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Patient and Provider Perspectives on a Novel, Low-Threshold HIV PrEP Program for People Who Inject Drugs Experiencing Homelessness
- Source :
- Journal of general internal medicine, vol 38, iss 4
- Publication Year :
- 2022
-
Abstract
- Background HIV outbreaks among people who inject drugs (PWID) and experience homelessness are increasing across the USA. Despite high levels of need, multilevel barriers to accessing antiretroviral pre-exposure prophylaxis (PrEP) for HIV prevention persist for this population. The Boston Health Care for the Homeless Program (BHCHP) initiated a low-threshold, outreach-based program to support engagement in PrEP services among PWID experiencing homelessness. Methods To inform dissemination efforts, we explored patient and provider perspectives on key program components. From March to December 2020, we conducted semi-structured qualitative interviews with current and former BHCHP PrEP program participants and prescribers, patient navigators, and outreach workers (i.e., providers). Thematic analysis explored perspectives on key program components. Results Participants (n = 21) and providers (n = 11) identified the following five key components of BHCHP’s PrEP program that they perceived to be particularly helpful for supporting patient engagement in PrEP services: (1) community-driven PrEP education; (2) low-threshold, accessible programming including same-day PrEP prescribing; (3) tailored prescribing supports (e.g., on-site pharmacy, short-term prescriptions, medication storage); (4) intensive outreach and navigation; and (5) trusting, respectful patient-provider relationships. Discussion Findings suggest that more patient-centered services formed the basis of BHCHP’s innovative, successful PrEP program. While contextual challenges including competing public health emergencies and homeless encampment “sweeps” necessitate ongoing programmatic adaptations, lessons from BHCHP’s PrEP program can inform PrEP delivery in a range of community-based settings serving this population, including syringe service programs and shelters.
- Subjects :
- Anti-HIV Agents
Clinical Sciences
substance use
8.1 Organisation and delivery of services
HIV Infections
Drug Users
Clinical Research
General & Internal Medicine
community health services
Behavioral and Social Science
Internal Medicine
Humans
harm reduction
pre-exposure prophylaxis
delivery of health care
Prevention
homeless persons
public health
Substance Abuse
program evaluation
Homelessness
Health Services
patient navigation
Infectious Diseases
Good Health and Well Being
Pharmaceutical Preparations
Ill-Housed Persons
intravenous
HIV/AIDS
Infection
Health and social care services research
Subjects
Details
- ISSN :
- 15251497
- Database :
- OpenAIRE
- Journal :
- Journal of general internal medicine
- Accession number :
- edsair.doi.dedup.....9bb1a7c4b01e29d391137ce899628f0f