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This summary is machine-generated.

Maintaining consistent pre-exposure prophylaxis (PrEP) use is challenging, especially for vulnerable populations. This study identifies key patient, provider, and system factors to improve long-term PrEP adherence and HIV prevention.

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Area of Science:

  • Public Health
  • HIV Prevention
  • Qualitative Research

Background:

  • Pre-exposure prophylaxis (PrEP) use is often short-term, with many individuals discontinuing use within 6-12 months.
  • Vulnerable populations, who could benefit most from PrEP, tend to have shorter durations of use.
  • Understanding factors influencing PrEP persistence is crucial for effective HIV prevention strategies.

Purpose of the Study:

  • To explore patient, provider, and contextual factors affecting pre-exposure prophylaxis (PrEP) persistence.
  • To identify barriers and facilitators in the PrEP care continuum from both patient and provider perspectives.
  • To inform interventions aimed at improving long-term PrEP adherence.

Main Methods:

  • Qualitative study employing semi-structured interviews.
  • Conducted interviews with 25 individuals using PrEP and 18 healthcare providers.
  • Focused on safety net clinics in San Francisco to capture experiences within accessible healthcare settings.

Main Results:

  • Identified distinct stages in PrEP care: clinic visits/lab tests, pharmacy interactions, and medication adherence.
  • Patients and providers reported various barriers and facilitators at each stage of PrEP receipt.
  • Highly desired interventions include drop-in visits, streamlined testing, standing lab orders, and 90-day prescriptions.

Conclusions:

  • Streamlining PrEP care processes, such as simplifying lab testing and extending prescription lengths, can enhance persistence.
  • Proactive support for adherence, including counseling and referrals for social determinants of health (housing, substance use, mental health), is vital.
  • Addressing structural barriers and optimizing the PrEP care continuum are essential for sustained HIV prevention.