A digital doorway to PrEP: Analysis of demographic trends and PrEP uptake in users requesting online testing outside London

17th June 2024 by Kate Ebbutt

Will Nutland, Love Tank, Mark Clune, Preventx, Ben Weil, Love Tank

Abstract Background

The UK aims for “zero HIV transmission” by 2030. However, reaching this goal requires broader PrEP access beyond sexual health clinics. We analysed online triage responses from users of England’s non-London Online Postal STI Service (OPSS) who triggered PrEP advice upon requesting an STI test kit. By understanding the demographics reached and influenced for PrEP uptake, public health interventions can be refined to bridge gaps, ultimately contributing to achieving public health targets.

Abstract Method

Triage responses, associated demographic data with self-reported information on sexual orientation were collected from users of OPSS outside London who, upon requesting a test kit, triggered PrEP advice, between July 1, 2021, and October 31, 2023.

Abstract Results

Our analysis revealed 450,366 unique users requested at least one STI test kit during the study period completing 769,385 triages in total. 6.9% (31,330/450,366) of the unique users accounting for 5.3% (40,994/769,385) of the triages received PrEP signposting.

The median age of users receiving PrEP advice was 29 (IQR = 23-36) years. Among those receiving PrEP advice, demographic details were as follows: GBMSM 35% (11,025/31,330); heterosexual males 26% (8,182/31,330); heterosexual females 29% (9,049/31,330); White British users 73% (22,815/31,330).

Among users receiving PrEP advice, 47.0% (14,719/31,330) returned for a subsequent test kit, with 7.4% (1,098/14,719) reporting PrEP initiation. Among those not initiating PrEP (13,621), 56.9% (8,381/13,621) received repeated PrEP advice during their return visit. The median age of users reporting PrEP uptake was 31 (IQR = 26-40) years. 93% (1,022/1,098) of the users reporting started PrEP were GBMSM, 1% (14/1,098) were heterosexual males and 1% (9/1,098) were heterosexual females. 69% (761/1,098) were from White British origins.
Users on PrEP who tested by OPSS increased by 144% from 0.9% (140/16,443) in July 2021 to 1.8% (747/33,593) in October 2023.

Abstract Conclusion

PrEP uptake lags in non-GBMSM and younger groups, despite potential benefits. Our study underscores the critical role of digital options in HIV prevention, effectively identifying at-risk users, and contributing to raising awareness for PrEP intervention. Addressing these overlooked groups is vital for achieving public health goals of zero transmission, highlighting an urgent need to expand PrEP accessibility and awareness.