Impact Insights: PrEP navigation for Vulnerable Populations
Breaking Down Barriers: Advancing HIV Prevention at Friends For All
The COVID-19 pandemic reshaped the world in countless ways, and its impact on healthcare delivery has been profound. For Friends For All (Friends), these changes have opened the door to rethink how we deliver critical HIV prevention services. A recent narrative review co-authored by David Closs, Director of Prevention at Friends For All, sheds light on the unique challenges faced by syringe service programs (SSPs) since the pandemic and highlights innovative ways forward. Here's what you need to know.
Why This Study Matters
HIV prevention for people who use drugs (PWUD) has always been challenging, but the pandemic introduced new hurdles. SSPs—community-based harm reduction hubs—have been instrumental in reducing HIV transmission by up to 50% and are critical to the U.S. Department of Health and Human Services' Ending the HIV Epidemic goals. Despite this, PrEP (pre-exposure prophylaxis), a highly effective tool for preventing HIV, remains underutilized among PWUD, with uptake consistently in the single digits.
This study, which synthesizes recent literature and hands-on clinical experiences, delves into the operational shifts during the pandemic, the barriers to PrEP adoption, and the promising interventions that can enhance HIV prevention among PWUD.
How the Study Was Conducted
The review examined:
Pandemic-induced operational changes: Social distancing, staff safety concerns, and funding reallocations led to disruptions in SSP services, including HIV testing.
Barriers at three levels:
Consumer attitudes: Low perceived HIV risk, stigma, and competing survival priorities like housing and food.
Provider challenges: Limited training and resources for SSP staff to discuss or administer PrEP.
Structural barriers: Transportation issues, housing instability, and restrictive policies.
Current PrEP models: Navigation to off-site PrEP services, on-site access, telehealth options, and combined approaches.
Recommendations: Practical strategies tailored to SSPs of varying sizes and resources.
Key Findings
HIV Testing Declined: HIV testing—a gateway to PrEP discussions—dropped by 18% nationwide in 2020, primarily due to supply shortages and pandemic-related closures.
Barriers to PrEP Uptake: Many PWUD prioritize immediate needs like food and shelter over sexual health. Stigma and mistrust further discourage engagement with prevention services.
Emerging Models for PrEP: Innovative approaches like tele-PrEP and integrated care within SSPs show promise but require addressing logistical and structural challenges.
What This Means for Friends For All
The insights from this study are invaluable as we strive to provide compassionate, effective care to our community. Here’s how we’re using these findings to enhance our services:
Expanding Access to Testing and PrEP: We’re committed to increasing on-site HIV testing and exploring telehealth options to make PrEP more accessible.
Addressing Social Determinants of Health: Recognizing that housing, food, and economic stability are foundational to health, we’re enhancing our wraparound services to address these needs.
Training Our Team: We’re investing in training for our Friends to confidently discuss PrEP, reduce stigma, and provide holistic, person-centered care.
Tailoring Our Approach: Using community feedback, we’re creating culturally relevant, non-stigmatizing materials to educate and empower PWUD to take charge of their health.
Looking Ahead
At Friends For All, we believe that everyone deserves access to the tools and support they need to stay healthy. This study reinforces the importance of meeting people where they are—both physically and emotionally—and addressing the barriers that prevent them from accessing care. Together, we can make strides toward ending the HIV epidemic, one step at a time.
Stay tuned for more updates on how we’re putting these strategies into action. Your support makes it possible for us to continue this critical work in our community.
To download the full research study, click here.
