Reducing Disparities in Rural HIV Prevention

Not Applicable

Completed

Interventions: Other: Virtual clinical visits with home lab kits and mailed HIV PrEP

Brief Summary: HIV and Sexually Transmitted Infection (STI) rates are increasing in rural areas including rural Colorado. Many rural residents find it difficult to access HIV and STI prevention services.

In this study, an online survey on HIV and STI Prevention and best practices to provide access to prevention will be administered to rural residents in three zip 3 zones in rural Colorado. In addition to the baseline survey, study participants who are interested and medically eligible may initiate PrEP services with the University of Colorado HIV Prevention Program and receive PrEP through telemedicine visits, mailed home lab kits, and mailed medication. Persistence in PrEP care, acceptability, and feasibility of telemedicine and home lab kits will be measured.

Detailed Description: HIV and Sexually Transmitted Infection (STI) rates are increasing in rural areas including rural Colorado. Many rural residents find it difficult to access HIV and STI prevention services. The goal of this study is to understand the risk for HIV and STIs, views on PrEP, and to determine if access to telemedicine visits and home lab kits increases engagement in PrEP services and persistence in care for at-risk rural populations.

An online survey on HIV and STI Prevention and best practices to provide access to prevention will be administered to rural residents in three zip 3 zones in rural Colorado, comprised of increased proportions of minority residents (Hispanic, Native American, and Black). In addition to the baseline survey, study participants who are interested and medically eligible may initiate PrEP services with the University of Colorado HIV Prevention Program and receive PrEP through telemedicine visits, mailed home lab kits, and mailed medication. Persistence in PrEP care, acceptability, and feasibility of telemedicine and home lab kits will be measured through baseline and follow-up survey questionnaires and clinical chart reviews for those engaged in PrEP care.

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

Arm && Interventions

Group	Intervention	Description
Telemedicine Clinical Care	Virtual clinical visits with home lab kits and mailed HIV PrEP	Rural participants who enter PrEP clinical care with University of Colorado HIV Prevention Program will receive care via telemedicine with mailed lab kits and mailed HIV PrEP.

Primary Outcome Measures

Name	Time	Method
Persistence in PrEP care	12 months	The proportion of study participants persisting in PrEP care at 12 months, stratified by race, ethnicity, zip 3 region, and type of insurance coverage.

Secondary Outcome Measures

Name	Time	Method
Feasibility of postal lab kits	12 months	Describe feasibility of postal lab kits, as determined by survey response and completion of quarterly lab monitoring.
Acceptability of Telemedicine visits	12 months	Describe acceptability of Telemedicine visits as determined by survey response and completion of quarterly visits.
Feasibility of Telemedicine visits	12 months	Describe feasibility of Telemedicine visits as determined by survey response and completion of quarterly visits.
Acceptability of postal lab kits	12 months	Describe acceptability of postal lab kits, as determined by survey response and completion of quarterly lab monitoring.
Medication adherence	12 months	Describe PrEP medication adherence rates at 12 months (as determined by pharmacy refill data) for rural CO PrEP users who utilize Telemedicine PrEP services and postal lab kits.
HIV seroconversion	12 months	Describe rate of HIV seroconversion in cohort at 12 months.

Locations (1): University of Colorado Hospital
🇺🇸
Aurora, Colorado, United States