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Retrospective challenges to pre-exposure prophylaxis (PrEP) use among people living with HIV-A qualitative analysis
Carina Hörst1, Hannah Kitt1, Helen Corkin1
1Blood Safety, Hepatitis, STI & HIV Division (BSHSH), UK Health Security Agency, London, United Kingdom.
PloS one
|February 13, 2026
Resumen
Barriers to Human Immunodeficiency Virus (HIV) prevention, including pre-exposure prophylaxis (PrEP), exist even for those living with HIV. Addressing knowledge gaps, healthcare provider identification, and societal stigma is crucial for effective HIV prevention strategies.
Área de la Ciencia:
- Public Health
- Epidemiology
- Behavioral Science
Sus antecedentes:
- Despite available Human Immunodeficiency Virus (HIV) prevention like pre-exposure prophylaxis (PrEP) in England, new HIV diagnoses are rising, particularly among heterosexuals and Black individuals.
- Existing research focuses on PrEP barriers for those without HIV; this study explores experiences of people currently living with HIV.
Objetivo del estudio:
- To qualitatively explore retrospective barriers and facilitators to Human Immunodeficiency Virus (HIV) prevention and pre-exposure prophylaxis (PrEP) use among individuals living with HIV.
- To identify actionable insights for behavior change interventions using the COM-B model.
Principales métodos:
- Qualitative interviews with 26 participants across England (March 2021-July 2022).
- Systematic analysis using the COM-B (Capability, Opportunity, Motivation, Behavior) model to categorize barriers and facilitators.
Principales resultados:
- Capability barriers: gaps in Human Immunodeficiency Virus (HIV)/pre-exposure prophylaxis (PrEP) knowledge, mental health challenges.
- Opportunity barriers: healthcare providers not identifying PrEP need, communication issues with partners, perceived inaccessibility.
- Motivational barriers: low perceived HIV risk, PrEP stigma, medication reservations, targeted HIV campaigns.
- Facilitators: PrEP knowledge, desire for health control.
Conclusiones:
- Findings on barriers and facilitators for Human Immunodeficiency Virus (HIV) prevention and pre-exposure prophylaxis (PrEP) use among people living with HIV mirror those in populations without HIV.
- Learning from the experiences of people living with HIV offers unique insights for Human Immunodeficiency Virus (HIV) prevention narratives.
- Structural societal changes in discussing sex, Human Immunodeficiency Virus (HIV), and pre-exposure prophylaxis (PrEP) are necessary for sustained HIV transmission reduction.
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