Implementation of HIV pre-exposure prophylaxis for women of color: Perspectives from healthcare providers and staff from three clinical settings

Abstract

Women of color (WOC) account for 83% of new HIV infections among women in the United States. While pre-exposure prophylaxis (PrEP) is a safe, effective HIV prevention method for women, WOC are less likely to be prescribed PrEP than other populations. Guided by an implementation science research framework, we investigated the implementation of a PrEP initiative for WOC in a US city with high HIV incidence. Across three clinical sites, only three WOC were prescribed PrEP after one year. Analysis of qualitative interviews with clinic staff and providers identified time constraints, reluctance to prescribe PrEP, and discomfort with counseling as implementation barriers. Implementation facilitators included staff and leadership support for PrEP, alignment of PrEP services with organizational missions, and having a centralized PrEP Coordinator. By addressing these identified implementation barriers and facilitators, clinic staff and providers can ensure that WOC are provided with the full range of HIV prevention options.

Keywords:

• HIV prevention
• i-PARIHS
• implementation science
• pre-exposure prophylaxis
• women’s health

Acknowledgements

The authors would like to thank the staff and providers at each clinic who graciously shared their time and perspectives for this study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Dr. Bazzi is partially supported by the National Institute on Drug Abuse [NIH grant No. K01DA043412]. The other authors have no pertinent funding or conflicts of interest to disclose.