ArticleBMC public health2023
Persistence in a pharmacist-led, same-day PrEP program in Mississippi: a mixed-methods study.
Article in BMC public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Expanding PrEP Access Through Decentralized Delivery Models.Current HIV/AIDS reports · 2026Review
- Role of pharmacists in HIV prophylaxis: a scoping review of pharmacists' services, interventions and outcomes.Journal of the International AIDS Society · 2026Article
- PrEParing for Long-acting Technologies: A Multistate Analysis of PrEP Persistence and HIV and STI Lab Coverage Among Oral PrEP Initiators in St. Louis, Missouri (2014-2021).Open forum infectious diseases · 2026Article
- Innovation in Providing Equitable Pre-exposure Prophylaxis Services in the United States: Expanding Access in Nontraditional Settings.Journal of acquired immune deficiency syndromes (1999) · 2025Article
- Policymaker Perspectives on Implementation Determinants of Rapid ART and Same-Day PrEP in Seven Priority Jurisdictions for Ending the HIV Epidemic: A Multisite Qualitative Study.Journal of acquired immune deficiency syndromes (1999) · 2025Article
- "I honestly didn't know it was for women too…" acceptability and feasibility of integrating PrEP services into OB/GYN practices from the perspectives of practice staff and cisgender women in the community: a qualitative study.Frontiers in health services · 2025Article
- Implementation Science of Integrating Pre-Exposure Prophylaxis in Pharmacist-Led Services in the United States.Current HIV/AIDS reports · 2024Review
- Leveling Up PrEP: Implementation Strategies at System and Structural Levels to Expand PrEP Use in the United States.Current HIV/AIDS reports · 2024Review
- Facilitators and barriers to community pharmacy PrEP delivery: a scoping review.Journal of the International AIDS Society · 2024Article
- Lower PrEP Retention among Young and Black Clients Accessing PrEP at a Cluster of Safety Net Clinics for Gay and Bisexual Men.Journal of the International Association of Providers of AIDS CareArticle
- Using implementation science to evaluate perceived feasibility of pharmacy-based HIV services in the Southeastern United States.Journal of the American Pharmacists Association : JAPhAArticle
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
introductionMississippi has one of the highest rates of HIV in the United States but low PrEP uptake. Understanding patterns of PrEP use can improve PrEP initiation and persistence.
methodsThis is a mixed-method evaluation of a PrEP program in Jackson, Mississippi. Between November 2018-December 2019, clients at high risk for HIV attending a non-clinical testing site were referred to a pharmacist for same-day PrEP initiation. The pharmacist provided a 90-day PrEP prescription and scheduled a follow-up clinical appointment within three months. We linked client records from this visit to electronic health records from the two largest PrEP clinics in Jackson to determine linkage into ongoing clinical care. We identified four distinct PrEP use patterns, which we used for qualitative interview sampling: 1) filled a prescription and linked into care within three months; 2) filled a prescription and linked into care after three months; 3) filled a prescription and never linked into care; and 4) never filled a prescription. In 2021, we purposively sampled patients in these four groups for individual interviews to ascertain barriers and facilitators to PrEP initiation and persistence, using guides informed by the Theory of Planned Behavior.
resultsThere were 121 clients evaluated for PrEP; all were given a prescription. One-third were less than 25 years old, 77% were Black, and 59% were cisgender men who have sex with men. One-quarter (26%) never filled their PrEP prescription, 44% picked up the prescription but never linked into clinical care, 12% linked into care at some point after three months (resulting in a gap in PrEP coverage), and 18% linked into care within 3 months. We interviewed 26 of 121 clients. Qualitative data revealed that cost, stigmas related to sexuality and HIV, misinformation about PrEP, and perceived side effects were barriers to uptake and persistence. Individuals' desire to stay healthy and the support of PrEP clinic staff were facilitators.
conclusionsThe majority of individuals given a same-day PrEP prescription either never started PrEP or stopped PrEP within the first three months. Addressing noted barriers of stigma and misinformation and reducing structural barriers may increase PrEP initiation and persistence.
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