Barriers and facilitators for access to PrEP by vulnerable populations in Brazil: the ImPrEP Stakeholders Study

HIV preexposure prophylaxis (PrEP) has been considered a fundamental strategy for controlling the HIV/AIDS epidemic, and since 2018 it has been the object of an implementation study (ImPrEP Stakeholders Study), conducted in Brazil, México, and Peru. A qualitative component of this study was develope...

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Published inCadernos de saúde pública Vol. 38; no. 1; p. e00290620
Main Authors Pimenta, Maria Cristina, Bermúdez, Ximena Pamela, Godoi, Alcinda Maria Machado, Maksud, Ivia, Benedetti, Marcos, Kauss, Bruno, Torres, Thiago Silva, Hoagland, Brenda, Pereira, Gerson Fernando Mendes, Grinsztejn, Beatriz, Veloso, Valdilea G
Format Journal Article
LanguagePortuguese
Published Brazil 2022
Subjects
Anti-HIV Agents - therapeutic use
Brazil
Health Personnel
HIV Infections - drug therapy
HIV Infections - prevention & control
Humans
Pre-Exposure Prophylaxis - methods
Vulnerable Populations
Brazil
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Summary:HIV preexposure prophylaxis (PrEP) has been considered a fundamental strategy for controlling the HIV/AIDS epidemic, and since 2018 it has been the object of an implementation study (ImPrEP Stakeholders Study), conducted in Brazil, México, and Peru. A qualitative component of this study was developed with the objective of identifying the social and structural contexts that involve and organize the supply of PrEP services in Brazil, the stakeholders' subjectivities, and the different perceptions that can impact the strategy's implementation. The current article's focus was to analyze access by vulnerable populations to PrEP services from the perspective of managers, health professionals, leaders or activists, and users of PrEP. This was a qualitative study using a comprehensive methodology, conducted in six Brazilian state capitals, interviewing 71 key actors from November 2018 to May 2019. The analysis was based on access analysis models as proposed by Giovanella & Fleury, McIntyre et al. and Penchansky & Thomas. The results are presented along three lines: "perceptions of combined prevention and PrEP", "availability and adequacy: profile and structure of services in the context of ImPrEP", and "acceptability: attitudes and practices of health professionals and users".
ISSN:1678-4464
DOI:10.1590/0102-311X00290620