Improving HIV pre-exposure prophylaxis (PrEP) uptake and initiation: process evaluation and recommendation...

Area of Science:

• Public Health
• Implementation Science
• HIV Prevention

Background:

• HIV pre-exposure prophylaxis (PrEP) is crucial for HIV transmission elimination.
• Program implementation faces significant challenges and requires further research.
• This study evaluates a national PrEP program's initial two years to identify barriers and facilitators to uptake and initiation.

Purpose of the Study:

• To explore barriers and facilitators impacting PrEP program implementation.
• To develop evidence-based recommendations for optimizing PrEP uptake and initiation.
• To enhance the reach of PrEP to all individuals who could benefit.

Main Methods:

• A two-stage process evaluation was conducted in Scotland.
• Stage 1 involved qualitative interviews and focus groups with diverse stakeholders.
• Stage 2 utilized implementation science tools to generate recommendations based on findings.

Main Results:

• Multi-level barriers included rapid implementation pace and lack of prescriber familiarity.
• Facilitators involved knowledge acquisition and normalization of PrEP initiation.
• 41 refined recommendations were developed using expert input and the APEASE criteria.

Conclusions:

• The study provides a robust, evidence-based framework for optimizing PrEP programs.
• Recommendations aim to improve PrEP uptake and initiation across diverse settings.
• Ensuring equitable access to PrEP is essential for maximizing public health benefits.