ArticleAddiction science & clinical practice2024
Centering autonomy and choice to support oral PrEP utilization among people who inject drugs: qualitative lessons from HPTN 094 INTEGRA.
Article in Addiction science & clinical practice, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04804027, which is not on this map. Cited by 5 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Who cites it
5 citing papers in PubMed.
- Reproductive health considerations for HIV prevention integrated care models for women who inject drugs: Qualitative perspective of participants and providers in HIV Prevention Trials Network 094.Drug and alcohol dependence · 2026Article
- Perceptions of Buprenorphine With Naloxone Treatment and the Fear of Precipitated Withdrawal: A Qualitative Exploration With HIV Prevention Trials Network 094 INTEGRA Participants and Staff.Drug and alcohol review · 2026Article
- Pre-exposure prophylaxis (PrEP) for men who have sex with men and transgender women in a clinic and a community-based setting: results from the first demonstration project in India.BMJ global health · 2026Article
- Prevalence of Illicit Drug Detection in 5 US Cities Among Out-of-Treatment People Who Inject Drugs.JAMA network open · 2026Article
- Advancing pre-exposure prophylaxis (PrEP) implementation for people who use drugs: an introduction to and lessons from the special series.Addiction science & clinical practice · 2025Article
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14 authors.
Funding
Abstract
backgroundOral Pre-exposure prophylaxis (PrEP) is effective in preventing HIV transmission. However, despite high rates of HIV risk behaviors among people who inject drugs (PWID), this population remains underserved by current HIV prevention efforts in the United States. To address this challenge, we conducted an in-depth exploration of perspectives on using oral PrEP among PWID engaged in the HIV Prevention Trials Network (HPTN) 094 INTEGRA Study.
methodsGuided by the Practical, Robust, Implementation, and Sustainability Model (PRISM), our qualitative study drew on semi-structured interviews conducted as part of the embedded implementation science evaluation of HPTN 094 INTEGRA. Seventy-seven PWID participants from five sites across New York City, Houston, Los Angeles, Philadelphia, and Washington DC were interviewed to assess intervention delivery, care access, and engagement sustainability. Audio files were transcribed verbatim and analyzed via an inductive and deductive thematic approach.
resultsMost participants (n = 46, 59.7%) discussed oral PrEP during their interview, though not directly prompted. Participants discussing PrEP had a mean age of 41.6 years and were predominantly white (54.3%) and cisgender men (60.9%). Among these, 15 participants described using PrEP. All participants had facilitated access to oral PrEP. Yet, the choice to use PrEP was influenced by personal risk perceptions, (mis)information about PrEP, and external factors (i.e. housing, financial security), which, for some, limited the autonomy to use PrEP. Two key themes emerged among participants using PrEP: ease of access and perceptions of high HIV risk. Those not using PrEP described two themes: low risk perception and prioritizing more urgent needs. Among participants not using PrEP a subgroup commonly described ambivalent interest, PrEP knowledge gaps, and PrEP readiness (i.e., contemplation).
conclusionsQualitative findings highlight that facilitated PrEP access was insufficient to motivate use for many participants. Rather, PrEP decision-making process (i.e., choice) was linked to risk perception and individuals' capability to leverage PrEP as a resource based on their circumstances (i.e., autonomy). Participants' descriptions of the centrality of choice and autonomy for PrEP use underscore that ease of access is a necessary pre-condition, but person-centered interventions should also address housing, financial stability, and urgent medical conditions to promote PrEP utilization among PWID. CLINICAL
trial registrationNCT04804027.
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