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Publication Profiles

Pre-exposure Prophylaxis Implementation in Family Planning Services Across the Southern United States: Findings from a Survey Among Staff, Providers and Administrators Working in Title X-Funded Clinics

Citation

Sales JM, Escoffery C, Hussen SA, et al. Pre-exposure Prophylaxis Implementation in Family Planning Services Across the Southern United States: Findings from a Survey Among Staff, Providers and Administrators Working in Title X-Funded Clinics. AIDS Behav. 2021;25(6):1901-1912. doi:10.1007/s10461-020-03120-9

Implementation stage:

Pre-Implementation

Implementation outcomes reported:

Not specified

Continuum target addressed:

PrEP initiation, Linkage to preventative care

Geography:

Non-priority jurisdiction

Study Participant Classification:

Providers, Implementer(s)

Plain Language Objectives

The researchers surveyed staff, providers, and administrators at southern family-planning clinics about offering HIV-prevention medication. They wanted to understand how many clinics provided PrEP and which leadership, resources, workplace climate, and provider attitudes were linked with readiness.

Plain Language Abstract

Family planning clinics could expand women’s access to pre-exposure prophylaxis, or PrEP, but many do not provide it. From February through June 2018, researchers surveyed medical staff, providers, and administrators at Title X-funded clinics across the Mid-Atlantic, Southeast, and Southwest. Survey questions were based on an implementation framework and assessed readiness, leadership, resources, clinic climate, and attitudes. Among 283 unique clinics, only about one fifth provided PrEP. Greater readiness was associated with a workplace climate supportive of HIV prevention, stronger leadership engagement, and available resources. Readiness was lower where providers held negative views about whether PrEP fit family planning services. The findings identify organizational conditions that may need attention before onsite PrEP delivery can expand. However, this cross-sectional survey cannot show that leadership or resources caused implementation, and responses may not represent every Title X clinic. The analysis assessed clinic readiness and current provision, not whether addressing the identified barriers would increase prescriptions, persistence, or equitable access.

Key Takeaways

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