Examining Perceptions Among Healthcare Providers on Their Awareness of and Experience with Prescribing and/or Referring Pre-Exposure Prophylaxis to Eligible Cisgender Black Female Patients: A Qualitative Inquiry

Mandy J. Hill (), Amber I. Sophus, Sarah Sapp, Jeffrey Campbell, Diane Santa Maria and Jamila K. Stockman
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Mandy J. Hill: Department of Population Health and Health Disparities, School of Public and Population Health, University of Texas Medical Branch at Galveston (UTMB), Galveston, TX 77555, USA
Amber I. Sophus: Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL 33199, USA
Sarah Sapp: School of Osteopathic Medicine, University of the Incarnate Word, San Antonio Campus, San Antonio, TX 78235, USA
Jeffrey Campbell: Allies in Hope Houston, Houston, TX 77030, USA
Diane Santa Maria: Department of Research, Cizik School of Nursing, University of Texas Health Science Center at Houston (UTHealth Houston), Houston, TX 77030, USA
Jamila K. Stockman: Department of Medicine, University of California, La Jolla, San Diego, CA 92093, USA

IJERPH, 2025, vol. 22, issue 3, 1-27

Abstract: Prescriptions for and use of pre-exposure prophylaxis (PrEP), an available and accessible HIV prevention strategy, remain low among cisgender Black women (CBW). Given PrEP is only available through a prescription from a licensed healthcare provider (HCP), there is a need to identify factors associated with HCP’s prescribing and/or referring PrEP to CBW. Qualitative methods (in-depth interviews) were used to examine factors shaping beliefs and behaviors among 12 HCPs that impact their willingness to prescribe or refer PrEP to CBW. Seven primary themes were identified during a thematic data analysis. The themes with the highest frequency of codes (fc) were the provider’s experience discussing sexual health (fc = 284), the provider approach to patient engagement (fc = 240), provider knowledge of PrEP (fc = 158), and the provider approach to determining PrEP eligibility (fc = 141). Findings indicate that prescribing and referral behaviors among HCPs can be influenced by their knowledge of PrEP; perceptions about PrEP for patients; comfort level in engaging/communicating with patients about PrEP; awareness of PrEP resources needed to improve PrEP access among patients; and patient–provider communication relative to sexual health, HIV vulnerability, and PrEP eligibility. Study findings illuminate how usual care practices contribute to gaps in PrEP access among CBW and highlight areas for intervention.

Keywords: health communication; healthcare provider engagement; healthcare provider; PrEP access; cisgender Black women; PrEP uptake; HIV prevention; healthcare access; women’s health (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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