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Publication Profiles

A qualitative study identifying implementation strategies using the i-PARIHS framework to increase access to pre-exposure prophylaxis at federally qualified health centers in Mississippi

Citation

Arnold T, Whiteley L, Giorlando KK, et al. A qualitative study identifying implementation strategies using the i-PARIHS framework to increase access to pre-exposure prophylaxis at federally qualified health centers in Mississippi. Implement Sci Commun. 2024;5(1):92. doi:10.1186/s43058-024-00632-6

Implementation stage:

Pre-Implementation

Implementation outcomes reported:

Acceptability, Appropriateness

Continuum target addressed:

PrEP initiation, PrEP persistence

Geography:

Mississippi

Study Participant Classification:

Recipients of care, Providers

Plain Language Objectives

The researchers interviewed patients and staff at Mississippi community health centers about HIV-prevention medication. They wanted to identify local barriers and work with staff to select education and training strategies that would fit these clinics.

Plain Language Abstract

Mississippi has high HIV incidence and limited access to pre-exposure prophylaxis, or PrEP. Federally qualified health centers could expand services, but implementation needs to fit local patients and clinics. Researchers interviewed 19 staff members and 17 PrEP-eligible patients between April 2021 and March 2022, using an implementation framework to examine context, the intervention, and the people involved. Nine staff members later reviewed proposed strategies. Participants linked greater patient and staff knowledge with more PrEP use. They described perceived side effects, low personal HIV-risk perception, and untrained providers as barriers, while patients expressed strong motivation to protect themselves, partners, and communities. Education for patients and providers and provider training were viewed as acceptable and appropriate strategies. The findings provide locally tailored implementation options for Mississippi health centers. Because this was qualitative planning work, it reflects participant perspectives and cannot determine how frequently each barrier occurs. The strategies were selected and reviewed, but the study did not test whether they increased PrEP initiation or persistence.

Key Takeaways

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