ArticleAIDS and behavior2026
A SWOT Analysis of PrEPChoices: Developing a Web-Based Decision Aid Tool to Support HIV Prevention Decision-Making.
Article in AIDS and behavior, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Sexual and gender minority youth (SGMY) experience a heightened risk of HIV acquisition due to barriers to HIV prevention, specifically connected to a lack of comfort in discussing sexual identity and practices with healthcare providers (HCPs). Decision-aid tools that support communication and shared decision-making may improve both access to and uptake of numerous HIV prevention modalities among SGMY. The study aimed to inform the decision-making process of HIV prevention modalities for HCPs and SGMY, providing key information about HIV prevention modalities with PrEPChoices, a web-based decision aid tool. Our study recruited two participant groups, HCPs (N = 15) and SGMY (N = 18). Eligible HCPs held a Doctor of Medicine (MD), Doctor of Osteopathic Medicine (DO), Nurse Practitioner (NP), or Physician Assistant/Associate (PA) degree, were licensed to prescribe medications in at least one United States state, had provided care to patients aged 15 to 24 within the past month, and were 18 years of age or older. Eligible SGMY were assigned male sex at birth, reported sexual attraction to and/or sexual behavior with cisgender men or transgender women in the past six months, and were 15 to 24 years of age. Participants completed a semi-structured Webex interview focused on the clarity and relevance, presentation and usability, and application of PrEPChoices, a web-based decision aid tool to support HIV prevention modalities selection among HCPs and SGMY. Interview transcripts were coded using an iteratively developed codebook. Findings were thematically analyzed within a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis framework. Thirty-three participants enrolled (N = 33), including 15 HCPs and 18 SGMY. Strengths included: (1) support for HIV prevention-based decision making; (2) utilization of the filtering tool to select preferred HIV prevention modalities; and (3) intuitive website design. Weaknesses included: (1) gaps in needs and literacy levels between HCPs and SGMY; (2) limited visual design appeal and inclusive representation; and (3) limited in-tool features for comparing HIV prevention modalities. Opportunities included: (1) potential for multimodal dissemination; and (2) expanding external resources provided. Threats included: (1) challenge of integrating PrEPChoices into clinical practices; and (2) ability to stand out compared to other online HIV prevention education resources. HCPs and SGMY highlight the value of PrEPChoices as a web-based decision aid tool to enhance HIV prevention modality selection among SGMY. Our results emphasize the critical role PrEPChoices can play in reducing barriers to sexual health education among SGMY, improving the patient-provider relationship with the PrEP landscape, and strengthening HIV prevention among SGMY.
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