Preexposure Prophylaxis Implementation in a Reproductive Health Setting: Perspectives From Planned Parenthood Providers and Leaders

Abstract

Integrating pregnancy and HIV prevention services would make reproductive health care settings an optimal venue for the promotion and delivery of preexposure prophylaxis (PrEP) to cisgender women. However, these settings have been slow to adopt PrEP. Planned parenthood clinicians and leaders possess critical insight that can help accelerate PrEP implementation in reproductive health care settings and elements of the Consolidated Framework for Implementation Research (i.e., relative priority of the intervention to staff, implementation climate, available resources to implement the intervention, and staff access to knowledge and information about the intervention) can shed light on elements of Planned Parenthood’s inner setting that can facilitate PrEP implementation. In this study, individual 60-min interviews were conducted with clinical care team members (n = 10), leadership team members (n = 6), and center managers (n = 2) to explore their perspectives on PrEP implementation and associated training needs. Transcripts were transcribed verbatim and thematically analyzed. Despite having variable PrEP knowledge, participants (100% women, 61% non-Hispanic White) expressed positive attitudes toward implementing PrEP. Barriers and facilitators toward providing PrEP were reported at the structural, provider, and patient levels. Participants desired PrEP training that incorporated culturally competent patient-provider communication. Although participants identified ways that Planned Parenthood uniquely enabled PrEP implementation, barriers must be overcome to optimize promotion and delivery of PrEP to cisgender women.

Provider views of pre-exposure prophylaxis (PrEP) for cisgender women – where do women fit in HIV elimination in Australia?

“…12,16,17 Provider based barriers include clinician difficulties identifying at-risk women, 10 lack of knowledge about PrEP, time constraints, concern about efficacy and cost to patients. 18,19 Potential PrEP enablers for women include increasing education and expanding public health messaging to services where women access health care. 16 Provider perspectives on enablers are limited in available literature 19 although some qualitative studies have recommended an increase in training for providers and resources for women.…”

“…16 Provider perspectives on enablers are limited in available literature 19 although some qualitative studies have recommended an increase in training for providers and resources for women. 18,20 The aim of this descriptive qualitative study 14,15 was to explore PrEP prescribing for Australian cisgender women A from the provider's perspective. Through interviews with prescribers, we aimed to determine the barriers to uptake and enablers to facilitate PrEP prescribing, in light of the new opportunities to focus on HIV prevention in sub-populations that have received less attention than GBMSM.…”