The Future of Pre-Exposure Prophylaxis (PrEP) for HIV Prevention: A Global Qualitative Consultation on Provider Perspectives on New Products and Differentiated Service Delivery

Differentiated service delivery and new products, such as long-acting injectable cabotegravir (CAB-LA) and the dapivirine vaginal ring (DVR), could increase uptake and use of pre-exposure prophylaxis (PrEP) for HIV prevention. We explored PrEP provider perspectives on differentiated PrEP service del...

Full description

Saved in:
Bibliographic Details
Published in:AIDS and behavior 2023-11, Vol.27 (11), p.3755-3766
Main Authors: Henderson, Mary, Schmidt, Heather-Marie A, Chitembo, Lastone, Peralta, Hortencia, Alaama, Ahmed S, Johnson, Cheryl, Baggaley, Rachel, Schaefer, Robin
Format: Article
Language:English
Subjects:
Antiretroviral drugs
Cisgender
Clients
COVID-19
Digital video recorders
Disease prevention
Familiarity
Guidelines
Health Psychology
Health services
HIV
Human immunodeficiency virus
Infectious Diseases
Medicine
Medicine & Public Health
Original Paper
Prevention
Prophylaxis
Prostitution
Public Health
Sex workers
Sexually transmitted diseases
STD
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Differentiated service delivery and new products, such as long-acting injectable cabotegravir (CAB-LA) and the dapivirine vaginal ring (DVR), could increase uptake and use of pre-exposure prophylaxis (PrEP) for HIV prevention. We explored PrEP provider perspectives on differentiated PrEP service delivery and new PrEP products to inform World Health Organization (WHO) guidelines and programme implementation. 150 PrEP providers who participated in a WHO survey were randomly selected and 67 were invited for interviews based on geographic representation, provider cadre, gender, experience with community-based PrEP service delivery, and familiarity with new PrEP products. Semi-structured interviews were conducted virtually. Key themes were inductively extracted relating to differentiated service delivery and benefits and concerns regarding new PrEP products. 30 PrEP providers from 24 countries were interviewed. Across regions, providers were supportive of differentiated service delivery to respond to clients’ needs and preferences, maintain services during COVID-19, and ensure access for priority populations that may face access challenges. Providers welcomed prospects of offering CAB-LA to their clients but had concerns about HIV testing, costs, and the need for clinic-based services, including staff who can administer injections. Providers felt the DVR was potentially important for some cisgender women, especially young clients and female sex workers, and raised fewer concerns compared to injectable PrEP. Providers’ views are critical for the development of guidelines and implementing programmes that will best serve PrEP users. Understanding areas where provider capacities and biases may create barriers can define opportunities for training and support to ensure that providers can deliver effective programmes.
ISSN:1090-7165
1573-3254
DOI:10.1007/s10461-023-04093-1