Presenting Author: Ana Martinez-Donate, PhD, Drexel University Dornsife School of Public Health

ABSTRACT

Background: Pre-exposure prophylaxis (PrEP) is a biomedical HIV prevention strategy that involves the use of antiretroviral medications to reduce HIV acquisition among at-risk individuals. Although the efficacy of PrEP has been proven through multiple clinical trials, adoption of PrEP in real-world clinical settings has been slow. Non-prescribing HIV prevention providers can play an important role in screening and referring eligible patients to PrEP services.

Objectives: The aim of this study was to examine PrEP referral practices and related barriers and facilitators among non-prescribing HIV prevention providers.

Methods: We conducted qualitative interviews with non-prescribing prevention providers, including 5 HIV testers, 6 case managers, and 1 client navigator (N=12), from Philadelphia-based HIV prevention organizations. Content analysis was performed to understand PrEP referral practices, as well as related attitudes, social norms, perceived control, and behavioral intentions.

Results: Non-prescribing HIV providers frequently refer high-risk clients to PrEP and appear to have sufficient knowledge, good attitudes about PrEP, and moderately strong behavioral intentions to continue referring their high-risk clients to these services. Barriers to referring clients to PrEP included lack of time to have conversations about PrEP with the clients, perceived lack of interest about PrEP among clients, and lack of access to PrEP on-site.

Implications: Non-prescribing providers are an under-utilized resource for referring high-risk clients for PrEP services. Screening for PrEP and educating their clients about PrEP should be part of these providers' services. Testing quotas should be modified to account for the time necessary to discuss PrEP with at-risk clients.

Authors: Ana Martinez-Donate, PhD; Zsofi Szep, MD, MSCE; Navya Karkada, BS; Marisa Felsher, MPH, DrPH(c); and Alexis Roth, PhD, MPH.