Accessing Pre-exposure Prophylaxis (PrEP): Perceptions of Current and Potential PrEP Users in Birmingham, Alabama

• Type of Material: Article
• Authors: Whitney Rice, Emory University; Kristi L. Stringer, Columbia University; Maira Sohail, University of Alabama Birmingham; Kaylee B. Crockett, University of Alabama Birmingham; Ghislaine C. Atkins, University of Alabama Birmingham; Kachina Kudroff, University of Alabama Birmingham; D. Scott Batey, University of Alabama Birmingham; Joshua Hicks, Mag City Wellness Center; Janet M. Turan, University of Alabama Birmingham; Michael J. Mugavero, University of Alabama Birmingham; Bulent Turan, University of Alabama Birmingham
• Language: English
• Date: 2019-11-01
• Publisher: SPRINGER/PLENUM PUBLISHERS
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2019, Springer Science Business Media, LLC, part of Springer Nature
• Final Published Version (URL): http://dx.doi.org/10.1007/s10461-019-02591-9
• Title of Journal or Parent Work: AIDS AND BEHAVIOR
• Volume: 23
• Issue: 11
• Start Page: 2966
• End Page: 2979
• Grant/Funding Information: This research was supported by the University of Alabama at Birmingham Center for AIDS Research, a National Institutes of Health (NIH) funded program (P30 AI027767) that was made possible by the following institutes: NIAID, NCI, NICHD, NHLBI, NIDA, NIA, NIDDK, NIGMS, and OAR. K.B.C. and W.S.R. received support through an institutional training grant from the Agency for Healthcare Research and Quality (AHRQ T32HS013852). K.L.S. received support through institutional training grants from the National Institute of Drug Abuse (5T32DA037801 and R25DA037190). Investigator support (B.T.) for this study was also provided by the National Institute of Mental Health (R01MH104114). The contents of this publication are the sole responsibility of the authors and do not represent the official views of the NIH or AHRQ.
• Keywords: PROVIDERS; HIV-INFECTION; WOMEN; PREVENTION; Biomedical Social Sciences; Continuum of care; KNOWLEDGE; HIV prevention; Life Sciences & Biomedicine; Public, Environmental & Occupational Health; CARE; Social Sciences, Biomedical; BLACK-MEN; Access; RISK; Pre-exposure prophylaxis (PrEP); SEX; Social Sciences; Science & Technology; ATTITUDES

Abstract

Limited studies to date assess barriers to and facilitators of PrEP uptake and utilization using a patient-centered access to care framework, among diverse socio-demographic groups, or in the U.S. Deep South, an area with disproportionate HIV burden. We examine perceptions of PrEP access in qualitative interviews with 44 current and potential PrEP users in Birmingham, Alabama. Participants were 32 years old on average, 66% Black, 66% gay or lesbian, 70% male, and 66% single. Perceived barriers to PrEP access included: lack of PrEP awareness and advertisement; sexuality-related stigma; time and resource constraints; and concerns about the adequacy and technical quality of PrEP services. Perceived facilitators to PrEP access were: PrEP-related information gathering and sharing; increased dialogue and visibility around PrEP; social, programmatic, and clinical support; and, lastly, self-preservation; personal motivation; and treatment self-efficacy. Results point to opportunities to address complex barriers to equitable PrEP access using multilevel and multimodal solutions.