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The Quantification of Injectability by Mechanical Testing
Published on: May 13, 2020
Stakeholder Perspectives on Long-Acting Injectable PrEP and MOUD: A Descriptive Qualitative Study.
Medrxiv : the Preprint Server for Health Sciences
|July 10, 2026
Summary
Long-acting injectable (LAI) pre-exposure prophylaxis (PrEP) and medications for opioid use disorder (MOUD) show promise in carceral settings. However, resource barriers, medication challenges, and infrastructure issues hinder successful implementation and care continuity.
Area of Science:
- Public Health
- Infectious Disease Prevention
- Substance Use Disorder Treatment
Background:
- Intersecting HIV and opioid use disorder (OUD) epidemics pose significant challenges within carceral settings.
- Long-acting injectable (LAI) formulations of pre-exposure prophylaxis (PrEP) and medications for opioid use disorder (MOUD) present innovative treatment avenues.
- Understanding stakeholder perspectives is crucial for effective implementation of these interventions in jails.
Purpose of the Study:
- To explore carceral and community stakeholder perspectives on implementing LAI PrEP and MOUD in jails.
- To identify barriers and facilitators to the successful delivery of these long-acting medications within carceral environments.
- To inform strategies for improving health outcomes for justice-involved individuals with HIV and/or OUD.
Main Methods:
- Qualitative study utilizing 17 semi-structured interviews with correctional staff and community healthcare providers.
- Participants recruited from jails in Washington, DC, and surrounding Maryland counties.
- Interviews analyzed using mixed inductive and deductive coding to identify key implementation themes.
Main Results:
- Four major themes emerged: resource barriers (staffing, finances), medication administration challenges (stigma, mistrust, knowledge gaps), restrictive carceral infrastructure, and the need for care continuity.
- Stakeholders recognized the potential of LAI PrEP and MOUD but highlighted significant systemic barriers to implementation.
- Successful delivery is challenged by jail infrastructure and the transition from carceral to community care.
Conclusions:
- Systemic barriers related to resources, medication delivery, and infrastructure impede the implementation of LAI PrEP and MOUD in carceral settings.
- Targeted interventions are needed to address staffing shortages, financial constraints, stigma, and patient education.
- Ensuring sustainable funding, staff training, patient education, and strong community linkages are essential for successful integration and improved health outcomes.
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