A behavioral economics approach to enhancing HIV preexposure and postexposure prophylaxis implementation

Jingjing Li; Yaxin Liu; Eric Nehl; Joseph D Tucker

doi:10.1097/COH.0000000000000860

A behavioral economics approach to enhancing HIV preexposure and postexposure prophylaxis implementation

Curr Opin HIV AIDS. 2024 Apr 29. doi: 10.1097/COH.0000000000000860. Online ahead of print.

Authors

Jingjing Li¹, Yaxin Liu², Eric Nehl¹, Joseph D Tucker³

Affiliations

¹ Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health.
² Department of Psychology, Emory University, Atlanta, Georgia.
³ Division of Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, USA.

PMID: 38686773
DOI: 10.1097/COH.0000000000000860

Abstract

Purpose of review: The 'PrEP cliff' phenomenon poses a critical challenge in global HIV PrEP implementation, marked by significant dropouts across the entire PrEP care continuum. This article reviews new strategies to address 'PrEP cliff'.

Recent findings: Canadian clinicians have developed a service delivery model that offers presumptive PEP to patients in need and transits eligible PEP users to PrEP. Early findings are promising. This service model not only establishes a safety net for those who were not protected by PrEP, but it also leverages the immediate salience and perceived benefits of PEP as a natural nudge towards PrEP use. Aligning with Behavioral Economics, specifically the Salience Theory, this strategy holds potential in tackling PrEP implementation challenges.

Summary: A natural pathway between PEP and PrEP has been widely observed. The Canadian service model exemplifies an innovative strategy that leverages this organic pathway and enhances the utility of both PEP and PrEP services. We offer theoretical insights into the reasons behind these PEP-PrEP transitions and evolve the Canadian model into a cohesive framework for implementation.