Barriers to PrEP uptake: Perspectives of community health workers in the Mid-South region of the United States

Abstract

Despite its promise, pre-exposure prophylaxis (PrEP) uptake has been slow in the United States with fewer than 100,000 of the 1.1 million Americans considered at substantial risk for HIV currently taking it. Community health workers play a critical role in promoting PrEP awareness and access in their local communities. However, there is currently limited literature that focuses on barriers faced by community health workers providing PrEP services. The present qualitative study draws upon the social ecological model (SEM) to examine barriers to PrEP uptake from the perspective of community health workers in a large Mid-South U.S. city. Study participants identified several barriers at all five levels of the SEM: individual, interpersonal, community, organizational, and policy. The study findings provide viable entry points for multilevel interventions aimed at promoting PrEP uptake.

Keywords:

• community health workers
• HIV
• intervention
• pre-exposure prophylaxis (PrEP)
• qualitative research

Acknowledgment

We appreciate the administrators and staff of the local county health department, especially the STD/HIV Clinic of the Office of Epidemiology and Infectious Diseases, for providing the logistical support and for participating in this project.

Ethical standards

The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008.