HIV Preexposure Prophylaxis Discussions and Provision Integrated Into Ob-Gyn Care [ID 1043]

INTRODUCTION: The American College of Obstetricians & Gynecologists recommends that obstetrician–gynecologists discuss HIV preexposure prophylaxis (PrEP) with all sexually active patients, but PrEP services have not been routinely integrated into ob-gyn settings in the United States. METHODS: In January 2024, a private ob-gyn practice in upstate New York integrated PrEP using a protocol that was developed via formative work with women in the community and practice staff. As part of new patient and annual paperwork, patients complete a PrEP screening form to indicate whether they want to discuss PrEP during their visit. Clinicians discuss PrEP with all patients who indicate interest (per the form) and with patients for whom the clinician believes PrEP may be appropriate. Patients interested in starting PrEP complete HIV testing and schedule a subsequent PrEP initiation visit. In June 2024, we conducted one-on-one interviews with clinicians to identify barriers and facilitators to PrEP integration. RESULTS: From January 2024 to March 2025, there were 19,362 patient encounters; 37% were obstetric encounters and 51% were among patients under 35 years old. Clinicians discussed PrEP during 3,925 (20%) encounters. The proportion of encounters where PrEP was discussed increased from 4.7% in the first 3 months to 24% in the subsequent 12 months. Preexposure prophylaxis was prescribed for eight patients. Themes from clinician interviews included: PrEP integration was less time-consuming than anticipated; PrEP paperwork facilitated conversations; and PrEP education is important despite ultimately low PrEP uptake. CONCLUSIONS/IMPLICATIONS: Despite few patients receiving a PrEP prescription, our study demonstrates that HIV PrEP discussions can be routinely integrated into visits at ob-gyn private practices.