Survey assessment of HIV pre-exposure prophylaxis availability in student health services in New England colleges and universities

Abstract

Objective: To determine HIV pre-exposure prophylaxis (PrEP) availability at student health services (SHS) in New England. Methods: We conducted an electronic survey of medical directors of SHS at New England colleges and universities. We measured the availability and volume of PrEP prescribing, barriers and facilitators to prescribing and provider knowledge. Results: Of 143 institutions surveyed, 39% completed questionnaires; 75% were private and 93% were 4 years. Thirty-six percent of institutions did not offer PrEP. Those offering PrEP started a mean of 2.0 per 1000 students/year. PrEP was available at more schools with higher vs. lower endowments (100 vs. 38%, p = 0.002), 4- vs. 2-year programs (68 vs. 0%, p = 0.042), and private vs. public schools (73 vs. 38%, p = 0.043). Conclusions: PrEP was not available at one in three New England SHS and prescribing rates at institutions that offered PrEP were low. Interventions are needed to improve PrEP access.

Keywords:

• Clinical medicine
• HIV
• pre-exposure prophylaxis
• student health

Acknowledgments

We thank Oni Blackstock MD, MHS for survey questions; Spiro Marinopoulous MD, MBA for reviewing our survey instrument and providing content recommendations; Karen Axten MD, Caitlin Bove MD, Leah Harvey MD, MPH, and Lily D. Yan MD, MSc for reviewing our survey for timing; Sarah Lipson PhD, EdM, Kathryn Fantasia MD, MSc, and Sarah Zieminski MSc for manuscript review and editorial guidance, and the patients who have informed this work.

Conflict of interest disclosure

S Rawlins-Pilgrim has received an honorarium from the Boston University Chobanian and Avedesian School of Medicine Continuing Medical Education office for a program funded via an unrestricted educational grant from Gilead Sciences, Inc. A Wheelock receives salary support from NIH training grant T32HL125232-07. CG Streed Jr receives salary support from: Providence/Boston Center for AIDS Research Interest Group (P30AI042853-23), Boston University School of Medicine Department of Medicine Career Investment Award American Heart Association career development grant (AHA 20CDA35320148), National Heart, Lung, and Blood Institute career development grant (NHLBI 1K01HL151902-01A1), Doris Duke Charitable Foundation (Grant #2022061). DS Krakower has consulted with Fenway Health for research funded by Gilead Sciences and Merck. He receives salary support from the Harvard University Center for AIDS Research (CFAR), an NIH funded program (P30 AI060354). He has also received honoraria from DKBMed and Virology Education for developing medical education content and royalties from UpToDate Inc for authoring medical education content. JL Taylor receives salary support from a grant from the Massachusetts Department of Public Health, Bureau of Infectious Disease and Laboratory Sciences, Office of HIV/AIDS for HIV/HCV/STI/TB Prevention, Linkage, and Retention in Care [INTF4944MM3181926007]. She has received an honorarium for an eHIV Review on PrEP in PWID from Johns Hopkins School of Medicine, a program funded via unrestricted educational grants from Gilead Sciences, Inc. and ViiV Healthcare. The authors confirm that the research presented in this article met the ethical guidelines, including adherence to the legal requirements, of the United States of America and received an exemption from the Institutional Review Board of the Boston University Medical Campus and Boston Medical Center.

Additional information

Funding

This work was funded by HRSA D33HP29243 and CTSI 1UL1TR001430.