Accessing Pre-exposure Prophylaxis (PrEP): Perceptions of Current and Potential PrEP Users in Birmingham, Alabama

Overview

Journal AIDS Behav

Specialty Infectious Diseases

Date 2019 Jul 13

PMID 31297683

Citations 29

Authors

Whitney S Rice

Kristi L Stringer

Maira Sohail

Kaylee B Crockett

Ghislaine C Atkins

Kachina Kudroff

D Scott Batey

Joshua Hicks

Janet M Turan

Michael J Mugavero

Bulent Turan

Affiliations

Soon will be listed here.

Abstract

Limited studies to date assess barriers to and facilitators of PrEP uptake and utilization using a patient-centered access to care framework, among diverse socio-demographic groups, or in the U.S. Deep South, an area with disproportionate HIV burden. We examine perceptions of PrEP access in qualitative interviews with 44 current and potential PrEP users in Birmingham, Alabama. Participants were 32 years old on average, 66% Black, 66% gay or lesbian, 70% male, and 66% single. Perceived barriers to PrEP access included: lack of PrEP awareness and advertisement; sexuality-related stigma; time and resource constraints; and concerns about the adequacy and technical quality of PrEP services. Perceived facilitators to PrEP access were: PrEP-related information gathering and sharing; increased dialogue and visibility around PrEP; social, programmatic, and clinical support; and, lastly, self-preservation; personal motivation; and treatment self-efficacy. Results point to opportunities to address complex barriers to equitable PrEP access using multilevel and multimodal solutions.

Citing Articles

Barriers and Facilitators That Influence HIV Pre-exposure Prophylaxis (PrEP)-Prescribing Behaviors Among Primary Care Providers in the Southern United States.

Traylor D, Enriquez M, Thompson-Robinson M, Yu M, Bloom T, Bullock L Cureus. 2024; 16(8):e66868.

PMID: 39280522 PMC: 11399752. DOI: 10.7759/cureus.66868.

How does online postal self-sampling (OPSS) shape access to testing for sexually transmitted infections (STIs)? A qualitative study of service users.

Spence T, Howarth A, Reid D, Sheringham J, Apea V, Crundwell D BMC Public Health. 2024; 24(1):2339.

PMID: 39198751 PMC: 11360737. DOI: 10.1186/s12889-024-19741-x.

Barriers and Facilitators to Accessing PrEP and Other Sexual Health Services Among Immigrant Latino Men Who Have Sex with Men in Los Angeles County.

Brooks R, Nieto O, Rosenberg-Carlson E, Morales K, Uskup D, Santillan M Arch Sex Behav. 2024; 53(9):3673-3685.

PMID: 38977534 PMC: 11390751. DOI: 10.1007/s10508-024-02928-z.

Correlates of oral pre-exposure prophylaxis cessation among men who have sex with men in China: implications from a nationally quantitative and qualitative study.

Liu Y, Wei S, Cheng Z, Xian Y, Liu X, Yang J BMC Public Health. 2024; 24(1):1765.

PMID: 38956521 PMC: 11221119. DOI: 10.1186/s12889-024-19182-6.

Responding to the HIV Health Literacy Needs of Clients in Substance Use Treatment: The Role of Universal PrEP Education in HIV Health and Prevention.

Zhai Y, Isadore K, Parker L, Sandberg J Int J Environ Res Public Health. 2023; 20(19).

PMID: 37835163 PMC: 10572580. DOI: 10.3390/ijerph20196893.

References

Wingood G, Dunkle K, Camp C, Patel S, Painter J, Rubtsova A . Racial differences and correlates of potential adoption of preexposure prophylaxis: results of a national survey. J Acquir Immune Defic Syndr. 2013; 63 Suppl 1:S95-101. PMC: 3673769. DOI: 10.1097/QAI.0b013e3182920126. View

Meehan S, Rossouw L, Sloot R, Burger R, Beyers N . Access to human immunodeficiency virus testing services in Cape Town, South Africa: a user perspective. Public Health Action. 2018; 7(4):251-257. PMC: 5753777. DOI: 10.5588/pha.17.0052. View

Patel R, Mena L, Nunn A, McBride T, Harrison L, Oldenburg C . Impact of insurance coverage on utilization of pre-exposure prophylaxis for HIV prevention. PLoS One. 2017; 12(5):e0178737. PMC: 5448799. DOI: 10.1371/journal.pone.0178737. View

Zhang H, Rhea S, Hurt C, Mobley V, Swygard H, Sena A . HIV Preexposure Prophylaxis Implementation at Local Health Departments: A Statewide Assessment of Activities and Barriers. J Acquir Immune Defic Syndr. 2017; 77(1):72-77. PMC: 5720898. DOI: 10.1097/QAI.0000000000001546. View

Pinto R, Berringer K, Melendez R, Mmeje O . Improving PrEP Implementation Through Multilevel Interventions: A Synthesis of the Literature. AIDS Behav. 2018; 22(11):3681-3691. PMC: 6208917. DOI: 10.1007/s10461-018-2184-4. View

Yakob B, Ncama B . Correlates of Strengthening Lessons from HIV/AIDS Treatment and Care Services in Ethiopia Perceived Access and Implications for Health System. PLoS One. 2016; 11(8):e0161553. PMC: 4993581. DOI: 10.1371/journal.pone.0161553. View

Oldenburg C, Perez-Brumer A, Hatzenbuehler M, Krakower D, Novak D, Mimiaga M . State-level structural sexual stigma and HIV prevention in a national online sample of HIV-uninfected MSM in the United States. AIDS. 2015; 29(7):837-45. PMC: 4439297. DOI: 10.1097/QAD.0000000000000622. View

Galindo G, Garrett-Walker J, Hazelton P, Lane T, Steward W, Morin S . Community member perspectives from transgender women and men who have sex with men on pre-exposure prophylaxis as an HIV prevention strategy: implications for implementation. Implement Sci. 2012; 7:116. PMC: 3527231. DOI: 10.1186/1748-5908-7-116. View

Corneli A, Perry B, McKenna K, Agot K, Ahmed K, Taylor J . Participants' Explanations for Nonadherence in the FEM-PrEP Clinical Trial. J Acquir Immune Defic Syndr. 2015; 71(4):452-61. DOI: 10.1097/QAI.0000000000000880. View

10.

Nwangwu-Ike N, Frazier E, Crepaz N, Tie Y, Sutton M . Racial and Ethnic Differences in Viral Suppression Among HIV-Positive Women in Care. J Acquir Immune Defic Syndr. 2018; 79(2):e56-e68. DOI: 10.1097/QAI.0000000000001779. View

11.

Siegler A, Mayer K, Liu A, Patel R, Ahlschlager L, Kraft C . Developing and Assessing the Feasibility of a Home-based Preexposure Prophylaxis Monitoring and Support Program. Clin Infect Dis. 2018; 68(3):501-504. PMC: 6336909. DOI: 10.1093/cid/ciy529. View

12.

Raifman J, Nunn A, Oldenburg C, Montgomery M, Almonte A, Agwu A . An Evaluation of a Clinical Pre-Exposure Prophylaxis Education Intervention among Men Who Have Sex with Men. Health Serv Res. 2017; 53(4):2249-2267. PMC: 6051979. DOI: 10.1111/1475-6773.12746. View

13.

Senn H, Wilton J, Sharma M, Fowler S, Tan D . Knowledge of and opinions on HIV preexposure prophylaxis among front-line service providers at Canadian AIDS service organizations. AIDS Res Hum Retroviruses. 2013; 29(9):1183-9. PMC: 3749697. DOI: 10.1089/aid.2013.0090. View

14.

Puro V, Palummieri A, De Carli G, Piselli P, Ippolito G . Attitude towards antiretroviral Pre-Exposure Prophylaxis (PrEP) prescription among HIV specialists. BMC Infect Dis. 2013; 13:217. PMC: 3658955. DOI: 10.1186/1471-2334-13-217. View

15.

Krakower D, Ware N, Mitty J, Maloney K, Mayer K . HIV providers' perceived barriers and facilitators to implementing pre-exposure prophylaxis in care settings: a qualitative study. AIDS Behav. 2014; 18(9):1712-21. PMC: 4127184. DOI: 10.1007/s10461-014-0839-3. View

16.

Reif S, Geonnotti K, Whetten K . HIV Infection and AIDS in the Deep South. Am J Public Health. 2006; 96(6):970-3. PMC: 1470626. DOI: 10.2105/AJPH.2005.063149. View

17.

Siegler A, Mouhanna F, Mera Giler R, Weiss K, Pembleton E, Guest J . The prevalence of pre-exposure prophylaxis use and the pre-exposure prophylaxis-to-need ratio in the fourth quarter of 2017, United States. Ann Epidemiol. 2018; 28(12):841-849. PMC: 6286209. DOI: 10.1016/j.annepidem.2018.06.005. View

18.

Hubach R, Currin J, Sanders C, Durham A, Kavanaugh K, Wheeler D . Barriers to Access and Adoption of Pre-Exposure Prophylaxis for the Prevention of HIV Among Men Who Have Sex With Men (MSM) in a Relatively Rural State. AIDS Educ Prev. 2017; 29(4):315-329. DOI: 10.1521/aeap.2017.29.4.315. View

19.

Saberi P, Berrean B, Thomas S, Gandhi M, Scott H . A Simple Pre-Exposure Prophylaxis (PrEP) Optimization Intervention for Health Care Providers Prescribing PrEP: Pilot Study. JMIR Form Res. 2019; 2(1). PMC: 6325636. DOI: 10.2196/formative.8623. View

20.

Siegler A, Bratcher A, Weiss K, Mouhanna F, Ahlschlager L, Sullivan P . Location location location: an exploration of disparities in access to publicly listed pre-exposure prophylaxis clinics in the United States. Ann Epidemiol. 2018; 28(12):858-864. PMC: 6261794. DOI: 10.1016/j.annepidem.2018.05.006. View