Markers of Quality Care in PrEP Services: Qualitatively Exploring Dimensions of Support Among Persons Who Engage in High-Risk Alcohol Use

Healthcare providers employ various strategies to ensure continuous care for patients taking pre-exposure prophylaxis (PrEP) for HIV prevention. However, sustained engagement in care remains challenging, especially among populations at a higher risk of acquiring HIV, such as individuals who engage in high-risk alcohol use or have alcohol dependence. Understanding the provider-level factors—markers of quality care—that positively influence patient engagement remains underexplored. Through a descriptive qualitative approach and thematic analysis of 38 interviews with 14 participants who use PrEP and who screened positive for hazardous or harmful alcohol consumption (AUDIT scores >7), six major themes were constructed that characterize PrEP quality care: (1) Access to Care and Continuity of Treatment, (2) Positive Patient-Provider Relationships, (3) Educational Engagement, (4) Psychosocial Support and Motivation, (5) Financial Accessibility, and (6) Peer Support. Overall, quality care in the context of PrEP is multifaceted, encompassing efficient service provision, positive patient-provider interactions, accessible and well-defined health education, psychosocial reinforcement, affordability, and peer-based support systems. These findings underscore the need for holistic approaches to PrEP care that address logistical, relational, educational, and financial factors to enhance patient experiences and outcomes.