Pre-exposure Prophylaxis: Clinical Considerations for Overcoming Barriers to Uptake and Persistence

Area of Science:

• Public Health
• Infectious Disease Prevention
• HIV/AIDS Research

Background:

• Pre-exposure prophylaxis (PrEP) is a key strategy for preventing HIV infection.
• Current PrEP options include oral and long-acting injectable antiretroviral medications.
• Despite its effectiveness, PrEP uptake and persistence remain suboptimal among those who could benefit.

Purpose of the Study:

• To identify barriers to PrEP care among priority populations.
• To discuss evidence-based solutions for improving PrEP access and adherence.
• To propose multilevel considerations for increasing PrEP utilization.

Main Methods:

• Review of existing literature on PrEP barriers and facilitators.
• Analysis of socio-ecologic factors influencing PrEP uptake and persistence.
• Synthesis of evidence-based interventions and strategies.

Main Results:

• Barriers to PrEP care are complex, spanning individual, interpersonal, community, and structural levels.
• Priority populations face unique challenges in accessing and adhering to PrEP.
• Multilevel interventions are necessary to address these multifaceted barriers.

Conclusions:

• Overcoming barriers to PrEP requires a comprehensive approach involving clinicians, researchers, and communities.
• Implementing evidence-based solutions can enhance PrEP uptake and persistence.
• Increased access to and sustained use of PrEP are vital for ending the HIV epidemic.