Evidence suggests that tools for identifying populations who may benefit from PrEP are required for monitoring progress in PrEP scale-up. Using a validated prediction model to estimate HIV risk, researchers evaluated PrEP coverage and disparities in use among nearly 3.3 million patients at high risk of HIV acquisition in a large healthcare system. The team used the prediction model to generate an HIV risk score for each participant based on historical EHR data. Pharmacy fill data were used to assess recent and ever PrEP use by HIV risk score strata. Chi-square tests were used to compare recent and ever PrEP use by demographic characteristics among those with very high risk scores. Among those with low and very high risk scores, recent PrEP use ranged from 0.02% to 40.4%, and ever PrEP use from 0.02% to 51.4%, respectively. “Of those identified by our model as being at very high risk of HIV acquisition, nearly 60% had not recently used PrEP and there were substantial disparities in use,” write the study authors. “Efforts are needed to increase PrEP uptake in insured populations, particularly among females, younger age groups, those with lower socioeconomic status, and Black individuals.”


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