Related Experiment Video
Updated: Oct 3, 2025
The Participant-Reported Implementation Update and Score PRIUS: A Novel Method for Capturing Implementation-Related Data Over Time
Published on: February 19, 2021
Logistical Facilitators and Barriers to PrEP Implementation in Methadone Clinic Settings: Provider and Staff
Jessica Jaiswal1, Marybec Griffin, Kevin Hascher
1From the Department of Health Science, University of Alabama, Tuscaloosa, AL (JJ); Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, CT (JJ); Department of Health Behavior, Society and Policy, Rutgers University, Piscataway, NJ (MG, CL); Department of Biology, Department of Anthropology, University of Alabama, Tuscaloosa, AL (KH); Department of Health Science, University of Alabama, Tuscaloosa, AL (ABC, KD, WMB); New York University College of Global Health, New York, NY (SW); Capstone College of Nursing, University of Alabama, Tuscaloosa, AL (MM).
Objectives:
The purpose of this study was to examine the feasibility of implementing pre-exposure prophylaxis (PrEP), a daily oral medication for human immunodeficiency virus (HIV) prevention, in methadone clinics.
Methods:
Medical and nonmedical staff (n = 30) at 2 methadone clinics in Northern New Jersey were qualitatively interviewed about various aspects of substance use treatment, clinical operations, and HIV risk and prevention among their patient populations. Audio-recorded interviews were professionally transcribed, then coded and analyzed by the research team.
Results:
Themes surrounding the viability of PrEP implementation emerged for both logistical facilitators and barriers. Facilitators included availability of prescribing clinicians, ability to conduct lab testing on-site, and availability of existing hepatitis C programs as a blueprint for PrEP management. Barriers included increased provider burden, financial concerns, and perceptions that PrEP provision is outside the clinic's treatment scope.
Conclusions:
Although staff expressed willingness and potential ability to provide PrEP, they identified barriers regarding insurance reimbursement, limited funding, and concerns that PrEP would extend the clinic's treatment scope. However, given the enabling factors such as availability of providers and existing clinical infrastructure, providing PrEP could increase clinic revenue through insurance reimbursement and federal funding for PrEP-related services. Clinic-level education is needed for clinical and nonclinical staff to better understand the logistics of implementing PrEP, particularly regarding prescribing practices, billing and insurance concerns, and the essential nature of HIV prevention as a critical component of substance use treatment.
Related Concept Videos
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic...
01:26Methods of Documentation II: POMR
01:29Therapeutic Drug Monitoring: Affecting Factors
01:21Barriers to Effective Communication II
Cultural barriers:
Differences in values, beliefs, religion, knowledge, and tradition can significantly impact communication. Awareness of nonverbal cues is critical, especially when conversing with a patient from a different culture. What appears appropriate in one culture may be inappropriate in another.
Semantic barriers:
As a result of their tendency to use...
01:26Drug Administration and Therapy Phases: Overview
The pharmaceutical phase focuses on leveraging the physicochemical properties of the drug to design and manufacture an effective product. Variants include orally administered tablets or capsules, topical creams or ointments, and parenteral-delivery solutions or emulsions.
The pharmacokinetic phase...
01:15Nursing Implementation
The five steps to implementing effective nursing care include reassessing the patient, reviewing and revising the existing nursing care plan, organizing the resources and care delivery, anticipating and preventing complications, and implementing nursing interventions.