Patient recommendations for PrEP information dissemination at family planning clinics in Atlanta, Georgia

Abstract

Objective: Family planning (FP) clinics are an ideal setting to disseminate information about pre-exposure prophylaxis (PrEP), but little is known about women's preferences for learning about PrEP in this setting. Study design:We surveyed 500 women seeking care at 4 FP clinics in Atlanta. Before their provider visit, participants completed an HIV-risk screener. After, we asked participants about the HIV prevention counseling they received and how clinics could share information about PrEP. We performed descriptive analyses on demographics, HIV risk, and PrEP awareness/interest, and conducted thematic analysis on open-ended responses.Results: Only 18% knew about PrEP before the study; 28% of 376 sexually-active women had ≥1 risk indicator consistent with PrEP eligibility. Three hundred forty seven women (69%) shared suggestions about how clinics should share PrEP information. We categorized suggestions into 4 themes -Advertising, Conversations, Awareness and Access. Participants (n=150) suggested clinics should advertise PrEP via brochures, posters, texts, or emails; 134 wanted providers to talk to patients about PrEP. Several (n=71) suggested sharing PrEP information broadly in the community and with other clinics/providers; others (n=11) wanted improved access to PrEP services. Conclusions:Our results demonstrate overwhelming patient interest in learning more about PrEP through educational materials and directly from FP providers. Women were vocal about increasing PrEP awareness in the community, particularly among populations especially at risk for HIV (e.g., teens). These suggestions can be translated into actionable steps FP clinics can take to increase PrEP awareness and expand their reach to benefit women at risk for HIV.

Exploring the heterogeneity of factors that may influence implementation of PrEP in family planning clinics: a latent profile analysis

“…Clinics in the “Incompatible Setting” group may consider this referral adaption, so that women who could benefit from PrEP are at a minimum educated and made aware of the availability of PrEP services in their community. Universal education pertaining to PrEP is especially important given consistently low knowledge and awareness about PrEP reported among women in the South [ 5 , 7 ]. Other potential adaptations to PrEP, that could help overcome barriers, include pharmacy-based PrEP services (which could be useful for clinics that have a pharmacy on-site) [ 52 ], telemedicine [ 53 ], and at-home PrEP services [ 54 ].…”

Understanding the Impact of Intimate Partner Violence Type and Timing on Pre-exposure Prophylaxis Knowledge, Acceptability, Sexual Behavior, and Gender Roles Among Women of Color

“…Self-silencing is one factor that influences traditional gender roles; it restricts self-expression undermining a woman’s feelings, thoughts, and actions in maintaining an intimate relationship (Maji & Dixit, 2019). Similarly, being subordinate to others is indicative of women’s obedience and respect for the hierarchical family structure, particularly toward men and elders (Sanchez et al, 2019). Control of sexual interactions between men and women occurs under power inequalities that force women to be passive sexually which can contribute to a reluctance to protect oneself against HIV, since it requires a degree of sexual autonomy (El-Bassel et al, 1998; Fasula et al, 2014).…”

“…PrEP-related research indicates knowledge as an important factor that influences PrEP interest, willingness, and uptake (Collier et al, 2017;Garfinkel et al, 2017;Rubtsova et al, 2013). Qualitative and quantitative studies on PrEP knowledge and acceptability among women in the U.S. have demonstrated wide approval of PrEP use as a female controlled prevention method (Auerbach et al, 2015;Bond & Gunn, 2016;Ravasi et al, 2016;Rubtsova et al, 2013;Sales et al, 2019). A recent study on PrEP interest found that social networks can influence PrEP use among women of color experiencing IPV (Willie et al, 2019).…”

Integrating HIV Pre-Exposure Prophylaxis into Family Planning Care: A RE-AIM Framework Evaluation

“…Data from family planning clinics in Georgia suggest that women want waiting-room materials on PrEP, such as brochures and posters, and that 39% wanted doctors to initiate discussions on PrEP. 16 Woman-centered PrEP materials continue to be developed and a list of patient and provider resources can be found at hiveonline.org. It was also suggested that one clinician be identified as the ''PrEP Champion,'' to take the lead in addressing systems issues.…”