Study of Rapid-Start HIV Prevention Medication and Follow-Up Care in the Parkland Emergency Department

What this Trial Is About

This research aims to improve awareness and use of HIV pre-exposure prophylaxis PrEP among people who want, need, or could benefit from it in Dallas, TX. The study focuses on a pilot program offering immediate PrEP prescriptions in the Parkland Memorial Hospital Emergency Department ED, linking patients to a dedicated PrEP clinic. It builds on previous work using an electronic health record-based HIV prediction tool and a successful ED HIV navigation program to identify and support eligible patients. Participants who qualify will be approached by a PrEP navigator in the ED based on specific criteria such as request for PrEP, high risk score, history of bacterial STIs, or clinician referral. After consent, participants receive education on all FDA-approved PrEP options and undergo a rapid HIV test. Those testing negative may receive a 30-day supply of oral PrEP from their ED clinician with referral to a PrEP clinic for ongoing care, including options for long-acting injectable PrEP. Participants choosing injectable PrEP may continue oral PrEP if needed while awaiting injections. Those testing positive for HIV or found pregnant will not enroll but receive standard care. Throughout the study, participants will be followed in the PrEP clinic for up to 12 months with regular visits every three months. Surveys will assess their experiences, satisfaction, barriers, and adherence to PrEP. Researchers will track prescription fills and injection schedules as adherence markers. The main outcome is to evaluate the feasibility of this rapid-start navigation program and connection to long-term PrEP care. Safety and persistence with PrEP will also be monitored during follow-up. Participants can continue PrEP through standard care after the study ends.

HIV Pre-Exposure Prophylaxis (PrEP) Linkage With Immediate Medications in the Emergency Department Study