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Health Care Providers' Reported Barriers to Pre-Exposure Prophylaxis Initiation Among Cisgender Women
Alison J Goldberg1, Rey A Flores2, Arielle Desir2
1Hunter College, City University of New York, New York, NY, USA.
Summary
Healthcare providers rarely prescribe pre-exposure prophylaxis (PrEP) to cisgender women, despite willingness. Key barriers include knowledge gaps, stigma, medication concerns, and access issues, hindering PrEP uptake.
Area of Science:
- Public Health
- Infectious Disease Prevention
- Sexual Health
Background:
- Previous research indicates low pre-exposure prophylaxis (PrEP) prescription rates for cisgender women by sexual and reproductive health providers.
- Despite recognizing a high HIV burden in this population, providers' prescribing practices remain limited.
Purpose of the Study:
- To explore healthcare providers' knowledge and experiences with PrEP for cisgender women.
- To assess providers' willingness to prescribe PrEP and identify perceived barriers to uptake.
- To analyze system, clinician, and patient-level factors influencing PrEP access for cisgender women.
Main Methods:
- Semistructured interviews were conducted with 18 healthcare providers (Obstetrics/Gynecology, Primary Care, Infectious Disease) across 12 US states.
- Interviews focused on PrEP knowledge, prescribing experiences, willingness, and perceived barriers.
- Data were analyzed using inductive/deductive hybrid thematic analysis.
Main Results:
- Nearly all interviewed providers (17/18) expressed willingness to prescribe PrEP to cisgender women.
- However, fewer than half (8/18) had ever prescribed PrEP.
- Identified barriers included knowledge gaps/misinformation, stigma, medication characteristics, and healthcare accessibility issues.
Conclusions:
- A significant gap exists between providers' willingness to prescribe PrEP and actual practice for cisgender women.
- Addressing barriers related to knowledge, stigma, medication understanding, and healthcare access is crucial for increasing PrEP uptake.
- Interventions are needed to improve PrEP implementation and accessibility for cisgender women to reduce HIV transmission.
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