P452 A nurse-led HIV pre-exposure prophylaxis program at cool aid community health centre for men who have sex with men
Bibliographic record
Abstract
<h3>Background</h3> Gay, bisexual and MSM continue to comprise the greatest number of new HIV diagnosis in BC (BCCDC, 2016). The complexity of the HIV epidemic among MSM has highlighted the need for broader approaches to HIV prevention. Publicly funded access to PrEP in BC began in 2018. The low barrier MSM STI testing clinic at Cool Aid CHC demonstrates that PrEP can be implemented successfully through a nurse-led program. <h3>Methods</h3> Description of model of care/intervention: This novel CHC based Men’s STI Testing Clinic is staffed by STI certified practice nurses and run in partnership with AIDS Vancouver Island (AVI). It is advertised through MSM social media sites by the AVI Men’s Wellness Coordinator. At the initial visit, clients complete a HIRI-MSM index, a sexual/medical history, required screening and participate in PrEP counseling and education. Physicians review the results and sign the PrEP prescription. Clients without primary care are accepted as patients at the clinic. <h3>Results</h3> Effectiveness: Our innovative non-judgemental, nurse-led model has removed barriers to sexual health screening and enrolled 124 MSM in the PrEP program. Initial PrEP screening showed an STI incidence of 19% and a previous syphilis diagnosis in 15% of those screened. After PrEP initiation STI incidence increased by 7%, highlighting the need for continued safer sex education. There have been no HIV infections amongst PrEP recipients. 20% have discontinued PrEP after approval. 56% of those enrolled felt unable to access PrEP through their physician. 44% of PrEP clients are now linked to primary care at Cool Aid CHC, demonstrating that PrEP can be a tool to prevent HIV transmission in MSM, while engaging patients in primary care and regular STI screening. <h3>Conclusion</h3> and next steps: This innovative program increased access to PrEP for MSM, increased STI testing/treatment, helped to prevent HIV transmission and linked clients to primary care. <h3>Disclosure</h3> No significant relationships.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.022 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".