Date of Award

Spring 2022

Degree Name

Master of Medical Science (Physician Assistant)

Department

Physician Assistant; College of Health Sciences

First Advisor

Stephanie Pillai

Abstract

It has been well documented over the years that lesbian, gay, bisexual, transgender, queer/ questioning (LGBTQ+) populations are disproportionately affected by a higher burden of mental health illnesses, alcohol abuse, and illicit substance abuse when compared to heterosexual populations. This article will recommend utilizing routine Pre-Exposure Prophylaxis (PrEP) therapy encounters, a common point of contact for primary care for sexual minority populations, to perform screening for mental health and substance use. Due to men who have sex with men (MSM) being the highest utilizing population of this therapy, and disproportionately burdened by psychiatric and substance use disorders, this article will focus on this population for its recommendations. This article will further expand on the United States Preventative Service Task Force’s (USPSTF) recently updated 2021 PrEP clinical guideline recommendation to screen for these conditions during these encounters. The guidelines suggest that the integration of the 4-item Patient Health Questionnaire (PHQ-4) and Two Item Conjoint Screening (TICS) screening tools into every other PrEP therapy encounter will raise awareness for these conditions and create opportunity for intervention.

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Implementation of Mental and Substance Misuse Screenings into Routine PrEP Therapy Encounters

It has been well documented over the years that lesbian, gay, bisexual, transgender, queer/ questioning (LGBTQ+) populations are disproportionately affected by a higher burden of mental health illnesses, alcohol abuse, and illicit substance abuse when compared to heterosexual populations. This article will recommend utilizing routine Pre-Exposure Prophylaxis (PrEP) therapy encounters, a common point of contact for primary care for sexual minority populations, to perform screening for mental health and substance use. Due to men who have sex with men (MSM) being the highest utilizing population of this therapy, and disproportionately burdened by psychiatric and substance use disorders, this article will focus on this population for its recommendations. This article will further expand on the United States Preventative Service Task Force’s (USPSTF) recently updated 2021 PrEP clinical guideline recommendation to screen for these conditions during these encounters. The guidelines suggest that the integration of the 4-item Patient Health Questionnaire (PHQ-4) and Two Item Conjoint Screening (TICS) screening tools into every other PrEP therapy encounter will raise awareness for these conditions and create opportunity for intervention.