Challenges of providing HIV pre-exposure prophylaxis across Australian clinics: qualitative insights of clinicians.

摘要: Background HIV pre-exposure prophylaxis (PrEP) has been rapidly implemented in Australia, initially through restricted access demonstration studies, and then prescribing across sexual health clinics general practice settings. In 2018, PrEP was publicly subsidised for people with Medicare (universal insurance citizens, permanent residents those from countries reciprocal arrangements). There is little research examining the experiences of providers existing primarily conducted before public subsidy. Methods: this qualitative study, we examine challenges that have emerged PrEP-providing clinicians after subsidy introduced. We 28 semi-structured interviews 2019–20 two Australian states, analysed data thematically. Participants included practitioners (GPs), nurses physicians. Results: Sexual services reconfigured to meet changing patient demand, an emphasis on ensuring equitable financial PrEP. Restrictions nurse-led frustrated some participants, given had demonstrated competence during trials. GPs were believed be less effective at PrEP, but GP participants themselves indicated easy intervention, difficult integrate into practice. expressed discomfort on-demand Conclusions: Our findings indicate supporting ways patients without inexpensively, advocating developing guidelines adapted consultations could ensure delivered more effectively equitably. Additionally, require encouragement build confidence providing