Pre-Exposure Prophylaxis (PrEP)

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Part
01

PrEP Barriers and Deterrents

The research was aimed at establishing barriers to adoption of PrEP for various high risk groups. The identified inhibitors included inadequate insurance cover, barriers associated with community re-entry, stigma, actual or perceived side effects and lack of awareness among providers. These barriers are discussed below in detail.

Inadequate insurance coverage

  • A report, titled "Evolving models and Ongoing Challenges for HIV PrEP Implementation in the US" states that "inadequate insurance coverage, including lack of insurance, high copayments and/or deductibles for office visit and laboratory procedures, contributes to disparities in PrEP use".
  • According to the report, close to 26 million Americans are uninsured. The high cost of PrEP drugs implies that the access to these drugs will remain a challenge for this population, hence inhibiting the implementation.
  • The risk group here according to NCBI include 15% of the Black, 28% of Hispanic/Latino, 18-24% of the lesbian, gay, bisexual, transgender and queer population who are estimated to be uninsured.
  • To overcome this barrier, health policies allowing equal access to affordable and high quality insurance throughout the US for all population groups are needed.
  • According to the report, some states and cities have "created special PrEP service reimbursement programs, such as New York State’s Pre-Exposure Prophylaxis Assistance Program (PrEP-AP) in order to address the issue".

Barriers associated with community re-entry

  • In a study that interviewed 26 MSM who were incarcerated to explore their knowledge on PrEP, a number of barriers related to incarceration were discussed by participants.
  • These included lack of housing, transportation and re-incarceration.
  • On lack of transportation as a concern that may affect PrEP uptake, participants cited that loss of personal car by confiscation and the expiration of a driver's license may deny them the ability to get to places where they could get the drugs.
  • Many participants noted that worries of lack of a place to live coupled with other compounding hardships like getting ID, going back to welfare and many other different things to be done during community re-entry would deprioritize PrEP.
  • The highlighted barriers affected the incarcerated, and also MSM with recent incarceration.
  • A solution is to "consider establishing PrEP access prior to release through referral to a PrEP clinic or prescribing PrEP shortly before discharge".

Stigma

Actual or perceived side effects

Lack of awareness among providers

  • A study conducted on online posts reported that individual experiences with poorly informed providers was a barrier to PrEP.
  • It states that lack of PrEP awareness among providers made it difficult for users to adhere to PrEP. One reason is the perception of PrEP users being promiscuous.
  • According to the study, this barrier was reported to affect gay, bisexual and other MSM groups.
  • The study recommends social support through online spin-off support group pages where user can share experiences, both positive and negative, and passionate PrEP advocates can discuss the positive impacts of PrEP.
  • Another recommended facilitator was to increase trust in healthcare providers through training, and to ease access of PrEP through non-traditional prescription methods such as online ordering.
Part
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Part
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Marketing Campaigns - PrEP

Pre-Exposure Prophylaxis commonly known as PrEP is a daily pill taken by HIV-negative people to prevent HIV. Three marketing campaigns that have been used to increase the awareness of PrEP treatment are: PrEP is For, #PrEPforHer/Dominate Your Sex Life and PrEP4Love. Details of each of the campaigns have been outlined below.

1. PrEP is For

What it is
  • PrEP is For is a public health bilingual campaign which urges Latino men who have sex with men to start taking PrEP.
Description
Visuals
  • The campaign is a series of five images which highlights that PrEP is for everyone and not just for the people featured in the ads.
  • The five images are PrEP is for drag queens & bears, good boys & bad boys, porn starts & amateurs, singles & couples, socialists & capitalists
  • Video ads are also accompanies for each visual ads. They can be found here.
  • The campaign ads have been placed on "buses, light rails, transit shelters, restaurants, convenience stores, bars and clubs". Static and video ads have also been posted on social networks such as Snapchat, Facebook, Scruff, Instagram and YouTube.
Location
Results
  • The PrEP is For campaign results were evaluated through a survey that was administered in person in San Jose, California and through a web-based platform.
  • As a result of the campaign, 75% agreed that they are more likely to talk to their doctors about PrEP and 65% agreed to talk to their partner about PrEP.
  • A full PrEP is For Evaluation report can be accessed here.

2. #PrEPforHer/Dominate Your Sex Life

What it is
  • #PrEPforHer is an awareness campaign that encourages women to learn more about healthy sex options specifically PrEP.
Description
  • Since women had been previously ignored in the PrEP awareness campaigns, the DC Health brainstormed for new efforts to reach women in the African American community at risk on contracting HIV.
  • The campaign's goal was to increase knowledge among black women of PrEP as a "sexy, empowering tool" with posters that features strong women making a proclamation to dominate their sex life.
  • The Dominate Your Sex Life campaign launched in October 2016, and garnered interest from the "local community, local and national media, community based organizations, and government agencies".
Visuals
  • Visuals of the #PrEPforHer campaign can be accessed via the google document.
Location
Results
  • The campaign resulted in an increase in women going to local clinics and community-based organizations to inquire about PrEP as well as an increase in usage of the HIV prevention pill.
  • The campaign received 12 media mentions, 64,275 visitors to the official website, 14,000 hashtag uses and over 40,000 clicks on online advertisements.

PrEP4Love

What it is
  • The PrEP4Love campaign is aimed at promoting PrEP information resources, prescribing providers and related social events throughout local communities geared towards those who are most vulnerable to HIV and are having unprotected sex.
Description
  • In 2016, the Chicago PrEP Working Group launched the PrEP4Love campaign, a citywide, which was designed to increase awareness of PrEP.
  • The campaign featured intimate photos of individuals from Chicago communities that are vulnerable to contracting HIV. The groups include "young, black, gay and bisexual men and other men who have sex with men, transgender women of color and black heterosexual women".
  • PrEP4Love displayed ads throughout Chicago on CTA trains and buses in addition to digital campaigns and pop-up events.
Visuals
Location
  • The PrEP4Love campaign was launched in the state of Illinois.
Results
  • The campaign generated an estimated 41 million unique views across various social media platforms and 25,000 users clicked on its content within four months of its launch.
Sources
Sources