Linking Black women to PrEP care using warm handoff referrals from emergency departments to local PrEP clinics

AIDS Care. 2025 Jan 2:1-8. doi: 10.1080/09540121.2024.2446698. Online ahead of print.

Abstract

New Human Immunodeficiency Virus (HIV) cases continue to disproportionately burden cisgender Black/African American women in the United States due to a confluence of structural and systemic factors. Pre-exposure prophylaxis (PrEP) is a safe and effective HIV prevention option, yet there is a striking gap between PrEP eligibility and uptake among cisgender Black women. The current study evaluates a novel warm handoff process in a hospital emergency department setting linking eligible women to local PrEP clinics within 72 hours of hospital discharge in a large southwestern metropolitan city. Participants received follow-up telephone consultations at 1-month (T1), 3-months (T2), and 6-months (T3) post-enrollment. Of 40 participants, one was successfully linked to their initial PrEP clinic visit. One additional participant reported attending their PrEP visit, but staff were unable to confirm linkage. Twenty-eight percent of participants attended follow-up telephone visits at T1, T2, and T3, while 35% of participants attended a combination of some, and 37% of participants did not engage in any follow-up visits. Findings suggest that culturally tailored linkage interventions are suitable mechanisms for engaging cisgender Black women in PrEP care. Implications for future research include exploring the sustainability and scalability of such interventions are discussed.

Keywords: Black women; Linkage; PrEP; SDG 10: Reduced inequalities; SDG 3: Good health and well-being; emergency department.