Engagement and Barriers to Implementation of Biomedical Human Immunodeficiency Virus (HIV) Prevention Strategies in New York State Local Health Departments

Abstract

Objective: An important strategy to decrease human immunodeficiency virus (HIV) acquisition in the United States involves expanding access to pre-exposure (PrEP) and post-exposure prophylaxes (PEP). With their ability to reach populations across various socioeconomic and geographic backgrounds, local health departments (LHDs) are ideal settings to provide PrEP- and PEP-related services to their communities. This cross-sectional study assesses PrEP and PEP knowledge, engagement, and barriers to implementation within LHDs across New York State (NYS).

Methods: From August 2020-February 2021, we distributed a web-based survey to senior-level staff at NYS LHDs that assessed current engagement in PrEP- and PEP-related activities, desired resources to support future PrEP and PEP implementation, and the impact of the COVID-19 pandemic on LHDs’ ability to provide these services.

Results: Of the 58 LHDs in NYS, 20 (34%) completed the survey. Of responding LHDs, 40% reported PrEP engagement for adults, 35% reported PrEP engagement for adolescents, and 45% reported PEP engagement. The most frequently requested resources to support PrEP and PEP implementation were protocols for PrEP referral and trainings to assist with identifying PEP candidates. LHDs expressed a need for educational materials related to PrEP and PEP for clients and the community.

Conclusion: The high levels of interest in PrEP- and PEP-related training and outreach suggest a potential avenue to expand these services within LHDs across NYS. Study findings may help characterize the role of LHDs in PrEP and PEP provision and provide an approach to improving uptake among NYS residents through expanded access.