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Enhancing HIV Prevention through Academic Detailing in San Francisco

Learn about academic detailing (AD) to improve patient care in HIV prevention. Explore key messages on PrEP, sexual history, and STD testing. Discover challenges and strategies in engaging providers for better sexual health care.

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Enhancing HIV Prevention through Academic Detailing in San Francisco

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  1. Alyson Decker, NP, MPH San Francisco Department of Public Health California Project PrIDE Meeting November 16, 2016

  2. What is academic detailing (AD)? • Provide unbiased, non-commercial, evidence-based information • Follow a series of steps tailored to the clinician to encourage behavior change • Ends with getting a commitment to improve patient care National Resource Center for Academic Detailing (NaRCAD)

  3. Key Messages • Take a thorough sexual history to identify patients who might benefit from PrEP. • Offer PrEP to patients identified as having risks for HIV. • Conduct an HIV test to confirm a patient is HIV negative before starting them on PrEP. • Follow-up with patients every 3 months for HIV/STD testing and 90-day PrEP refill.

  4. Highlight disparities in HIV

  5. New sexual history taking mnemonic

  6. Provider pocket card

  7. Stressing importance of quarterly STD screening • Recommend q 3 month 3-site STD screening  • Encouraging patient self-collection if time/costs are barriers to testing • “Starter kits”: 50 Aptima swabs • Self-collection rectal and pharyngeal swab posters

  8. Patient educational tool

  9. Patient Schwag ClinicianSchwag

  10. After visit – Getting commitment • Use PrEP mnemonic  • Offer PrEP when appropriate (PrEP Basics) • Create a plan for follow-up every 3 months (pocket card/brochure)  • Screen patients for STIs with site-specific swabs (self-collection kit)  • Give patient schwag for PrEP starts

  11. Identifying providers • Serving priority populations • "Data to PreP” • Patient-identified  • PleasePrEPMe.org & Greaterthan.org

  12. Detailing experiences to date • 7 detailing visits • 67 evaluations collected • Many providers still not providing PrEP • Uncertainties around prescribing

  13. Challenges • Getting time from providers • Clinic sessions or free time • Scheduling time without program assistance • Desire for group presentation • How to engage providers who don’t feel that their population would benefit • Improving sexual health care/STD testing in clinics

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