HIV Pre-exposure Prophylaxis (PrEP) Care in Belgium: A mixed-methods Study on PrEP Users’ Experiences and Service Delivery Preferences

被引:0
|
作者
Anke Rotsaert
Jef Vanhamel
Thibaut Vanbaelen
Bea Vuylsteke
Maarten Schim van der Loeff
Bernadette Hensen
Karina Kielmann
Steven Callens
Thijs Reyniers
机构
[1] Institute of Tropical Medicine,Department of Public Health
[2] Institute of Tropical Medicine,Department of Clinical Sciences
[3] Public Health Service of Amsterdam,Department of Infectious Diseases
[4] Amsterdam UMC location University of Amsterdam,Department of Internal Medicine
[5] Amsterdam Institute for Infection and Immunity (AII),Department of General Internal Medicine
[6] Amsterdam Public Health Research Institute (APH),undefined
[7] Ghent University Hospital,undefined
来源
AIDS and Behavior | 2024年 / 28卷
关键词
Pre-exposure Prophylaxis; PrEP; HIV Prevention; Differentiated Service Delivery; Mixed-methods;
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学科分类号
摘要
In Belgium, HIV pre-exposure prophylaxis (PrEP) services are mainly provided through specialised HIV clinics. To optimise PrEP uptake and retention in care, we require insights into users’ perspectives on PrEP care. We aimed to elicit experiences with, and preferences for, PrEP service delivery among PrEP users in Belgium, including willingness to involve their family physician (FP) in PrEP care. We adopted a sequential mixed-methods design. We used a web-based longitudinal study among 326 PrEP users that consisted of two questionnaires at six-month intervals, and complemented this with 21 semi-structured interviews (September 2020-January 2022). We conducted descriptive analyses and logistic regression to examine factors associated with willingness to involve their FP in PrEP care. Interviews were analysed using thematic analysis. Survey respondents reported high satisfaction with care received in HIV clinics [median score 9 (IQR 8–10), 10=’very satisfied’]. Interviews revealed the importance of regular HIV/STI screening, and the expertise and stigma-free environment of HIV clinics. Yet, they also contextualised service delivery barriers reported in the questionnaire, including the burden of cost and challenges integrating PrEP visits into their private and professional lives. Although 63.8% (n = 208/326) of baseline respondents preferred attending an HIV clinic for PrEP follow-up, 51.9% (n = 108/208) of participants in the follow-up questionnaire reported to be willing to have their FP involved in PrEP care. Participants reporting trust in FPs’ PrEP and sexual health expertise, or who didn’t feel judged by their FP, were more likely to be willing to involve them in PrEP care. Therefore, we recommend a differentiated PrEP service delivery approach, including involving FPs, to make PrEP care more client-centred.
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页码:393 / 407
页数:14
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