scholarly journals Acceptability of remote prescribing and postal delivery services for contraceptive pills and treatment of uncomplicated Chlamydia trachomatis

2020 ◽  
pp. bmjsrh-2020-200687
Author(s):  
Tom Nadarzynski ◽  
Ynez Symonds ◽  
Robert Carroll ◽  
Jo Gibbs ◽  
Sally Kidsley ◽  
...  
Keyword(s):  
Online Survey ◽  
Home Delivery ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sti Testing ◽  
Contraceptive Pills ◽  
Remote Management ◽  
Delivery Services ◽  
The Cost ◽  
To Receive

ObjectivesThe digitalisation of sexual and reproductive health (SRH) services offers valuable opportunities to deliver contraceptive pills and chlamydia treatment by post. We aimed to examine the acceptability of remote prescribing and ‘medication-by-post’ in SRH.Study designAn online survey assessing attitudes towards remote management was distributed in three UK SRH clinics and via an integrated sexually transmitted infection (STI) postal self-sampling service. Logistic regressions were performed to identify potential correlates.ResultsThere were 1281 participants (74% female and 49% <25 years old). Some 8% of participants reported having received medication via post and 83% were willing to receive chlamydia treatment and contraceptive pills by post. Lower acceptability was observed among participants who were: >45 years old (OR 0.43 (95% CI 0.23–0.81)), screened for STIs less than once annually (OR 0.63 (0.42–0.93)), concerned about confidentiality (OR 0.21 (0.90–0.50)), concerned about absence during delivery (OR 0.09 (0.02–0.32)) or unwilling to provide blood pressure readings (OR 0.22 (0.04–0.97)). Higher acceptability was observed among participants who reported: previously receiving medication by post (OR 4.63 (1.44–14.8)), preference for home delivery over clinic collection (OR 24.1 (11.1–51.9)), preference for home STI testing (OR 10.3 (6.16–17.4)), ability to communicate with health advisors (OR 4.01 (1.03–15.6)) and willingness to: register their real name (OR 3.09 (1.43–10.6)), complete online health questionnaires (OR 3.09 (1.43–10.6)) and use generic contraceptive pills (OR 2.88 (1.21–6.83)).ConclusionsPostal treatment and entering information online to allow remote prescribing were acceptable methods for SRH services and should be considered alongside medication collection in pharmacies. These methods could be particularly useful for patients facing barriers in accessing SRH. The cost-effectiveness and implementation of these novel methods of service delivery should be further investigated.

scholarly journals Uncovering a Role for Electronic Personal Health Records in Reducing Disparities in Sexually Transmitted Infection Rates Among Students at a Predominantly African American University: Mixed-Methods Study (Preprint)

2017 ◽  
Author(s):  
Kevon-Mark Jackman ◽  
Stefan David Baral ◽  
Lisa Hightow-Weidman ◽  
Tonia Poteat
Keyword(s):  
Health Communication ◽  
Online Survey ◽  
Black Youth ◽  
Personal Health ◽  
Test Results ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sti Testing ◽  
Signed Rank ◽  
Electronic Personal Health Records

BACKGROUND Black youth continue to bear an overwhelming proportion of the United States sexually transmitted infection (STI) burden, including HIV. Several studies on web-based and mobile health (mHealth) STI interventions have focused on characterizing strategies to improve HIV-related prevention and treatment interventions, risk communication, and stigma among men who have sex with men (MSM), people who use substances, and adolescent populations. The Electronic Sexual Health Information Notification and Education (eSHINE) Study was an exploratory mixed-methods study among students at a historically black university exploring perceptions on facilitating STI testing conversations with partners using electronic personal health records (PHRs). OBJECTIVE The purpose of this paper is to use eSHINE Study results to describe perceived impacts of electronic PHRs on facilitating STI testing discussions between sexual partners. METHODS Semistructured focus groups and individual in-depth interviews were conducted on a heterogeneous sample of students (n=35) between May and July 2014. Qualitative phase findings guided development of an online survey instrument for quantitative phase data collection. Online surveys were conducted using a convenience sample of students (n=354) between January and May 2015. Online survey items collected demographic information, sexual behaviors, beliefs and practices surrounding STI testing communication between partners, and beliefs about the impact of electronic PHR access on facilitating these discussions with partners. Chi-square analysis was performed to assess gender differences across quantitative measures. A Wilcoxon signed rank sum test was used to test the null hypothesis that electronic PHRs are believed to have no effect on the timing of dyadic STI health communication. RESULTS Participants described multiple individual and dyadic-level factors that inhibit initiating discussions about STI testing and test results with partners. Electronic PHRs were believed to improve ability to initiate conversations and confidence in STI screening information shared by partners. Among online survey participants, men were more likely to believe electronic PHRs make it easier to facilitate STI talks with potential partners (59.9% vs 51.9%; χ2=3.93, P=.05). The Wilcoxon signed-rank test results indicate significant increases in perceived discussion timing before sex with electronic PHR access (61.0% vs 40.4%; P<.001). CONCLUSIONS Findings suggest that electronic PHR access in STI screening settings among similar populations of Black youth may improve both motivation and personal agency for initiating dyadic STI health communication. Results from this study will likely inform novel interventions that use access to electronic PHRs to stimulate important health-related discussions between sexual partners. Moving forward requires studying strategies for implementing interventions that leverage electronic PHRs to create new sexual health communication channels with providers, peers, and family among black youth.

scholarly journals Characteristics of youth agreeing to electronic sexually transmitted infection risk assessment in the emergency department

2017 ◽  
Vol 35 (1) ◽  
pp. 46-51 ◽  
Author(s):  
Fahd A Ahmad ◽  
Donna B Jeffe ◽  
Katie Plax ◽  
Kenneth B Schechtman ◽  
Dwight E Doerhoff ◽  
...  
Keyword(s):  
Demographic Data ◽  
Chief Complaint ◽  
Sexual History ◽  
Computer Assisted ◽  
Inconsistent Condom ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Multiple Partners ◽  
Sti Testing ◽  
To Receive

ObjectivesAdolescents and young adults are at high risk for sexually transmitted infections (STIs). We previously reported an increase in STI testing of adolescents in our ED by obtaining a sexual history using an Audio-enhanced Computer-Assisted Self-Interview (ACASI). We now examine associations among demographics, sexual behaviour, chief complaint and willingness to be tested.MethodsThis was a prospective study conducted in a paediatric ED between April and December 2011. After triage, eligible patients between 15 and 21 years presenting with non-life-threatening conditions were asked to participate in the study. Consenting participants used an ACASI to provide their demographic data and answer questions about their sexual history and willingness to be tested. Our primary outcome was the association of demographics, chief complaint and ACASI recommendation with the participant’s willingness to be tested.ResultsWe approached 1337 patients, of whom 800 (59%) enrolled and completed the ACASI. Eleven who did not answer questions related to their sexual history were excluded from analysis. Of 789 participants, 461 (58.4%) were female and median age was 16.9 years (IQR 16.0–17.8); 509 (64.5%) endorsed a history of anal, oral and/or vaginal intercourse. Disclosing a sexual history and willingness to be tested did not differ significantly by gender. 131 (16.6%) had a chief complaint potentially referable to an STI; among the 658 participants with non-STI-related complaints, 412 (62.6%) were sexually active, many of whom disclosed risky behaviours, including multiple partners (46.4%) and inconsistent condom use (43.7%). The ACASI identified 419 patients as needing immediate STI testing; the majority (81%) did not have a chief complaint potentially related to STIs. 697 (88.3%) participants were willing to receive STI testing. Most (94.6%) of the patients with STI-related complaints were willing to be tested, and 92.1% of patients with a recommendation for immediate testing by the ACASI indicated a willingness to be tested.ConclusionsAdolescents were willing to disclose sexual activity via electronic questionnaires and were willing to receive STI testing, even when their chief complaint was not STI related. The ACASI facilitated identification of adolescent ED patients needing STI testing regardless of chief complaint.

Regular STI testing amongst men who have sex with men and use social media is suboptimal – a cross-sectional study

2016 ◽  
Vol 28 (6) ◽  
pp. 573-583 ◽  
Author(s):  
Jamie Frankis ◽  
Lisa Goodall ◽  
Dan Clutterbuck ◽  
Abdul-Razak Abubakari ◽  
Paul Flowers
Keyword(s):  
Confidence Interval ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Anal Intercourse ◽  
Sex Partners ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sti Testing ◽  
Male Sex ◽  
Sex With Men

Sexually transmitted infections (STIs) disproportionately affect men who have sex with men, with marked increases in most STIs in recent years. These are likely underpinned by coterminous increases in behavioural risks which have coincided with the development of Internet and geospatial sociosexual networking. Current guidelines advocate regular, annual sexually transmitted infection testing amongst sexually active men who have sex with men (MSM), as opposed to symptom-driven testing. This paper explores sexually transmitted infection testing regularity amongst MSM who use social and sociosexual media. Data were collected from 2668 men in Scotland, Wales, Northern Ireland and the Republic of Ireland, recruited via social and gay sociosexual media. Only one-third of participants report regular (yearly or more frequent) STI testing, despite relatively high levels of male sex partners, condomless anal intercourse and high-risk unprotected anal intercourse. The following variables were associated with regular STI testing; being more ‘out’ (adjusted odds ratio = 1.79; confidence interval = 1.20–2.68), HIV-positive (adjusted odds ratio = 14.11; confidence interval = 7.03–28.32); reporting ≥10 male sex partners (adjusted odds ratio = 2.15; confidence interval = 1.47–3.14) or regular HIV testing (adjusted odds ratio = 48.44; confidence interval = 28.27–83.01). Men reporting long-term sickness absence from work/carers (adjusted odds ratio = 0.03; confidence interval = 0.00–0.48) and men aged ≤25 years (adjusted odds ratio = 0.36; 95% confidence interval = 0.19–0.69) were less likely to test regularly for STIs. As such, we identify a complex interplay of social, health and behavioural factors that each contribute to men’s STI testing behaviours. In concert, these data suggest that the syndemics placing men at elevated risk may also mitigate against access to testing and prevention services. Moreover, successful reduction of STI transmission amongst MSM will necessitate a comprehensive range of approaches which address these multiple interrelated factors that underpin MSM's STI testing.

scholarly journals 1296. Potential use of Sexually Transmitted Infection (STI) Testing for Expanding HIV Pre-Exposure Prophylaxis (PrEP) at an Urban Hospital Center

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S396-S396
Author(s):  
Robert Pitts ◽  
Robert Holzman ◽  
Richard Greene ◽  
Emily Lam ◽  
Ellie Carmody ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Medical Center ◽  
Positive Test ◽  
Prescription Data ◽  
Urban Hospital ◽  
Enrichment Programs ◽  
Transmitted Infection ◽  
Missed Opportunities ◽  
Sexually Transmitted ◽  
Sti Testing

Abstract Background Despite the high efficacy of PrEP, it continues to be underutilized. We examined the extent to which patients with a documented positive test for STIs were provided PrEP at an urban municipal medical center. Methods We reviewed data of all patients seen between January 1, 2014 and July 30, 2017 who were &gt; 18 years old and had an initial HIV negative test and ≥1 positive test for Chlamydia, Gonorrhea, or Syphilis. We examined PrEP prescription data by gender, race/ethnicity, and clinic location. Differences between groups were compared using Chi-squared analysis and logistic regression. Results Of 1,142 initially HIV− patients who were identified as having a positive STI result, 52% were female, 89% either Black or Hispanic, with a median age of 40 years (quartiles 30, 47). 58% had Medicare/Medicaid and 34% were self-pay or uninsured (Table 1). Only 25 (2.1%) of 1,142 patients who had ≥1 STI test positive were prescribed PrEP. No women received PrEP. Whites (aOR: 21.7 [95% CI:4.4, 107, P &lt; 0.001] and Hispanics (aOR:6.64 [95% CI:1.35, 32.8, P = 0.02] were both more likely to receive PrEP than Blacks, after adjusting for age, sex, marital status, and insurance. All PrEP prescriptions originated from the Medicine, Emergency, or HIV specialty clinics although most STI testing was obtained in Emergency and Obstetrical/Gynecological clinics (Table 2). Conclusion There were significant missed opportunities for HIV prevention among patients with STIs within the medical center, particularly among Hispanic and Black patients. Enrichment programs to educate providers and increase PrEP prescriptions may have a major impact on expanding HIV prevention, especially for women. Disclosures All authors: No reported disclosures.

College students’ preferences for information on self-initiated sexually transmitted infection testing

2020 ◽  
pp. 001789692095969
Author(s):  
Oluwamuyiwa Winifred Adebayo ◽  
Jocelyn C Anderson ◽  
Britney M Wardecker
Keyword(s):  
College Students ◽  
Sexually Transmitted Infection ◽  
Qualitative Content Analysis ◽  
Low Cost ◽  
Transmitted Disease ◽  
Structured Interview ◽  
Sexual History ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sti Testing

Objective: The purpose of this study was to identify preferences for content, method of delivery and frequency of information to encourage self-initiated sexually transmitted infection (STI) testing. Design: Qualitative study involving individual in-depth interviews with 35 college students aged 18–24 years. Setting: A university in Central Pennsylvania, USA. Method: Data were collected using a demographic and sexual history questionnaire, Sexually Transmitted Disease Knowledge Questionnaire and a semi-structured interview guide. Transcribed interviews were analysed using qualitative content analysis. Results: Findings from the study document STI testing information preferences as they relate to self-initiated testing. The majority of participants preferred receiving STI testing information through email. Themes within their accounts included Actionable Information Content, Frequently Accessed Delivery Method, and Routine STI Testing Information. Conclusion: The high incidence of STIs among US college students is an indication of the need to increase diagnosis and treatment to reduce transmission. Study findings have implications for the development and evaluation of low-cost interventions to improve the uptake of STI testing and reduce STI burden among college students.

Safeguarding outcomes of 16 and 17-year-old service users of Sexual Health London (SHL.uk), a pan-London online sexual health service

2020 ◽  
Vol 31 (14) ◽  
pp. 1373-1379
Author(s):  
Sara Day ◽  
Ryan Kinsella ◽  
Sophie Jones ◽  
Victoria Tittle ◽  
Tara Suchak ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Sexual Health ◽  
Social Services ◽  
Child Protection ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Health Clinics ◽  
Sti Testing ◽  
Sexual Health Service ◽  
Sexual Health Clinics

Guidance around how to safeguard young people using online sexual health services (e-SHSs) is limited. Sexual Health London (SHL.uk) is an e-SHS, integrated with London’s sexual health clinics (SHCs), offering users aged 16 years and above sexually transmitted infection (STI) testing. For a safeguarding risk assessment, under 18s must complete a safeguarding e-triage, and any concern raised results in a ‘call back’ (CB) by the SHL.uk team. The safeguarding outcomes of CBs between 8 January 2018 and 18 September 2018 were reviewed; 261/454 (57.5%) users never triggered a CB on their e-triage (non-CB group) and 193/454 (42.5%) users triggered one or more CB(s) (CB group). Safeguarding concerns disclosed predominantly related to drug/alcohol use and partner's age imbalance. Successful telephonic risk assessment took place in 84.5% CB cases. Safeguarding outcomes comprised referrals to: SHC in 35.5%; child protection team in 8.5%; social services in 7%. STI positivity was 16.4% and 15.2% in the CB and non-CB groups, respectively. Although a high number of safeguarding triggers were disclosed, only a small proportion warranted referral for further support/intervention. Using e-triage with telephony support to screen and safeguard adolescents accessing an e-SHS was acceptable to users and enabled their clinical and safeguarding needs to be safely met. e-SHS integration within a network of SHCs further supported this model.

scholarly journals Developing a Typology of HIV/STI Testing Patterns Among Gay, Bisexual, and Queer Men: A Framework to Guide Interventions

2019 ◽  
Vol 30 (4) ◽  
pp. 610-621 ◽  
Author(s):  
Rayner Kay Jin Tan ◽  
Nashwinder Kaur ◽  
Mark I-Cheng Chen ◽  
Chen Seong Wong
Keyword(s):  
Thematic Analysis ◽  
External Factors ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Factors Associated ◽  
Sti Testing ◽  
Semistructured Interviews ◽  
Testing Patterns ◽  
Purposive Sample ◽  
Inductive Thematic Analysis

Although factors associated with HIV/sexually transmitted infection (STI) testing among gay, bisexual, and queer (GBQ) men are well-established in the literature, few studies have attempted to delineate the processes underlying different patterns of testing. We conducted a qualitative study involving 35 semistructured interviews with a purposive sample of GBQ men in Singapore from October 2017 to July 2018. Topics explored included formative sexual experiences, relationships, and experiences of HIV/STI testing. Interviews were audio-recorded, transcribed, coded, and analyzed through inductive thematic analysis. A typology comprising four distinct HIV/STI testing patterns was identified from the data, categorized based on the regularity of testing, relative to internal or external factors that motivate testing behaviors. These include triggered episodic testing, influenced episodic testing, institutionalized regular testing, and value-based regular testing. The typology highlights the preconditions that underlie different testing patterns and provides a framework for developing interventions that promote HIV/STI testing among GBQ men.

scholarly journals 1294. Long-Term Impact of an HIV Testing Program on High-Risk HIV Screening in the Emergency Department

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S466-S466
Author(s):  
Jillian T Baron ◽  
Alexis Schwartz ◽  
Ebony Davis ◽  
Julie E Uspal ◽  
Brendan Kelly
Keyword(s):  
Emergency Department ◽  
High Risk ◽  
Hiv Testing ◽  
Retrospective Chart Review ◽  
Hiv Screening ◽  
Transmitted Infection ◽  
Testing Program ◽  
Sti Testing ◽  
Hiv Test ◽  
To Receive

Abstract Background Emergency Departments (EDs) are important sites for HIV testing. However, there is little guidance on how best to implement HIV testing in the ED. The purpose of this study was to evaluate HIV screening practices of high-risk individuals presenting to an ED in the absence (ED1) and in the presence (ED2) of an established HIV testing program within the same academic hospital. Methods We performed a retrospective chart review of all individuals 18 years or older presenting to either ED between January 1, 2016 and December 31, 2018. High-risk of HIV infection was determined by receipt of bacterial sexually transmitted infection (STI) testing for Neisseria gonorrhoeae or Chlamydia trachomatis. The primary outcome was receipt of any HIV test in the ED. Overall proportions of patients tested for HIV at the same time of STI testing were compared between sites by chi-square test. Predictors of HIV testing were analyzed by logistic regression. Results During the study period, 7,956 individuals received STI testing at ED1 and 10,815 received STI testing at ED2. The majority of individuals receiving STI testing at both sites were female, 81.2% at ED1 and 66.4% at ED2 (P <0.001). Only 4.0% of individuals received HIV testing at ED1 compared with 47.4% at ED2 (P <0.001). Individuals were significantly more likely to receive HIV testing at the time of STI testing in the ED with an HIV testing program (aOR 19.66, 95% CI 17.28–22.37). In the ED without an HIV testing program, individuals were more likely to receive HIV testing if they were male (aOR 3.57, 95% CI 2.78–4.55) and less likely if they were black (aOR 0.57, 95% CI 0.50–0.97). In the ED with an HIV testing program, individuals were more likely to receive HIV testing if they were male (aOR 2.17, 95% CI 1.92–2.44) and more likely if they were black (aOR 1.74, 95% CI 1.37–2.20). Conclusion Overall, the presence of an HIV testing program in the ED significantly increased the probability that individuals would receive an HIV test at the time of bacterial STI testing and mitigated disparities in care. The results of this study will help guide ongoing interventions to improve HIV screening among high-risk individuals in the emergency department. Disclosures All authors: No reported disclosures.

Intention of college students to receive the human papillomavirus vaccine

2016 ◽  
Vol 116 (4) ◽  
pp. 342-355 ◽  
Author(s):  
Keith Richards
Keyword(s):  
College Students ◽  
Human Papillomavirus ◽  
Information Seeking ◽  
Hpv Vaccine ◽  
Human Papillomavirus Vaccine ◽  
Transmitted Infection ◽  
Content Type ◽  
Sexually Transmitted ◽  
The Usa ◽  
To Receive

Purpose – The purpose of this paper is to better understand what influences the intentions of college students to receive the human papillomavirus (HPV) vaccine. HPV is the most common sexually transmitted infection in the USA and cancers related to HPV are on the rise. Design/methodology/approach – A 2×2 experimental design was used to predict the intentions. Messages were created that manipulated the level of severity and vulnerability to determine which would increase intentions to receive the HPV vaccine. Each of the 278 participants viewed a message that contained one severity message (high or low) and one vulnerability message (high or low). Findings – Regression was used to determine that elements of the protection motivation theory such as vulnerability and fear, along with norms, and information seeking explained a significant portion of the variance in intent to be vaccinated (R2=0.40, F(4, 268)=44.47, p < 0.001). Norms had the most influence on intention (β=0.42, p < 0.001), next was vulnerability (β=0.21, p < 0.001) then fear (β=0.16, p=0.002), and finally information seeking (β=0.10, p=0.01). Originality/value – The current college age population did not have the opportunity to be vaccinated early and the recent (2011) recommendation that males get vaccinated makes this research valuable to those designing vaccination messages. The current study shows that norms were the most influential variable in regards to increasing intent to get vaccinated. This means that if the participant believed their friends would support or endorse their intent to get vaccinated they were more likely to say they would follow through and get vaccinated. This finding should be highlighted in any future campaign.

scholarly journals 1529. Sexually-Transmitted Infection Testing and Positivity among Adults Receiving HIV Pre-Exposure Prophylaxis within an Integrated Health Care Delivery System in the United States

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S765-S765
Author(s):  
Mark A Schmidt ◽  
John F Dickerson ◽  
Suzanne B Schmidt ◽  
Maureen O’Keeffe-Rosetti ◽  
Judy L Donald ◽  
...  
Keyword(s):  
Sexually Transmitted Infection ◽  
Care Delivery ◽  
The United States ◽  
Health Care Delivery System ◽  
Transmitted Infection ◽  
Record System ◽  
Sexually Transmitted ◽  
Sti Testing ◽  
Exposure Prophylaxis ◽  
The Impact

Abstract Background The goal of this project was to assess the frequency of sexually-transmitted infection (STI) testing and positivity among adult individuals initiating HIV Pre-Exposure Prophylaxis (PrEP) within Kaiser Permanente Northwest (KPNW). Methods We identified KPNW members, 18 years of age and older, who initiated PrEP (tenofovir+emtricitabine) between January 1, 2015 – December 31, 2018. Using data elements abstracted from the electronic health record system, we assessed demographic characteristics of those initiating PrEP and the rate of testing and positivity for HIV, chlamydia (CT) and gonorrhea (GC) and syphilis within a window around 120 days after PrEP initiation. Results Overall, 685 members initiated PrEP during our study period, 661 (96.5%) of whom were male. Mean and median ages were 38 and 36 years, respectively, with those 25-34 years of age comprising the highest proportion (241; 35.2%). The 460 PrEP initiators (67.2% of total) who continued use beyond 120 days were significantly older than those who discontinued use (39 vs. 36 years, p=0.0008). Among continuous users, 78.3% were tested for CT+GC and 83.9% were tested for syphilis roughly 120 days post-initiation, with positivity proportions of 6.9%, 6.7%, and 2.3%, respectively. Among those discontinuing, 39.6% were tested for CT+GC and 37.3% were tested for syphilis, with positivity proportions of 10.1%, 9.0%, and 2.4%, respectively. HIV testing was completed for 87.4% of continuous PrEP users and 40.9% of those who discontinued use; and we identified a total of three individuals who tested positive for HIV, all among the latter group. Manual chart review of these individuals confirmed that HIV exposure and infection occurred after PrEP discontinuation. Conclusion We found high rates of STI testing among individuals receiving PrEP, in accordance with recommendations. Our findings of a lower STI prevalence among PrEP users is encouraging, although further work is required to assess the impact of differential testing rates and age between those who continue and discontinue PrEP use as well as reasons for PrEP discontinuation. Regular testing remains an important part of comprehensive PrEP care management and should continue to be encouraged to identify and treat STI among those at high risk for disease. Disclosures All Authors: No reported disclosures

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