Delivering PrEP to adults with “low” or “no” HIV risk and youth: experiences and perspectives of PrEP providers

Abstract

Health care providers have an important role to play in expanding PrEP uptake to populations disproportionately burdened by HIV. In this study, in-depth, semi-structured qualitative interviews were conducted with 20 PrEP providers in Los Angeles, California to explore their experiences and perspectives prescribing PrEP. Overall, the findings indicate that providers generally adhered to US CDC clinical guidelines in determining PrEP eligibility. However, they also identified special considerations with respect to adults with “low” or “no” HIV risk. Three themes were developed from the data related to the delivery of PrEP to such individuals: 1) patients may not disclose sexual behaviours; 2) patient autonomy and agency; and 3) the importance of PrEP in gay male monogamous relationships. Two additional themes were identified related to prescribing PrEP to young people under the age of consent: 4) the need for more PrEP and sexual health education with youth and 5) challenges in providing PrEP to youth without parental consent. Findings highlight the importance of providing PrEP to patients who could potentially benefit from adoption, whether or not they present with clear behavioural indicators for PrEP. Providers should also consider the potential barriers to delivering PrEP to youth to ensure successful adoption among members of this population.

KEYWORDS:

• Health care providers
• pre-exposure prophylaxis
• PrEP eligibility
• men who have sex with men
• youth

Acknowledgements

The authors thank the participants for sharing their views and experiences for this study.

Disclosure statement

The authors disclose that no competing financial interests exist.

Additional information

Funding

This work was supported by the California Community Foundation under Grant # BA-17-136260; the US National Institute of Mental Health under Grant # R21MH107339 and T32MH109205; and the UCLA Center for HIV Identification, Prevention, and Treatment Services (CHIPTS) under Grant # P30MH058107. The content is solely the responsibility of the authors and does not necessarily reflect the official views of the US National Institutes of Health or any of the other funding sources.