Impact of a patient portal reminder system on PrEP and STI follow-up in transgender women
Creators: name: Amsal, Tigest
Publisher: name: No Publisher Supplied
Year: 2023

description: Purpose of the Project: In the United States (U.S.) 1,189,700 million people are living with HIV. Research shows that transgender women (TGW) are disproportionately affected by HIV as well as other sexually transmitted infections (STI), such as gonorrhea (GC) and chlamydia (CT). The primary purpose of this project was to evaluate how a patient portal reminder system impacted the engagement and retention of TGW, at high-risk of acquiring HIV, in routine clinical care. Current guidelines for persons receiving PrEP recommend follow-up HIV and STI testing every 3 months. For persons diagnosed with an STI, the Centers for Disease Control and Prevention recommends that patients be seen for a routine 3-month re-test to assess for any new infections. Methods: Using a quality improvement framework, this project used secondary data to conduct a retrospective chart review of all eligible TGW seen at a community-based health center in Newark, NJ over an 18-month period. The project used a convenience sample of patients who identified as TGW, were 18 years or older, and who received either HIV PrEP or were diagnosed and treated for CT and/or GC.Results: A total of 17 eligible patients were identified through the chart review. Of all the eligible patients, 23 % were 18- 24 years old, 53 % were 25-34 years, 18% were 35-44 and 6% were between the age 45-55. Reminders were sent through the patient portal system prior to each patient’s visit to remind them to attend their appointment. For patients receiving PrEP, the expected number of visits over the course of the 18-month time period was 6 visits. This number is based on the clinical recommendation patients to be seen once every 3 months. At visit 1, 69% of patients who were eligible for a portal message opened and examined the message and 62% completed a follow-up visit. At visit 2, only 46% of the 54% of patients who opened the portal message kept their appointments. At visit 3, 46% of patients opened their portal message and 31% kept their appointment. At visit 4, 62% of patients opened and received their portal message, but only 46% kept appointments. For the 5th visit 77% of patients received a message and 62% of patients kept their appointment. At visit 6, only 69% of the 77% of patients who opened the message kept their appointment. With regards to STI re-testing, there were 2 people who acquired a new diagnosis of GC over the 18-month period. Both received portal messages to remind them about re-testing, but only 1 out of the 2 individuals came back as scheduled.Discussion/Implications: This project demonstrates that the patient portal reminder system may be a useful tool for TGW on PrEP who need to be seen every 3 months for routine testing. It may also assist with those who need to return for routine 3-month retesting following the diagnosis of GC or CT. Limitations of the portal system relate to the need for email access in order to receive and send messages. Additional strategies that incorporate direct contact with patients, such as text-messaging may improve communication. Additional research is needed.