(PL5) PUBLIC HEALTH DETAILING TO PROMOTE DOXYCYCLINE POST-EXPOSURE PROPHYLAXIS (DOXY-PEP) FOR SEXUALLY TRANSMITTED INFECTION PREVENTION AMONG PROVIDERS IN LOS ANGELES COUNTY

Background:
In 2024 national and state guidelines were released for the use of Doxycycline Post-Exposure Prophylaxis (Doxy-PEP) as a biomedical prevention option for bacterial STIs, but awareness and use of Doxy-PEP are low. The Los Angeles County (LAC) Department of Public Health (DPH) deployed public health detailing to expedite Doxy-PEP use among LAC providers.

Methods:
Six public health detailers were trained to deliver guidance and evidence of Doxy-PEP efficacy and deployed to visit 920 facilities with a history of reporting syphilis and HIV cases. Between April and July 2024, detailers conducted initial and follow-up provider visits, separated by four weeks. A pre-and post-test design was used to compare change in provider knowledge, willingness to prescribe, and Doxy-PEP prescription from initial to follow-up visit. We describe results from the initial detailing visits to date.

Results:
From April 29 through May 31, 2024, detailers completed initial visits with 677 providers at 404 facilities (44% of identified facilities).  The majority were primary care providers (79%), 9% women’s health, and 6% adolescent medicine. The majority of providers (63%) have been in practice for over 10 years. At the initial visit, most providers (44%) were not familiar with Doxy-PEP. Of providers reporting any prior knowledge of Doxy-PEP (n=381), 49% reported they were likely to prescribe it and, 9% of providers were already prescribing Doxy-PEP. One third of providers (33%) reported barriers to prescribing Doxy-PEP. Among those, the top three barriers were cost to the patient (41%), efficacy (31%), and side effects (30%); only 13% reported concerns around antimicrobial resistance.

Conclusion:
Public health detailing was a successful strategy to promote knowledge of Doxy-PEP to medical providers in LAC. Baseline data indicate low provider familiarity with Doxy-PEP; follow-up visit data available in four weeks will describe the impact of detailing on knowledge and prescribing patterns.  -