Previous research has demonstrated that sexual and reproductive health care providers never or rarely prescribe pre-exposure prophylaxis (PrEP) to cisgender women, despite their perception that HIV burden is high in this population. The present research was therefore designed to explore: (1) providers' PrEP knowledge and relevant experiences, (2) providers' willingness to prescribe PrEP to cisgender women, and (3) providers' perceived barriers to PrEP uptake among cisgender women at the systems/community level, clinician level, and patient level. We conducted semistructured individual interviews with 18 health care providers currently working in a clinical capacity with cisgender women, including Obstetrics/Gynecology (OB/GYN) (n = 10), Primary Care (n = 4), Infectious Disease (n = 2), and Other Specialty (n = 2) providers. Participants practiced in 12 states across the Northeast (n = 10), West Coast (n = 4), South (n = 3), and Midwest (n = 1) regions of the United States. Interviews were coded using inductive/deductive hybrid thematic analysis. Of the 18 health care providers interviewed, nearly all (n = 17) expressed willingness to prescribe PrEP. However, among those theoretically willing to prescribe PrEP, fewer than half (n = 8) had ever prescribed it. When asked open-ended questions about their attitudes and experiences, all providers identified barriers to prescribing PrEP to cisgender women. These barriers fell into four categories: (1) knowledge, messaging, and (mis)information; (2) stigma and/or fear of stigma; (3) characteristics of the medication itself; and (4) accessibility of health care services. We discuss the implications for developing interventions to address the identified implementation gap and increase PrEP access and uptake among cisgender women.
Goldberg et al. (Mon,) studied this question.