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13.12.2018 | Original Paper | Ausgabe 7/2019

AIDS and Behavior 7/2019

Health Care Facility Characteristics are Associated with Variation in Human Immunodeficiency Virus Pre-exposure Prophylaxis Initiation in Veteran’s Health Administration

AIDS and Behavior > Ausgabe 7/2019
Marissa M. Maier, Ina Gylys-Colwell, Elliott Lowy, Puja Van Epps, Michael Ohl, Maggie Chartier, Lauren A. Beste
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The online version of this article (doi:https://​doi.​org/​10.​1007/​s10461-018-2360-6) contains supplementary material, which is available to authorized users.

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To quantify health care facility-level variation in pre-exposure prophylaxis (PrEP) use in the Veteran’s Health Administration (VHA); to identify facility characteristics associated with PrEP use. Retrospective analysis of the health care facility-level rate of PrEP initiation in VHA through June 30, 2017. Standardized PrEP initiation rates were used to rank facilities. Characteristics of facilities, prescribers, and PrEP recipients were examined within quartiles. Multiple linear regression was used to identify associations between facility characteristics and PrEP use. We identified 1600 PrEP recipients. Mean PrEP initiation rate was 20.0/100,000 (SD 22.8), ranging from 3.0/100,000 (SD 2.0) in the lowest quartile to 48.1/100,000 (SD 29.1) in the highest. PrEP prescribing was positively associated with proportions of urban dwellers and individuals < 45, tertiary care status, and location. Variability in PrEP uptake across a national health care system highlights opportunities to expand access in non-tertiary care facilities and underserved areas.

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