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Evolving Models and Ongoing Challenges for HIV Preexposure Prophylaxis Implementation in the United States
Kenneth H Mayer1,2,3, Philip A Chan4, Rupa R Patel5
1The Fenway Institute, Fenway Health, Boston, MA.
Journal of Acquired Immune Deficiency Syndromes (1999)
|October 31, 2017
Summary
Preexposure prophylaxis (PrEP) for HIV prevention delivery in the U.S. faces challenges. Diverse care models, including clinics, CBOs, and pharmacies, are emerging to improve access and uptake of this critical HIV prevention tool.
Area of Science:
- Public Health
- HIV Prevention
- Implementation Science
Background:
- Preexposure prophylaxis (PrEP) for HIV prevention was FDA-approved in 2012.
- Implementation and access to PrEP in at-risk populations have lagged.
- This review examines PrEP implementation in the U.S., identifying barriers and solutions.
Purpose of the Study:
- To analyze the current state of PrEP implementation in the United States.
- To identify barriers to PrEP access and uptake.
- To review innovative solutions for enhancing PrEP delivery.
Main Methods:
- A critical review of over 100 recent peer-reviewed publications.
- Analysis of diverse clinical care settings, public health programs, and community-based organizations.
Main Results:
- PrEP is delivered through various models: STD clinics, community health centers, CBOs, pharmacies, and PCPs.
- STD clinics offer expertise but PCPs offer integrated care potential.
- CBOs enhance adherence and navigation, while pharmacies offer accessibility.
Conclusions:
- PrEP implementation is advancing with diverse delivery models in the U.S.
- Optimizing scale-up requires understanding and leveraging the strengths of each model.
- Offering consumer choice is key to enhancing engagement and uptake of PrEP.
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