Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jun;24(6):1942-1950.
doi: 10.1007/s10461-019-02767-3.

Barriers and Facilitators to PrEP Use Among People Who Inject Drugs in Rural Appalachia: A Qualitative Study

Sean T Allen  1 , Allison O'Rourke  2 , Rebecca Hamilton White  3 , Katherine C Smith  3 , Brian Weir  3 , Gregory M Lucas  4 , Susan G Sherman  3 , Suzanne M Grieb  5
Affiliations

Barriers and Facilitators to PrEP Use Among People Who Inject Drugs in Rural Appalachia: A Qualitative Study

Sean T Allen et al. AIDS Behav. 2020 Jun.

Abstract

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.

Keywords: HIV; People who inject drugs; PrEP; Rural health.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest

Dr. Susan Sherman is an expert witness in ongoing opioid litigation. No other authors have any conflicts of interest.

References

    1. Centers for Disease Control and Prevention. HIV Among People Who Inject Drugs. https://www.cdc.gov/hiv/group/hiv-idu.html Accessed 19 Aug 2019.
    1. Centers for Disease Control and Prevention. Lifetime risk of HIV diagnosis: half of black gay men and a quarter of Latino gay men projected to be diagnosed within their lifetime [Press Release]. https://www.cdc.gov/nchhstp/newsroom/2016/croi-press-releaserisk.html Accessed 19 August 2019.
    1. Jones CM, Logan J, Gladden RM, Bohm MK. Vital Signs: Demographic and Substance Use Trends Among Heroin Users - United States, 2002–2013. MMWR. 2015;64(26):719–25. - PMC - PubMed
    1. Zibbell JE, Asher AK, Patel RC, Kupronis B, Iqbal K, Ward JW, et al. Increases in Acute Hepatitis C Virus Infection Related to a Growing Opioid Epidemic and Associated Injection Drug Use, United States, 2004 to 2014. Am J Public Health. 2018;108(2):175–81. - PMC - PubMed
    1. Van Handel MM, Rose CE, Hallisey EJ, Kolling JL, Zibbell JE, Lewis B, et al. County-Level Vulnerability Assessment for Rapid Dissemination of HIV or HCV Infections Among Persons Who Inject Drugs, United States. J Acquir Immune Defic Syndr. 2016;73(3):323–31. - PMC - PubMed

Substances