Participant perceptions on the acceptability and feasibility of a telemedicine-based HIV PrEP and buprenorphine/naloxone program embedded within syringe services programs: a qualitative descriptive evaluation

Abstract

Background People who inject drugs (PWID) are at risk for HIV and opioid overdose. We piloted PARTNER UP, a telemedicine-based program to provide PWID with access to both oral pre-exposure prophylaxis (PrEP) for HIV prevention and medication for opioid use disorder (MOUD) through two syringe services programs (SSPs) in North Carolina. We conducted a qualitative evaluation to assess the acceptability and feasibility of PARTNER UP from the participant perspective. Methods PARTNER UP participants met with a provider for an initial in-person visit at the SSP, followed by weekly telemedicine visits in month 1 and then monthly telemedicine visits until program end at month 6. Using a qualitative descriptive study design, we conducted in-depth interviews with a subsample of PARTNER UP participants at 1 month and 4 months. Informed by the technology acceptance model, we assessed participant perceptions of the usefulness and ease of use of PARTNER UP, as well as their intent to continue to use the program’s components. We audio-recorded all interviews with participants’ permission and used applied thematic analysis to analyze the verbatim transcripts. Results We interviewed 11 of 17 people who participated in PARTNER UP—10 in the month 1 interview and 8 in the month 4 interview. Nearly all participants were motivated to join for consistent and easy access to buprenorphine/naloxone (i.e., MOUD); only a few joined to access PrEP. Most were comfortable accessing healthcare at the SSP because of their relationship with and trust toward SSP staff, and accessing services at the SSP was preferred compared with other healthcare centers. Some participants described that telemedicine allowed them to be honest and share more information because the visits were not in-person and they chose the location, although the initial in-person meeting was helpful to build provider trust and rapport. Most participants found the visit schedule to be feasible, although half described needing to reschedule at least once. Nearly all participants who were interviewed intended to continue with MOUD after the program ended, whereas none were interested in continuing with PrEP. Conclusions Participant narratives suggest that the PARTNER UP telemedicine program was acceptable and feasible. Future studies should continue to explore the benefits of embedding both PrEP and MOUD into SSPs with larger numbers of participants. Trial registration Clinicaltrials.gov Identifier: NCT04521920.

Providing medication for opioid use disorder and HIV pre-exposure prophylaxis at syringe services programs via telemedicine: a pilot study

“…Additionally, the questionnaires assessed attitudes towards MOUD and PrEP. Acceptability and feasibility of using telemedicine from the participants’ perspective has been reported earlier [ 41 ]. At the end of study, participants who were interested in continuing their care and treatment with MOUD and/or PrEP were connected with local providers or had the option of continuing treatment with the study provider after conclusion of the study.…”

“…Our pilot program, entitled PARTNER UP, was implemented to provide and evaluate the delivery of MOUD and PrEP via telemedicine for PWID utilizing SSPs in North Carolina. Participant perceptions of the acceptability and feasibility of the program have been described previously [ 41 ]. Here, we present the overall results from the PARTNER UP program, including participant retention and medication adherence.…”

Effectiveness of PrEPTECH: Findings From a 180-Day Randomized Controlled Trial of a Pre-Exposure Prophylaxis Telehealth Intervention

“…12 Preliminary evidence from research on these early efforts suggests that PrEP telehealth is well received, often preferred to traditional models, and has been effective in delivering PrEP care to its clients. 13–29 There have been relatively few reports in the literature on PrEP telehealth outside the United States, but efforts have been described in Brazil, Vietnam, Thailand, Germany, and Kenya. 27,30,31…”

Providing medication for opioid use disorder and HIV pre-exposure prophylaxis at syringe services programs via telemedicine: A pilot study

“…Interest remained low over the course of the study. In interviews conducted towards the end of the program in a separate sub-study, none of the participants interviewed said they were interested in continuing PrEP primarily because they did not feel at risk for HIV (40). The low perceived risk of HIV among participants should be explored further.…”

“…Participant perceptions of the acceptability and feasibility of the program have been described previously. (40) Here, we present the overall results from the PARTNER UP program, including treatment retention and medication adherence.…”