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Publication Profiles

Provider Perspectives on HIV Pre-Exposure Prophylaxis Service Disruptions and Adaptations During the COVID-19 Pandemic in Baltimore, Maryland: A Qualitative Study

Citation

Rosen JG, Zhang L, Pelaez D, et al. Provider Perspectives on HIV Pre-Exposure Prophylaxis Service Disruptions and Adaptations During the COVID-19 Pandemic in Baltimore, Maryland: A Qualitative Study. AIDS Patient Care STDS. 2022;36(8):313-320. doi:10.1089/apc.2022.0058

Implementation stage:

Sustainment

Implementation outcomes reported:

Not applicable

Continuum target addressed:

PrEP initiation, PrEP persistence, Linkage to preventative care

Geography:

Baltimore City-MD

Study Participant Classification:

Providers

Plain Language Objectives

The researchers wanted to understand how the COVID-19 pandemic disrupted HIV-prevention medicine services in Baltimore and how providers adapted. They also examined who benefited from telemedicine and which barriers continued or worsened.

Plain Language Abstract

The COVID-19 pandemic disrupted health services, including pre-exposure prophylaxis, or PrEP, for populations already facing barriers to care. Between February and April 2021, researchers held four virtual focus groups with 20 Baltimore PrEP providers from different professions and practice settings. Providers described reduced demand and high discontinuation early in the pandemic, which they linked to changes in sexual behavior and competing responsibilities such as caregiving. They also reported suspended outreach, staffing shortages, and restrictions on face-to-face visits, with effects lasting beyond the initial disruption. Telemedicine made PrEP care more convenient and accessible for some clients and faster for some providers. However, lack of telephone or internet access and difficulty building rapport virtually limited equitable use. Providers proposed rebuilding outreach capacity and offering alternatives such as community-based PrEP delivery and self-collected laboratory specimens. The findings identify service adaptations and continuing access problems but do not test whether any adaptation improved PrEP initiation or continuation. Because this was a qualitative study, the themes represent participating providers’ experiences rather than all providers or clients in Baltimore.

Key Takeaways

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