(P153) SCALING UP HIV PREVENTION AT THE SEXUAL HEALTH CLINIC OF A LOCAL HEALTH DEPARTMENT IN TEXAS WITH THE IMPLEMENTATION OF UNIVERSAL ACCESS TO ORAL AND LONG-ACTING INJECTABLE PRE-EXPOSURE PROPHYLAXIS

Background:
With 2.6 million residents, Dallas County is the second most populous county in Texas and is celebrated for its vibrant diversity. In 2021, Dallas County accounted for 798 out of 4,363 or 18.3% of new HIV diagnoses in the state. In May 2020, to address this concern, Dallas County Health and Human Services (DCHHS) Sexual Health Clinic (SHC) began an initiative offering PrEP (pre-exposure prophylaxis) to targeted priority populations at high risk for HIV transmission—men who have sex with men (MSM), transgender individuals, people who inject drugs (PWID), and Black or Hispanic women with recent STI diagnoses. The initiative expanded in September 2021 to include status-neutral PrEP access, initially offering oral PrEP (Truvada and Descovy), and later introducing injectable Cabotegravir (Apretude) in June 2022. Both oral and injectable PrEP are highly effective in preventing new HIV infections through sex.

Methods:
A retrospective review was conducted on the medical records of 95 patients newly prescribed PrEP at the SHC from June 2022 to September 2023. The study examined retention rates for both oral and injectable PrEP, defined as patients who maintained at least one follow-up visit at 6 months (±30 days) from their first appointment.

Results:
Out of the 95 patients, 10 (11%) started on injectable PrEP, while 85 (89%) started on oral PrEP. At 6 months, 43 patients (45%) remained engaged, with 20 (47%) on injectable PrEP and 23 (53%) on oral PrEP. No HIV seroconversions occurred among adherent PrEP users during this time.

Conclusion:
The study indicates a potential preference for injectable PrEP over oral PrEP, with higher retention rates observed at 6 months. These findings highlight the importance of offering PrEP options to meet individual preferences. Further research is needed to understand the factors influencing retention rates and medication preferences, providing valuable insights to optimize PrEP utilization and HIV prevention efforts.