Medical Providers and Harm Reduction Views on Pre-Exposure Prophylaxis for HIV Prevention Among People Who Inject Drugs

AIDS Educ Prev. 2019 Aug;31(4):363-379. doi: 10.1521/aeap.2019.31.4.363.


Despite high pre-exposure prophylaxis (PrEP) acceptability among people who inject drugs (PWID) and PrEP providers, PrEP uptake is low and little is known about how to promote PrEP among PWID. This qualitative study with providers in North Carolina explored views on PrEP delivery approaches for PWID. Interviewers conducted semistructured interviews with 10 PrEP providers and 10 harm reduction (HR) providers. Interviews were transcribed and analyzed. Many participants expressed acceptability for providing PrEP referrals at syringe exchange sites, stationing PrEP providers at syringe exchange sites to provide PrEP prescriptions, and providing standing orders for PrEP at syringe exchange sites. Barriers were identified, including low PrEP awareness and limited resources. Many advocated for co-location of HR and PrEP services and scaled-up outreach services. PrEP providers emphasized maintenance of clinical requirements, while HR providers emphasized flexibility when treating PWID. Promoting PrEP uptake and adherence among PWID likely requires integration of HR and PrEP services.

Keywords: HIV prevention; intervention development; people who inject drugs; pre-exposure prophylaxis; qualitative research.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Anti-HIV Agents / administration & dosage*
  • Attitude of Health Personnel*
  • Awareness
  • Female
  • HIV Infections / epidemiology*
  • HIV Infections / prevention & control*
  • Harm Reduction*
  • Health Knowledge, Attitudes, Practice
  • Health Personnel / psychology*
  • Humans
  • Interviews as Topic
  • Male
  • North Carolina
  • Pre-Exposure Prophylaxis*
  • Professional-Patient Relations
  • Qualitative Research
  • Social Stigma
  • Substance Abuse, Intravenous / complications*
  • Surveys and Questionnaires


  • Anti-HIV Agents