A Clinical Home for Preexposure Prophylaxis: Diverse Health Care Providers' Perspectives on the "Purview Paradox"
Susie Hoffman, John A Guidry, Kate L Collier, Joanne E Mantell, Daria Boccher-Lattimore, Farnaz Kaighobadi, Theo G M Sandfort, Susie Hoffman, John A Guidry, Kate L Collier, Joanne E Mantell, Daria Boccher-Lattimore, Farnaz Kaighobadi, Theo G M Sandfort
Abstract
Background: One barrier to wider preexposure prophylaxis (PrEP) availability is uncertainty about the most appropriate providers and practice settings for offering PrEP.
Methods: The authors conducted in-depth interviews with 30 clinicians--primary care and HIV specialists--in the New York City (NYC) region to explore issues related to PrEP rollout, including who should provide it and in what settings.
Results: A diverse group favored offering PrEP in non-HIV specialty settings in order to reach high-risk HIV-negative individuals. Yet, for each clinical skill or ancillary service deemed important for providing PrEP--knowledge of the medications, ability to assess and counsel around sexual risk behavior, and ability to provide support for retention and medication adherence--participants were divided in whether they thought primary care providers/practices could achieve it. Five participants strongly favored providing PrEP in HIV care practices.
Conclusion: Although there may be multiple "homes" for PrEP, implementation research is needed to identify the most effective delivery approaches.
Keywords: biomedical HIV prevention; health care provider; implementation; preexposure prophylaxis (PrEP).
© The Author(s) 2015.
Source: PubMed