Why is PrEP use an essential public health issue? Current PrEP coverage is low, and the change in PrEP coverage over the years in the Deep South is unclear. This study aims to report on any demographic and socio-cultural issues that may impact patients in my service area.

Methods

Data was extracted through a chart review at a local HIV service organization (i.e., HopeHealth) in South Carolina (SC) from 2018 to 2024. PrEP users were defined as any patient with a prescription for a PrEP medication such as Descovy, Truvada, Emtricitabine-Tenofovir, and Bictegravir-Emtricitab-Tenofov, without a diagnosis of HIV in their chart review. Socio-demographic characteristics (e.g., race, age, gender, sexual orientation, etc) and social determinants of health (e.g., housing status, veteran status, migrant status, etc.) related variables were extracted from the EHR.

Results

A total of 236 PrEP users were identified from 2018 to 2024. There has been a dramatic increase trend of PrEP use over the years spread out over 75 zip codes over 12 counties in 3 states of SC. 69.5% of them identify as male, 26.3% identify as female, 30.1% identify as gay, age ranges from 15-74 years old. 52.5% are insured and 47.5% are uninsured. 5 patients were migrant workers, 3 were veterans, and 28 were homeless. Almost all (232, 98.3%) patients fell under 200% of the federal poverty level, meaning they qualify for grant-funded financial assistance, even with health insurance.

Conclusion

We observed a significant increasing trend in PrEP use. However, there are still barriers to care, such as the ability to get care due to transportation issues. Many of these clients are poor and live in rural areas, and getting transportation is a massive barrier to care. There are also socio-cultural issues as barriers. 48% of the patients identify as heterosexual, meaning either these patients engage in a high-risk lifestyle or do not wish to identify as anything other than straight due to socio-cultural pressure and stigma against homosexuals.