To assess how restricting or omitting sexual orientation and gender identity (SOGI) information affects surveillance detection of disparities in documented HIV preexposure prophylaxis (PrEP) orders.
Approach:
Design and data: Cross-sectional analysis linking structured SOGI and demographic fields with PrEP medication orders in a Southern California safety-net health system.
Population and outcome: The final sample included 165,198 adults with classifiable sex assigned at birth (SAAB), sexual orientation, and gender identity. The outcome was any documented PrEP order through October 27, 2025.
Surveillance scenarios: The same population and outcome were assessed with complete SOGI data, SAAB-only data, and simulated joint SOGI missingness ranging from 0% to 90%. Analyses also assessed whether missingness was associated with measured patient characteristics or underlying SOGI values.
Key Findings:
The analysis compared which disparities were observable with complete SOGI data, SAAB-only monitoring, and simulated joint SOGI missingness; the supplied context does not provide scenario-specific results.
Structured SOGI collection began in 2021, and completeness for both SOGI fields exceeded 95% by 2023.
Observation duration could vary across patients because registration and first-encounter dates were unavailable.
Interpretation:
The analysis compared the disparities observable under complete SOGI data, SAAB-only monitoring, and simulated SOGI missingness. The supplied context states that the approach showed which disparities remained observable, but does not provide the scenario-specific findings.
Limitations:
A uniform follow-up period could not be established because registration and first-encounter dates were unavailable.
Race and ethnicity fields did not identify who supplied or recorded the information.
