• Prepping for PrEP: A Qualitative Study of HIV Service Providers’ Experiences in working with Women Who Inject Drugs (WWIDs)

      Bass, Sarah Bauerle; Temple University. Honors Program (Temple University. Libraries, 2021)
      Purpose/Hypothesis: Women who inject drugs (WWIDs) are at elevated risk for HIV due to myriad factors including injecting drugs and engagement in sex work. Pre-exposure prophylaxis (PrEP) can reduce HIV risk when taken-daily and is indicated for use in this population. Few studies have explored barriers and facilitators to PrEP use in WWIDs despite the medication’s harm-reducing potential. As such, this study explored the perspectives of HIV service providers on PrEP care in WWIDs at a community-based syringe exchange. Methods: A purposeful sample of 10 HIV-service providers of WWIDs at a Philadelphian syringe exchange were interviewed. Audio recordings were transcribed verbatim. Transcripts were read to develop a coding schema, coded, and analyzed by thematic analysis using the qualitative software, DeDoose. The Temple University IRB approved this study protocol number 25028. Results: Most participants were female (n=6), half were white, 20% were black, 20% Hispanic/Latinx, and 10% were multi-racial. Interviewees had a high-level understanding of harm reduction efforts in serving WWIDs. Barriers to PrEP for WWIDs included homelessness, gender stigmas, low socioeconomic status, mistrust in healthcare, PrEP and HIV misinformation. WWIDs can be empowered by emboldened patient-provider relationship, which may improve access and adherence to PrEP. To achieve empowerment, recommendations included bundling PrEP care with other services and female-focused events that may reduce HIV, PrEP, and help-seeking stigmas. Conclusions: Providers reported many barriers to PrEP use in WWIDs. Access barriers may be surmounted by linking PrEP-services with other health- and social services within a community-facing organization. PrEP adherence may improve when patients are empowered to surmount stigmas through PrEP education.