Implementation Strategies to Increase PrEP Uptake in the South

Area of Science:

• Public Health
• HIV Prevention
• Health Disparities

Background:

• Pre-exposure prophylaxis (PrEP) significantly reduces HIV infection risk.
• Despite increased PrEP use nationally, uptake is disproportionately low in the Southern United States.
• Significant disparities exist between PrEP need and utilization in the South.

Purpose of the Study:

• To review the reasons for inequitable PrEP uptake in the Southern United States.
• To identify implementation strategies to increase PrEP uptake in this underserved region.

Main Methods:

• Literature review
• Analysis of PrEP service provider locations
• Review of pharmacy prescription data
• Examination of HIV surveillance and healthcare provider data
• Assessment of health literacy factors

Main Results:

• Multiple factors contribute to limited PrEP uptake in the South, including structural, capacity, and policy challenges.
• Alternative service delivery models like pharmacy-based and telemedicine PrEP are needed.
• Stigma reduction, policy changes (Medicaid expansion, ACA), integrated STI/PrEP services, and technology (mHealth) are key strategies.
• Streamlining clinical procedures for same-day starts can improve access.

Conclusions:

• Equitable PrEP uptake in the South requires innovative clinical approaches, technological integration, and significant policy changes.
• Multisectoral responses are essential to overcome barriers and expand PrEP access.
• Addressing the unique challenges in the South is critical for reducing HIV disparities.