J Acquir Immune Defic Syndr

Background:Men who have sex with men (MSM) with bacterial STDs are at elevated risk for HIV. We evaluated the integration of pre-exposure prophylaxis (PrEP) referrals into STD partner services (PS) for MSM.Setting:King County, WashingtonMethods:Disease Intervention Specialists (DIS) in King County attempt to provide PS to all MSM with early syphilis and, as resources allow, MSM with gonorrhea or chlamydia. Our health department defines MSM with any of the following as at high HIV risk: early syphilis, rectal gonorrhea, methamphetamine/poppers use, sex work, or an HIV-unsuppressed partner. DIS offer high-risk MSM referral to our STD Clinic for PrEP and other MSM referral to community providers. In 2017, we interviewed a random sample of MSM offered referrals in 2016 to assess PrEP initiation following PS.Results:From 8/2014-8/2017, 7546 cases of bacterial STDs were reported among HIV-negative MSM. DIS provided PS to 3739 MSM, of whom 2055 (55%) were at high risk. DIS assessed PrEP use in 1840 (90%) of these men, 895 (49%) of whom reported already using PrEP. DIS offered referrals to 693 (73%) of 945 MSM not on PrEP; 372 (54%) accepted. Among 132 interviewed for the random sample, men who accepted referrals at initial interview were more likely to report using PrEP at follow-up (32/68=47%) than those who did not (12/64=19%) [p=0.0006]. 10.4% of all interviewed MSM initiated PrEP following PS-based referral.Conclusions:Integrating PrEP referrals into STD PS is an effective population-based strategy to link MSM at high HIV risk to PrEP.20192020-04-15T00:00:00ZH25 PS004364/PS/NCHHSTP CDC HHS/United StatesH25 PS005108/PS/NCHHSTP CDC HHS/United StatesP30 AI027757/AI/NIAID NIH HHS/United StatesUL1 TR002319/TR/NCATS NIH HHS/United States30649032PMC7027991770