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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

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Abstract

To improve women’s access to pre-exposure prophylaxis (PrEP) in family planning (FP) clinics, we examined readiness to provide PrEP, and barriers and facilitators at the clinic level to integrate PrEP services into Title X-funded FP clinics across the Southern US. Title X-funded FP clinics across DHHS regions III (Mid-Atlantic), IV (Southeast), and VI (Southwest), comprising the Southern US. From February to June, 2018, we conducted a web-based, geographically targeted survey of medical staff, providers and administrators of Title X-funded FP clinics in DHHS regions III (Mid-Atlantic), IV (Southeast), and VI (Southwest). Survey items were developed using the Consolidated Framework for Implementation Research to assess constructs relevant to PrEP implementation. One-fifth of 283 unique Title X clinics across the South provided PrEP. Readiness for PrEP implementation was positively associated with a climate supportive of HIV prevention, leadership engagement, and availability of resources, and negatively associated with providers holding negative attitudes about PrEP’s suitability for FP. The Title X FP network is a vital source of sexual health care for millions of individuals across the US. Clinic-level barriers to providing PrEP must be addressed to expand onsite PrEP delivery in Title X FP clinics in the Southern US.

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Funding

This research was supported by the National Institutes of Health Grant U24HD089880. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. A. Sheth receives funding from the National Institutes of Health (K23AI114407). L. Haddad’s effort is supported by the National Institutes of Health (K23HD078153).

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Authors and Affiliations

  1. Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA

    Jessica M. Sales & Cam Escoffery

  2. Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA

    Sophia A. Hussen

  3. Division of Family Planning, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA

    Lisa B. Haddad

  4. Department of Biostatistics, Collaborative Studies Coordinating Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Micah McCumber, Evan Kwiatkowski, Teresa Filipowicz, Maria Sanchez & Matthew A. Psioda

  5. Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA

    Anandi N. Sheth

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Correspondence to Jessica M. Sales.

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Conflict of interest

J Sales received grant funding for an Investigator Sponsored Grant from Gilead Sciences, Inc. (CO-US-276-4060). A. Sheth also received grant funding from Gilead Sciences.

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Sales, J.M., Escoffery, C., Hussen, S.A. 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 25, 1901–1912 (2021). https://doi.org/10.1007/s10461-020-03120-9

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