Emergency Department Patients' Perspectives on Being Offered Human Immunodeficiency Virus Pre-Exposure Prophylaxis Services in an Urban Emergency Department

HIV pre-exposure prophylaxis (PrEP) is underutilized in the United States. Emergency departments (EDs) can be strategic locations for initiating PrEP; however, knowledge concerning patients' receptivity to ED PrEP programs is limited. This study explores ED patients' perspectives on PrEP service delivery and their preferences for implementation. Semi-structured qualitative interviews were conducted with 15 potentially PrEP-eligible ED patients to examine their receptiveness to PrEP services, preferences for delivery methods, and logistical considerations. Most participants were open to learning about PrEP in the ED, provided it did not delay care, occur during distress, or compromise privacy. Universal PrEP education was viewed as reducing stigma and increasing awareness, while targeted screening was considered efficient. Participants strongly preferred receiving information in person rather than via videos or pamphlets. Concerns included ensuring ED staff expertise and maintaining privacy during PrEP-related discussions. Opinions on initiating same-day PrEP versus prescriptions or referrals varied, with participants valuing flexibility and linkage to care. This first qualitative study of ED patients' perspectives on PrEP services highlights general receptiveness, with key concerns about privacy, expertise, and wait times. Patient-centered approaches, such as integrating services into ED workflows, offering flexible initiation options, and providing privacy, can address barriers and enhance the feasibility of ED-based PrEP programs.