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Persistence in a pharmacist-led, same-day PrEP program in Mississippi: a mixed-methods study.

Christine M Khosropour1, Taylor Riley2, Elise Healy3

  • 1Department of Epidemiology, Hans Rosling Center for Population Health, University of Washington, 3980 15th Ave NE, Seattle, WA, 98195, USA. ckhosro@uw.edu.

BMC Public Health
|June 13, 2023
PubMed
Summary
This summary is machine-generated.

Many individuals did not initiate or persist with pre-exposure prophylaxis (PrEP) for HIV prevention, despite same-day prescriptions. Addressing cost, stigma, and misinformation is crucial for improving PrEP uptake and adherence.

Keywords:
BarriersHIVMississippiPre-exposure prophylaxisRetention

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Area of Science:

  • Public Health
  • Epidemiology
  • HIV Prevention

Background:

  • Mississippi faces high HIV rates and low pre-exposure prophylaxis (PrEP) uptake.
  • Understanding PrEP use patterns is vital for enhancing initiation and persistence.

Purpose of the Study:

  • To evaluate a same-day PrEP initiation program in Jackson, Mississippi.
  • To identify barriers and facilitators to PrEP initiation and persistence using a mixed-methods approach.

Main Methods:

  • A mixed-method evaluation of 121 high-risk individuals referred for same-day PrEP prescriptions.
  • Linking non-clinical site records to electronic health records for care linkage assessment.
  • Conducting qualitative interviews with 26 participants representing four PrEP use patterns.

Main Results:

  • 18% linked to care within 3 months; 12% linked after 3 months; 26% never filled prescription; 44% filled but never linked to care.
  • Key barriers included cost, stigma (sexuality, HIV), misinformation, and side effects.
  • Facilitators included a desire to stay healthy and support from PrEP clinic staff.

Conclusions:

  • Most individuals receiving same-day PrEP prescriptions did not initiate or persist with medication within three months.
  • Addressing stigma, misinformation, and structural barriers is essential to improve PrEP initiation and persistence.