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PrEP in Substance Abuse Treatment: A Qualitative Study of Treatment Provider Perspectives.

Substance Abuse Treatment, Prevention, and Policy 2015;10:1. [doi: 10.1186/1747-597X-10-1]

Anya Y. Spector, PhD, Robert H. Remien, PhD, Susan Tross, PhD (all from Columbia University, GNY Node).

In the US, there are approximately two million substance users in community treatment programs who are at risk for HIV. Pre-exposure prophylaxis (PrEP) has been shown to be efficacious in preventing HIV acquisition among individuals at risk for HIV, if they are adherent to its use, and it has recently been approved by the FDA. This study aimed to examine substance abuse treatment providers' views on engaging clients in PrEP care and research trials. Thirty-six medical and counseling service providers in six New York City outpatient substance abuse treatment programs participating in the National Drug Abuse Treatment Clinical Trials Network (CTN) participated in semi-structured qualitative interviews. Thematic content analysis was conducted by three coders, independently.

Providers' perspectives toward PrEP were characterized by six salient themes: 1) Limited PrEP awareness. 2) Ambivalence about PrEP. 3) Perception of multiple challenges to delivery. 4) Uncertainty about clients' ability to be adherent to medication. 5) Concerns about medication safety/side effects. 6) Perception of multiple barriers to conducting clinical trials.

Conclusions: This is the first study to explore substance abuse treatment providers' views on PrEP. Despite anticipated challenges, providers supported the introduction of PrEP in outpatient substance abuse treatment. Comprehensive training for providers is needed and should include PrEP eligibility criteria, strategies to support adherence, and medication monitoring guidelines. Linkages between substance abuse treatment and primary care and/or enhancement of capacity within clinics to offer PrEP may help facilitate PrEP delivery. Given access to training, supervision, and linkages to appropriate referral sources, substance abuse treatment providers are likely to engage at-risk clients in accessing PrEP. (Article (Peer-Reviewed), PDF, English, 2015)

Keywords: Attitudes of health personnel | Community health services | Counselors | CTN platform/ancillary study | HIV/AIDS | Substance Abuse Treatment, Prevention, and Policy (journal)

Document No: 1143, PMID: 25575428, PMCID: PMC4298071.

Submitted by CTN Dissemination Librarians, 5/6/2015.


Remien, Robert H.
Spector, Anya Y. mail
Tross, Susan mail
Greater New York www

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Supported by a grant from the National Institute on Drug Abuse to the University of Washington Alcohol and Drug Abuse Institute.
The materials on this site have neither been created nor reviewed by NIDA.
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