Implementing PrEP Services in Diverse Health Care Settings.

Area of Science:

• Public Health
• Implementation Science
• HIV Prevention

Background:

• Pre-exposure prophylaxis (PrEP) uptake in the US remains suboptimal.
• Limited evidence exists on factors influencing successful PrEP service integration across diverse clinical settings.

Purpose of the Study:

• To identify contextual factors that facilitate and challenge the implementation of PrEP services.
• To understand how organizations navigate implementation determinants in their specific environments.

Main Methods:

• Qualitative study employing an interview guide based on the Consolidated Framework for Implementation Research.
• Conducted 20 interviews with participants implementing PrEP programs in various settings and delivery models.
• Utilized template and matrix analysis to characterize determinants and strategies.

Main Results:

• Implementation determinants and strategies were often described fluidly and contextually.
• Key constructs included implementation climate, stakeholder knowledge/beliefs about PrEP, and associated costs.
• Organizations adapted to determinants based on their unique contexts.

Conclusions:

• Identified patterns in PrEP program implementation and organizational adaptation.
• Emphasizes the need to integrate rigorous implementation research with frontline implementer perspectives.
• Findings can inform and improve future PrEP implementation strategies.