Hill Mandy J, Sophus Amber I, Sapp Sarah, Campbell Jeffrey, Santa Maria Diane, Stockman Jamila K
Department of Population Health and Health Disparities, School of Public and Population Health, University of Texas Medical Branch at Galveston (UTMB), Galveston, TX 77555, USA.
Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL 33199, USA.
Int J Environ Res Public Health. 2025 Mar 18;22(3):450. doi: 10.3390/ijerph22030450.
Prescriptions for and use of pre-exposure prophylaxis (PrEP), an available and accessible HIV prevention strategy, remain low among cisgender Black women (CBW). Given PrEP is only available through a prescription from a licensed healthcare provider (HCP), there is a need to identify factors associated with HCP's prescribing and/or referring PrEP to CBW. Qualitative methods (in-depth interviews) were used to examine factors shaping beliefs and behaviors among 12 HCPs that impact their willingness to prescribe or refer PrEP to CBW. Seven primary themes were identified during a thematic data analysis. The themes with the highest frequency of codes (fc) were the provider's experience discussing sexual health (fc = 284), the provider approach to patient engagement (fc = 240), provider knowledge of PrEP (fc = 158), and the provider approach to determining PrEP eligibility (fc = 141). Findings indicate that prescribing and referral behaviors among HCPs can be influenced by their knowledge of PrEP; perceptions about PrEP for patients; comfort level in engaging/communicating with patients about PrEP; awareness of PrEP resources needed to improve PrEP access among patients; and patient-provider communication relative to sexual health, HIV vulnerability, and PrEP eligibility. Study findings illuminate how usual care practices contribute to gaps in PrEP access among CBW and highlight areas for intervention.
暴露前预防(PrEP)是一种可行且可及的艾滋病预防策略,在顺性别黑人女性(CBW)中的处方开具及使用情况仍然较低。鉴于PrEP仅可通过持牌医疗服务提供者(HCP)的处方获取,因此有必要确定与HCP为CBW开具PrEP处方和/或将其转介至PrEP相关的因素。采用定性方法(深度访谈)来研究影响12位HCP为CBW开具或转介PrEP意愿的信念和行为的影响因素。在主题数据分析过程中确定了七个主要主题。编码频率(fc)最高的主题是提供者讨论性健康的经验(fc = 284)、提供者与患者互动的方式(fc = 240)、提供者对PrEP的了解(fc = 158)以及提供者确定PrEP资格的方式(fc = 141)。研究结果表明,HCP的处方开具和转介行为可能会受到他们对PrEP的了解、对患者PrEP的看法、与患者就PrEP进行互动/沟通的舒适度、对改善患者PrEP可及性所需PrEP资源的认识,以及与性健康、HIV易感性和PrEP资格相关的医患沟通的影响。研究结果阐明了常规护理实践如何导致CBW在PrEP可及性方面存在差距,并突出了干预领域。