Decision Support Tool to Improve Decision-Making for HIV Pre-Exposure Prophylaxis (PrEP): Development Process and...

Area of Science:

• Public Health
• Health Services Research
• Digital Health

Background:

• African, Caribbean, and Black (Black) communities in Canada face a disproportionate HIV burden.
• Pre-exposure prophylaxis (PrEP) is effective but underutilized among eligible Black clients due to decisional conflict and unmet needs.
• Existing decision support tools (DSTs) are not tailored for Black clients considering PrEP.

Purpose of the Study:

• To develop a decision support tool (DST) specifically for Black clients in Canada to improve decision-making regarding HIV pre-exposure prophylaxis (PrEP).
• To evaluate the acceptability and usability of the developed PrEP DST among Black clients and healthcare providers.

Main Methods:

• A multidisciplinary team, including community members, developed the PrEP DST following the Ottawa Decision Support Group guideline.
• Methods included assessing decisional needs, content and design determination, evidence synthesis, prototype development, and steering committee review.
• Acceptability and usability were tested with Black clients and PrEP providers.

Main Results:

• A 27-page, web-based PrEP DST was created with six distinct sections covering decision clarification, knowledge, values, support, and next steps.
• Both Black clients and PrEP providers reported the tool was easy to use, satisfactory, and useful for supporting PrEP decisions.
• Feedback indicated a need for a user guide to further enhance usability, which was incorporated into the final version.

Conclusions:

• A systematically developed PrEP DST is acceptable and usable for Black clients and providers in Canada.
• The tool addresses a critical gap in decision support for this population regarding HIV prevention.
• Further research, such as randomized controlled trials, is recommended to assess the efficacy of the PrEP DST.