Susie Hoffman1, John A Guidry2, Kate L Collier3, Joanne E Mantell3, Daria Boccher-Lattimore4, Farnaz Kaighobadi5, Theo G M Sandfort4. 1. Division of Gender, Sexuality, and Health, New York State Psychiatric Institute and Columbia University, New York, NY, USA Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA sh51@cumc.columbia.edu. 2. Gay Men's Health Crisis (GMHC) and SAE & Associates, New York, NY, USA. 3. Division of Gender, Sexuality, and Health, New York State Psychiatric Institute and Columbia University, New York, NY, USA. 4. Division of Gender, Sexuality, and Health, New York State Psychiatric Institute and Columbia University, New York, NY, USA Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA. 5. Visiting Assistant Professor of Psychology, Bard College, Annandale-on-Hudson, NY, USA.
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.
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.
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