Philadelphia FIGHT
Title: Hepatitis B Status Among PrEP Patients at a Philadelphia Community Health Clinic
Student Interns:
Isabel Bruckman
Thomas Jefferson University, Sidney Kimmel Medical College
Academic Preceptor:
Zoë Van Orsdol, MA, MPH
Thomas Jefferson University, College of Population Health
Community Preceptor:
Dana Serafin, NP
Philadelphia FIGHT
Community Site:
Philadelphia FIGHT provides comprehensive, equitable, and compassionate healthcare and support services for individuals and communities facing health disparities. It works to eliminate barriers to health and well-being through primary and specialized care, harm reduction, clinical research, education, and advocacy.
Team’s Experience:
The Bridging the Gaps intern carried out a quality improvement project under the leadership of Dana Serafin, NP, investigating the hepatitis B status of every patient on HIV pre-exposure prophylaxis (PrEP) across five FIGHT clinics. The student used electronic medical records (EMR) to determine if patients were due for initial serologies, re-immunization, or confirmatory serologies, or were definitively immune or nonimmune following vaccination. These findings were communicated directly to providers so they could address each patient’s hepatitis B needs at the next appointment. Providers’ awareness of a patient’s HBV immunity status matters when a regimen changes or is discontinued, given the rise of long-acting injectable PrEP regimens, which, unlike oral PrEP, do not contain tenofovir. As part of this project, the intern updated each patient’s problem list to reflect immunity status, so providers can quickly consult it when adjusting PrEP care.
Reflections
I want to use this space to sing the praises of the FIGHT staff. The PrEP team, MJ, Manny, and Maggie were my first friends at FIGHT and very warm office mates (for the three weeks before I relocated). I watched them race between patients to educate, ease anxieties, welcome vulnerability, and restore dignity. They showed me the ethos of FIGHT through their sustained playfulness and compassion despite it all. I also want to recognize Shams, who has the unique challenge of retaining patients at the youth clinic. They taught me how to navigate the EMR (many times). Finally, I am in awe of the number of hats Dana Serafin wears and the guidance she provided me while keeping them balanced. Her mentorship defined this project and my positive experience at FIGHT.
Isabel Bruckman
