Chandler Cristian J, Schlundt David G, Dagostino Chloe, Bonnet Kemberlee R, Sellers Ashley J, Pichon Latrice C, Alexander Leah R
Division of Infectious Diseases, Vanderbilt University Medical Center, Nashville, TN 37203, USA.
Department of Psychology, Vanderbilt University, Nashville, TN 37240, USA.
Int J Environ Res Public Health. 2025 Apr 23;22(5):662. doi: 10.3390/ijerph22050662.
Tennessee is in the southern region of the United States and has not yet fully benefitted from HIV pre-exposure prophylaxis (PrEP). Relatively little research has focused on pivotal roles of PrEP navigators. This study examined PrEP navigator perceptions of implementing long-acting injectable (LAI) PrEP in Tennessee. Semi-structured interviews with state-funded navigators were audio-recorded, transcribed, and systematically coded using a hierarchical system. Coded transcripts were aggregated, sorted, and analyzed using an iterative inductive/deductive qualitative approach. Using the Consolidated Framework for Implementation Research (CFIR), institutional, individual, and modifying factors to initiating and transitioning to LAI PrEP were identified. Most navigators initially had limited training and experience with LAI PrEP. Navigators reported systemic barriers associated with accessibility to LAI PrEP such as health insurance, pharmaceutical policies, and cost policies. While navigators noted the continued support of the state health department, strategies for circumventing individual and structural barriers are needed for universally implementing injectable PrEP.
田纳西州位于美国南部地区，尚未充分从艾滋病毒暴露前预防（PrEP）中受益。相对较少的研究关注PrEP导航员的关键作用。本研究考察了田纳西州PrEP导航员对实施长效注射（LAI）PrEP的看法。对由州政府资助的导航员进行的半结构化访谈进行了录音、转录，并使用分层系统进行系统编码。编码后的转录本进行汇总、分类，并采用迭代归纳/演绎定性方法进行分析。利用实施研究综合框架（CFIR），确定了启动和过渡到LAI PrEP的机构、个人和调节因素。大多数导航员最初对LAI PrEP的培训和经验有限。导航员报告了与LAI PrEP可及性相关的系统性障碍，如健康保险、药品政策和费用政策。虽然导航员指出了州卫生部门的持续支持，但普遍实施注射用PrEP需要规避个人和结构性障碍的策略。
