Pre-exposure Prophylaxis Implementation in Family Planning Services Across the Southern United States: Findings from a Survey Among Staff, Providers and Administrators Working in Title X-Funded Clinics


To improve women’s access to pre-exposure prophylaxis (PrEP) in family planning (FP) clinics, we examined readiness to provide PrEP, and barriers and facilitators at the clinic level to integrate PrEP services into Title X-funded FP clinics across the Southern US. Title X-funded FP clinics across DHHS regions III (Mid-Atlantic), IV (Southeast), and VI (Southwest), comprising the Southern US. From February to June, 2018, we conducted a web-based, geographically targeted survey of medical staff, providers and administrators of Title X-funded FP clinics in DHHS regions III (Mid-Atlantic), IV (Southeast), and VI (Southwest). Survey items were developed using the Consolidated Framework for Implementation Research to assess constructs relevant to PrEP implementation. One-fifth of 283 unique Title X clinics across the South provided PrEP. Readiness for PrEP implementation was positively associated with a climate supportive of HIV prevention, leadership engagement, and availability of resources, and negatively associated with providers holding negative attitudes about PrEP’s suitability for FP. The Title X FP network is a vital source of sexual health care for millions of individuals across the US. Clinic-level barriers to providing PrEP must be addressed to expand onsite PrEP delivery in Title X FP clinics in the Southern US.

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This research was supported by the National Institutes of Health Grant U24HD089880. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. A. Sheth receives funding from the National Institutes of Health (K23AI114407). L. Haddad’s effort is supported by the National Institutes of Health (K23HD078153).

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Correspondence to Jessica M. Sales.

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J Sales received grant funding for an Investigator Sponsored Grant from Gilead Sciences, Inc. (CO-US-276-4060). A. Sheth also received grant funding from Gilead Sciences.

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Sales, J.M., Escoffery, C., Hussen, S.A. et al. Pre-exposure Prophylaxis Implementation in Family Planning Services Across the Southern United States: Findings from a Survey Among Staff, Providers and Administrators Working in Title X-Funded Clinics. AIDS Behav 25, 1901–1912 (2021).

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  • Southern US
  • Women
  • PrEP
  • HIV prevention
  • Family planning
  • Implementation