(P117) IS DOXY-PEP RIGHT FOR ME? PILOTING A NOVEL PATIENT DECISION AID IN AN URBAN AMBULATORY CLINIC

Background:
Utilizing doxycycline as post-exposure prophylaxis (Doxy-PEP) requires shared decision-making between patients and providers. Patient decision aids (PDAs) are tools that help patients and providers talk together about care options. We piloted a Doxy-PEP PDA to assess its impact on the knowledge and attitudes of participants considering Doxy-PEP and its ability to be implemented in the clinical setting.

Methods:
The PDA was iteratively developed by New York Presbyterian-Columbia sexual health providers and coordinators and reviewed by our sexual health research group.  Participants assigned male at birth and with at least one STI in the past 12 months were eligible for enrollment.  After enrollment, participants completed a pre-intervention questionnaire covering Doxy-PEP attitudes, knowledge, and experiences.  The intervention involved 5-10 minutes of provider counseling using the PDA.  Participants then completed a post-intervention questionnaire re-assessing knowledge and attitudes, as well as the intervention's acceptability, appropriateness, and feasibility.

Results:
18 participants were enrolled. 33% self-identified as white, 89% as cisgender men, 89% as gay or bisexual and 17% as living with HIV. At enrollment, 28% had taken Doxy-PEP from a provider or friend. After the intervention, there was a positive change in most attitude categories, including a 32% increase in familiarity, 26% in comfort, 14% in safety and 8% in efficacy. There was a 16% increase in Doxy-PEP knowledge. 89% found the intervention acceptable, appropriate, and feasible.

Conclusion:
Using a PDA among participants undergoing a brief counseling session in a sexual health clinic increased their familiarity, comfort with, and knowledge of Doxy-PEP.  They found this intervention acceptable, appropriate, and feasible.  New sexual health interventions may benefit from the use of formally evaluated PDAs to enhance patient-provider communication. Further research is needed to see if this intervention could be delivered by non-provider staff and whether its use has impacts on Doxy-PEP effective use.