HIV

Another PrEP Use Barrier: Health Care Providers

Health care providers are a major barrier to pre-exposure prophylaxis (PrEP) use among black and Hispanic men who have sex with men (MSM), according to new research.

 

The research, authored by Taylor Silverman, AB, and colleagues, was presented on November 11 at the American Public Health Association’s 2018 Annual Meeting & Expo.

 

Because black and Hispanic MSM are at the highest risk for HIV and their use of PrEP remains low, the researchers examined whether health care providers can be a barrier to PrEP use in this population.

 

To conduct their study, the researchers held 3 semi-structured focus groups. Each focus group consisted of 5 to 7 black and Hispanic MSM (N = 17) who did not have HIV and were living in the Providence area. During the sessions, the participants discussed barriers to PrEP uptake.

 

The analysis showed that health care providers are a major barrier to PrEP use, with nearly 50% of participants saying that PrEP use was never discussed with a health care provider. Half of the participants who did have the discussion about PrEP reported initiating the conversation themselves and that their providers refused to prescribe PrEP.

 

Participants also reported provider behavior as:

  • Lacking either knowledge or respect,
  • Curtailing patient autonomy,
  • Rooted in general discomfort with homosexuality,
  • Unfairly expecting risk compensation, and
  • Delivering moral judgments about their sexual practices and taking PrEP.

 

“Our findings raise serious concerns about the way health care providers discuss PrEP with their patients,” the researchers concluded. “Provider awareness, knowledge, and sensitivity are critical factors for the successful implementation of PrEP, especially among Black/African American and Hispanic/Latino MSM.”

 

 

—Amanda Balbi

 

Reference:

Silverman T, Asante N, Santamaria EK, Jennings E, van den Berg JJ. A qualitative analysis of provider barriers to pre-exposure prophylaxis uptake among Black/African American and Hispanic/Latino men who have sex with men in the northeastern United States. Paper presented at: American Public Health Association 2018 Annual Meeting & Expo; October 10-14, 2018; San Diego, CA. https://apha.confex.com/apha/2018/meetingapp.cgi/Paper/410036. Accessed November 14, 2018.