Innovation in Providing Equitable Pre‐exposure Prophylaxis Services in the United States: Expanding Access in Nontraditional Settings

作者：Joanne E. Mantell, Laurie J. Bauman, Stephen Bonett, Susan Buchbinder, Susie Hoffman, Erik D. Storholm, Katryna McCoy, Christine Tagliaferri Rael, Ethan Cowan, Tatiana Gonzalez-Argoti, Hussein Safa, Hyman Scott, Kimberly Ling Murtaugh, Natalie Wilson, Albert Liu · 发表于：JAIDS Journal of Acquired Immune Deficiency Syndromes · 年份：2025 · DOI：10.1097/qai.0000000000003610 · 被引用次数：14 · 研究领域：HIV/AIDS Research and Interventions、Infection Control in Healthcare、Sex work and related issues

BACKGROUND: Pre-exposure prophylaxis (PrEP) usage has slowly increased in the United States, but significant disparities persist across race, ethnicity, sex, gender, age, and geography. Determinants of PrEP inequities include stigma and medical mistrust, lack of patient-centered services, lack of access to clinical care, and organizational resistance to change-within a health care system that neglects these barriers. METHODS: We describe 5 implementation strategies to providing PrEP in nontraditional settings to underserved populations, using an equity-based approach to address key structural determinants. The alternative settings used in these Ending the HIV Epidemic projects (community-based organizations, telePrEP, mobile clinics, pharmacies, emergency departments) were chosen for the setting characteristics and their serving structurally underserved populations. RESULTS: Community-based organizations have earned trust within communities and can serve as hubs for comprehensive sexual health services, including PrEP. Telehealth, which expanded significantly because of COVID-19, can help overcome transportation and scheduling barriers to PrEP access. Mobile clinics can also broaden PrEP delivery by bringing tailored services directly to communities, often providing shorter wait times and extended hours. Pharmacists can prescribe PrEP in certain states through legislation or collaborative practice agreements, offering a convenient, community-based option. Emergency department...