• Mirinda Ann Gormley, Tibor R Nagy, Phillip Moschella, Zhexi Lu, Julia Rodriguez, and Prerana Roth.
• Department of Emergency Medicine, Prisma Health Upstate, Greenville, SC; University of South Carolina School of Medicine Greenville, Greenville, SC; Clemson University School of Health Science Research, Greenville, SC. Electronic address: mirinda.gormley2@prismahealth.org.
• Ann Emerg Med. 2023 Apr 1; 81 (4): 468481468-481.

Study ObjectiveMany emergency departments (EDs) have identified the importance of HIV prevention and have implemented steps to screen and offer preexposure prophylaxis (PrEP). The objective of this study was to systematically review existing literature that identifies PrEP eligibility in the ED and summarize outcomes along the PrEP cascade of care (awareness, interest, linkage to treatment, initiation, and retention) for patients in ED.MethodsFour databases captured all PrEP-related studies in EDs from January 1, 2013 to January 27, 2022. Data were extracted on study characteristics and outcomes, and study quality was assessed using a modified quality assessment tool by the Effective Public Health Practice Project.ResultsOf the 218 articles, 16 were subjected to full-text review, and 7 met inclusion criteria. Although most studies identified patients who were PrEP eligible using criteria adapted from the 2017 Centers for Disease Control and Prevention PrEP guidelines, the number and time frame for each criterion varied. Six studies reported outcomes on the PrEP cascade of care, showing a relatively high prevalence of awareness and interest but a very low prevalence of linkage and uptake. No studies documented retention in PrEP treatment.ConclusionAlthough up to a third of patients in ED assessed in the current study were PrEP eligible, less than half of PrEP-eligible participants had prior knowledge of PrEP, and very few who expressed interest in the ED were ultimately linked to PrEP treatment or initiated PrEP. Future research is necessary to identify strategies to increase PrEP education, interest, and linkage to care from the ED.Copyright © 2022 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

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