(1124) A Geospatial Analysis of Pre-exposure Prophylaxis Access Along Fixed Public Transit Routes in Georgia

Objectives: Despite awareness of pre-exposure prophylaxis (PrEP) exceeding 89% in the southern United States, which accounts for over 50% of new Human Immunodeficiency Virus (HIV) infections, uptake of the preventative health measure is limited. Poor geographic proximity and access to PrEP services is one compelling explanation for poor uptake. While previous geospatial analyses have attempted to quantify the presence of PrEP deserts in the southern United States, these analyses rely on calculations of “drive times” and assume all PrEP-eligible patients have access to their own freely directable modes of transportation, failing to consider how patients without personal transportation methods may access care. To better understand how patients who rely on public transit access PrEP services in Georgia, we sought to (1) compare PrEP rate uptake between counties with and without fixed-route public transit systems, (2) assess the geospatial accessibility of PrEP services along public transit routes, and (3) evaluate if care access points along such routes would increase if community pharmacies were to provide PrEP services.

Methods: A dataset of over 15,000 public transit stops was compiled from individual county-level datasets. County-level PrEP data was sourced from AIDSVu’s 2021 public datasets. Georgia PrEP providing clinics were identified with the National Prevention Information Network database. Community pharmacy addresses in Georgia were provided by the Georgia Board of Pharmacy. Continuous variables were analyzed with the Mann-Whitney U test. ArcGIS Pro and Geoda were used for geospatial analysis. Change in care access points for PrEP along fixed-route public transit was quantified as the number of counties with at least a 50% increase in pre-exposure access when community pharmacies were considered care access points.

Results: PrEP uptake is significantly higher in Georgia counties with a fixed-public transit system versus counties without a fixed-public transit system (P < 0.001). Georgia counties with fixed-route public transit systems would experience at least a doubling (80%) or quadrupling (46.7%) in PrEP care access points if community pharmacies provided PrEP services. Additional geospatial analyses are currently being completed.

Conclusions: N/A - Research in Progress