Need for informed providers: exploring LA-PrEP access in focus groups with PrEP-indicated communities in Baltimore, Maryland
Need for informed providers: exploring LA-PrEP access in focus groups with PrEP-indicated communities in Baltimore, Maryland
Blog Article
Abstract Background The approval of long-acting pre-exposure prophylaxis PrEP (LA-PrEP) in the United States brings opportunities to overcome barriers of oral PrEP, particularly among sexual and gender minority communities who bear a higher HIV burden.Little is known about real-time decision-making among potential PrEP users of LA-PrEP post-licensure.Methods We held focus group discussions with people assigned male at birth who have sex with men in Baltimore, Maryland to explore decision-making, values, and priorities surrounding PrEP usage.
A sexual and gender minority-affirming health center that provides PrEP services supported recruitment.Discussions included a pile-sorting activity and were audio-recorded.Recordings were transcribed and analyzed iteratively, combining an inductive and deductive approach.
Results We held five focus groups from Jan-June 2023 with 23 participants (21 cisgender men who have sex with men, two transgender women who have sex with men; mean age 37).Among participants, 21 were on oral PrEP, one was on injectable PrEP, TV Stand with Fireplace and one had never taken PrEP.Most had never heard about LA-PrEP.
When making decisions about PrEP, participants particularly valued efficacy in preventing HIV, side effects, feeling a sense of security, and ease of use.Perceptions varied between whether oral or injectable PrEP was more convenient, but participants valued the new opportunity for a choice in modality.Factors influencing PrEP access included cost, individual awareness, provider awareness, and level of comfort in a healthcare environment.
Participants emphasized how few providers are informed about PrEP, placing the burden of Bottle Sleeves being informed about PrEP on them.Comfort and trust in a provider superseded proximity as considerations for if and where to access PrEP.Conclusions There is still low awareness about LA-PrEP among sexual and gender minority communities; thus, healthcare providers have a critical role in influencing access to LA-PrEP.
Despite this, providers are still vastly underinformed about PrEP and underprepared to support clients in contextualized ways.Clients are more likely to engage in care with affirming providers who offer non-judgmental conversations about sex and life experiences.Provider education in the United States is urgently needed to better support clients in choosing a PrEP modality that is right for them and supporting adherence for effective HIV prevention.