Patient and Provider Decision Making About HIV Postexposure Prophylaxis Following Sexual Violence: A Qualitative...

Area of Science:

• Public Health
• Medical Sociology
• Infectious Disease Prevention

Background:

• Sexual assault survivors require timely medical care, including HIV postexposure prophylaxis (PEP).
• Decision-making processes for initiating and adhering to HIV PEP can be complex for both patients and healthcare providers.

Purpose of the Study:

• To explore the decision-making factors influencing HIV PEP provision for patients and healthcare providers following sexual assault.
• To identify barriers and facilitators in the HIV PEP decision-making process for sexual assault survivors.

Main Methods:

• Qualitative descriptive study utilizing semistructured interviews with 15 patients and 10 healthcare providers.
• Thematic analysis was employed to derive key themes from interview data.

Main Results:

• Four major themes emerged: medical concerns, emotional/trauma/support factors, daily medication management, and ensuring access to HIV PEP.
• Significant variations were observed in how patients and providers prioritized and described these themes.
• Patient decision-making was influenced by trauma, information processing, and side effect management, differing from provider perspectives.

Conclusions:

• Aligning provider communication with patient-centered decision-making factors, such as trauma-informed care, can improve HIV PEP uptake.
• Systemic policy changes are necessary to improve equitable access to HIV PEP for sexual assault survivors, reducing reliance on individual provider efforts.