, Dunn DT, Desai M, et al. . Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial. Lancet 2016; 387:53–60.
    1. Baeten JM, Heffron R, Kidoguchi L, et al. . Integrated delivery of antiretroviral treatment and pre-exposure prophylaxis to HIV-1-serodiscordant couples: a prospective implementation study in Kenya and Uganda. PLoS Med 2016; 13:e1002099.
    1. Hosek SG, Rudy B, Landovitz R, et al. . An HIV preexposure prophylaxis demonstration project and safety study for young MSM. J Acquir Immune Defic Syndr 2017; 74:21–9.
    1. Liu AY, Cohen SE, Vittinghoff E, et al. . Preexposure prophylaxis for HIV infection integrated with municipal- and community-based sexual health services. JAMA Intern Med 2016; 176:75–84.
    1. Marcus JL, Hurley LB, Nguyen DP, Silverberg MJ, Volk JE.. Redefining human immunodeficiency virus (HIV) preexposure prophylaxis failures. Clin Infect Dis 2017; 65:1768–9.
    1. Harris NS, Johnson AS, Huang YA, et al. . Vital signs: status of human immunodeficiency virus testing, viral suppression, and HIV preexposure prophylaxis—United States, 2013-2018. MMWR Morb Mortal Wkly Rep 2019; 68:1117–23.
    1. Stephenson R, Walsh AR, Chavanduka TMD, et al. . Widespread closure of HIV prevention and care services places youth at higher risk during the COVID-19 pandemic. PLoS One 2021; 16:e0249740.
    1. Czeisler ME, Marynak K, Clarke KEN, et al. . Delay or avoidance of medical care because of COVID-19-related concerns—United States, June 2020. MMWR Morb Mortal Wkly Rep 2020; 69:1250–7.
    1. Sanchez TH, Zlotorzynska M, Rai M, Baral SD.. Characterizing the impact of COVID-19 on men who have sex with men across the United States in April, 2020. AIDS Behav 2020; 24:2024–32.
    1. Centers for Disease Control and Prevention. Preexposure prophylaxis for the prevention of HIV infection in the United States—2017 update: a clinical practice guideline. 2018. . Accessed 23 May 2020.
    1. Saberi P, Ming K, Legnitto D, Neilands TB, Gandhi M, Johnson MO.. Feasibility and acceptability of novel methods to estimate antiretroviral adherence: a longitudinal study. PLoS One 2019; 14:e0210791.
    1. Saberi P. Research in the time of coronavirus: continuing ongoing studies in the midst of the COVID-19 pandemic. AIDS Behav 2020; 24:2232–35.
    1. Ming K, Shrestha I, Vazquez A, et al. . Improving the HIV PrEP continuum of care using an intervention for healthcare providers: a stepped-wedge study protocol. BMJ Open 2020; 10:e040734.
    1. Molecular Testing Labs. Infectious disease assays. 2021. . Accessed 6 December 2021.
    1. Brooke J. System Usability Scale (SUS). 1986. . Accessed 9 March 2017.
    1. Saberi P, Ming KS, Scott H, Liu AL, Steward W.. “You can’t have a PrEP program without a PrEP coordinator”: implementation of a PrEP panel management intervention. PLoS One 2020; 15:e0240745.
    1. Siegler AJ, Mayer KH, Liu AY, et al. . Developing and assessing the feasibility of a home-based preexposure prophylaxis monitoring and support program. Clin Infect Dis 2019; 68:501–4.
    1. Grov C, Cain D, Whitfield TH, et al. . Recruiting a US national sample of HIV-negative gay and bisexual men to complete at-home self-administered HIV/STI testing and surveys: challenges and opportunities. Sex Res Soc Policy 2016; 13:1–21.
    1. Hoagland B, Torres TS, Bezerra DRB, et al. . High acceptability of PrEP teleconsultation and HIV self-testing among PrEP users during the COVID-19 pandemic in Brazil. Braz J Infect Dis 2021; 25:101037.
    1. Refugio ON, Kimble MM, Silva CL, Lykens JE, Bannister C, Klausner JD.. PrEPTECH: a telehealth-based initiation program for HIV pre-exposure prophylaxis in young men of color who have sex with men. A pilot study of feasibility. J Acquir Immune Defic Syndr 2019; 80:40–5.
    1. John SA, Rendina HJ, Grov C, Parsons JT.. Home-based pre-exposure prophylaxis (PrEP) services for gay and bisexual men: an opportunity to address barriers to PrEP uptake and persistence. PLoS One 2017; 12:e0189794.
    1. DiClemente RJ, Ruiz MS, Sales JM.. Barriers to adolescents’ participation in HIV biomedical prevention research. J Acquir Immune Defic Syndr 2010; 54:S12–7.
    1. Rolle CP, Rosenberg ES, Siegler AJ, et al. . Challenges in translating PrEP interest into uptake in an observational study of young black MSM. J Acquir Immune Defic Syndr 2017; 76:250–8.
    1. Serota DP, Rosenberg ES, Sullivan PS, et al. . Pre-exposure prophylaxis uptake and discontinuation among young black men who have sex with men in Atlanta, Georgia: a prospective cohort study. Clin Infect Dis 2020; 71:574–82.
    1. Mayer KH, Agwu A, Malebranche D.. Barriers to the wider use of pre-exposure prophylaxis in the United States: a narrative review. Adv Ther 2020; 37:1778–811.
    1. Yusuf H, Fields E, Arrington-Sanders R, Griffith D, Agwu AL.. HIV preexposure prophylaxis among adolescents in the US: a review. JAMA Pediatr 2020; 174:1102–8.
    1. Centers for Disease Control and Prevention. PrEP during COVID-19. 2020. . Accessed 24 May 2020.
    1. National Alliance of State and Territorial AIDS Directors. PrEP coverage brief: PrEP services covered with no cost-sharing. 2021. . Accessed 31 July 2021.

Source: PubMed

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