Open AccessBarriers and Facilitators to PrEP Use Among People Who Inject Drugs in Rural Appalachia: A Qualitative Study
Author(s) -
Sean T. Allen,
Allison O’Rourke,
Rebecca Hamilton White,
Katherine Clegg Smith,
Brian W. Weir,
Gregory M. Lucas,
Susan G. Sherman,
Suzanne M. Grieb
Publication year - 2019
Publication title -
aids and behavior
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.994
H-Index - 106
eISSN - 1573-3254
pISSN - 1090-7165
DOI - 10.1007/s10461-019-02767-3
Subject(s) - appalachia , health psychology , pre exposure prophylaxis , qualitative research , medicine , injection drug use , rural area , focus group , environmental health , human immunodeficiency virus (hiv) , public health , family medicine , nursing , men who have sex with men , drug injection , sociology , paleontology , social science , biology , syphilis , pathology , anthropology
The opioid crisis has increased risks for injection drug use-associated HIV outbreaks in rural communities throughout the United States. Existing research has examined pre-exposure prophylaxis (PrEP) utilization among people who inject drugs (PWID); however, no studies have been conducted to explore barriers and facilitators of PrEP use among rural PWID in Appalachia. We conducted qualitative interviews with PWID (n = 48) in two rural counties in West Virginia to explore barriers and facilitators of PrEP use. Among our participants, the majority (68.8%) had never heard of PrEP. Upon learning about PrEP, most participants expressed willingness to use it. Rural PWID described several factors that may impede PrEP utilization (e.g., housing instability, forgetting to take PrEP). Participants also identified practical strategies to support sustained PrEP utilization, such as integrating PrEP services into venues PWID access. This research provides important insights into the barriers and facilitators of PrEP utilization among rural PWID.