Dr Matthew Smith
Glasgow Caledonian University
Pre-exposure prophylaxis for people who inject drugs: results from an exploratory study carried out during an ongoing HIV outbreak in Glasgow, Scotland
To explore perspectives of people who inject drugs (PWID) and service providers on the potential of pre-exposure prophylaxis (PrEP) provision prior to introduction, as a response to an ongoing HIV outbreak.
A qualitative approach was taken, with 30 semi-structured interviews carried out with both PWID (n=20) and service providers (n=10). PWID were recruited from a drug treatment centre and a homelessness drop-in service in the city centre of Glasgow, the area with the highest levels of HIV recorded during the ongoing outbreak. Service providers were recruited from frontline and strategic positions of health and voluntary sector services responding to the outbreak.
Participants were mostly were supportive of PrEP, but identified barriers to successful provision and uptake including: lack of prioritisation of HIV by PWID; lack of cohesive messages on HIV; lack of knowledge about the outbreak; dissonance in risk awareness between intravenous and sexual transmission of HIV; and the ongoing influence of severe stigma as a barrier to engagement with. Participants also described pragmatic issues for design of a PrEP service their ideal service designs for PrEP provision and related pragmatic issues including: resource requirements; need for education and awareness raising; and the need to integrate PrEP into existing outreach and services such as opiate replacement therapy.
There is substantial appetite for the introduction of PrEP amongst PWID and service providers, however a cultural shifts will be required by both groups with view to prioritising PrEP and embedding it in existing services should it be introduced.
Professor Sharon Hutchinson, Professor Lawrie Elliott, Dr Andrew McAuley
Conflicts of interest:
No conflict of interest