Assessing Provider-, Clinic-, and Structural-Level Barriers and Recommendations to Pre-Exposure Prophylaxis (PrEP) Uptake: A Qualitative Investigation Among Women Experiencing Intimate Partner Violence, Intimate Partner Violence Service Providers, and Healthcare Providers.

Abstract

Intimate partner violence (IPV) relates to HIV susceptibility and acquisition. Existing research examined barriers to pre-exposure prophylaxis (PrEP) uptake among women but few studies assess uptake and delivery among IPV service providers, along with provider-, clinic-, and structural-level barriers. We conducted 34 semi-structured interviews with PrEP-eligible cisgender heterosexual women experiencing IPV, Reproductive Health providers, PrEP providers, and IPV service providers in Northeast US. Systems theory was used to examine barriers from individuals who either work closely with or are part of the population. The framework method was used to draw descriptive and explanatory conclusions. Findings suggest limited knowledge for Reproductive Health and IPV Service Providers. Providers often did not feel equipped to discussed PrEP in visits or focused efforts solely on safety. Expanding PrEP awareness is necessary and marketing should include women. Future research should investigate how providers can work collaboratively across sectors to ensure women receive comprehensive trauma-informed care.