Provider Perspectives on Factors Affecting the PrEP Care Continuum Among Black Cisgender Women in the Midwest United States: Applying the Consolidated Framework for Implementation Research

Abstract

Background: To End the HIV Epidemic and reduce the number of incident HIV infections in the United States by 90%, pre-exposure prophylaxis (PrEP) uptake and persistence among cisgender women, particularly racial and ethnic minority women, must be increased. Medical providers play a pivotal role across the PrEP care continuum. Methods:In this qualitative study, guided by the Consolidated Framework for Implementation Research, we explored health care provider perspectives on facilitators and barriers to PrEP implementation strategies for Black cisgender women in the Midwest United States. Data were analyzed using a deductive thematic content analysis approach.Results: A total of 10 medical providers completed individual qualitative interviews. Using the Consolidated Framework for Implementation Research framework, we identified intervention characteristics (cost, dosing, and adherence), individual patient and provider level factors (self-efficacy, knowledge, and attitudes), and systematic barriers (inner setting and outer setting) that ultimately lead to PrEP inequalities. Implementation strategies to improve the PrEP care continuum identified include provider training, electronic medical record optimization, routine patient education, and PrEP navigation. Conclusion:This study provides (1) medical provider insight into implementation factors that can be modified to improve the PrEP care continuum for Black cisgender women and (2) an implementation research logic model to guide future studies.

PrEP prescription in indiana 2017−2022: Implications for clinical practice

“…Research reveals that health care providers are often unwilling to raise the subject of PrEP when interacting with their patients (Pleuhs et al, 2020). A recent study by Johnson et al exploring providers' perspectives on increasing the uptake of PrEP discovered that optimizing the electronic charting system and using a dedicated PrEP navigator are significant clinical factors associated with improving HIV prevention outcomes (Johnson et al, 2022). This agrees with our finding that patients identified with suspected exposure to HIV were more likely to report a PrEP prescription, suggesting that patient assessment and documentation are an essential part of the HIV prevention cascade.…”