Montefiore Einstein Researchers Awarded $4.2 Million NIH Grant to Improve PrEP Access and Prevent New HIV Infections

Montefiore Einstein physician-researchers have received a five-year, $4.2 million grant from the National Institutes of Health (NIH). The grant will go toward comparing two strategies for improving pre-exposure prophylaxis (PrEP) medication access and use in the Bronx, continuing Montefiore Einstein’s decades-long leadership in HIV/AIDS research and treatment.

Bronx County has the country’s fifth-highest rate of HIV diagnosis—but the lowest rate in New York State for the use of HIV PrEP medications that are extremely effective in preventing HIV infection. Rates of new infections among Black/African American people are more than eight times as high—and among Hispanic/Latino people nearly four times as high—as those of White people, according to the U.S. Department of Health and Human Services. People in urban areas with high poverty rates are 10 times more likely to be living with HIV than those from more affluent areas.

“Our goal is to meet Bronx residents where they are to improve PrEP access and reduce HIV infection rates,” said Uriel R. Felsen, MD, MS, Physician, Infectious Disease, Internal Medicine, and Associate Professor of Medicine, Montefiore Einstein; Medical Director for HIV testing at the Montefiore AIDS Center; and Assistant Director of the Clinical and Translational Sciences Core at the Einstein-Rockefeller-CUNY Center for AIDS Research (ERC-CFAR). Felsen is a principal investigator on the grant.

“It’s crucial to find more efficient ways to connect emergency department (ED) patients for whom PrEP is recommended to the clinicians who can provide this highly effective medicine,” said Viraj V. Patel, MD, MPH, Physician, Internal Medicine, and Associate Professor of Medicine, Montefiore Einstein; Co-Director of the Montefiore Prevention Program (which focuses on HIV); and Associate Director of the Behavioral and Implementation Sciences Core at the ERC-CFAR. Patel is also a principal investigator on the grant.

Fourteen hundred people will participate in the study, which will be conducted at Bronx EDs. All will receive treatment for their sexually transmitted infection (STI) during their ED visit. One strategy will assign a sexual health navigator to contact patients after the ED visit to provide PrEP education and enroll them in ongoing sexual and HIV preventive care. The second strategy, Tele-PrEP, offers people a telehealth consultation with a sexual health specialist while they are still in the ED.

The study is centered in EDs because many people at risk for HIV seek care for their sexually transmitted infections in emergency departments, a setting that is not well suited for preventing HIV.