Addressing Barriers to Implementing and Scaling PrEP in Carceral Settings: Applying Insights From Implementation...

Area of Science:

• Public Health
• Infectious Disease Prevention
• Implementation Science

Background:

• Individuals in US carceral settings face higher HIV risks and barriers to prevention services.
• HIV pre-exposure prophylaxis (PrEP) is recommended in carceral settings, especially during reentry.
• Limited efforts exist to scale PrEP within correctional facilities.

Purpose of the Study:

• To identify and address barriers to implementing HIV pre-exposure prophylaxis (PrEP) in carceral settings.
• To develop strategies for scaling PrEP services within the unique environment of correctional facilities.
• To create a practical guide for implementing PrEP in carceral settings.

Main Methods:

• Utilized an implementation research logic model based on experience in Rhode Island's state carceral system.
• Evaluated implementation determinants, barriers, and successful strategies for PrEP scale-up.
• Developed a comprehensive 14-step toolkit for PrEP implementation in carceral settings.

Main Results:

• A 14-step 'toolkit' was created to guide PrEP implementation in carceral settings.
• The toolkit includes strategies for clinical protocols and community linkage.
• Successfully identified and leveraged implementation strategies to overcome barriers.

Conclusions:

• The developed toolkit facilitates PrEP implementation projects in carceral settings.
• Encourages scaling this work to reach underserved populations at elevated HIV risk.
• Addresses critical gaps in HIV prevention for incarcerated individuals and those reentering the community.