Table 2 Potential barriers for implementing same-day prescription of PrEP and MOUD among PWID and Clinical Stakeholders (N = 23)
“If a person wanted to start on PrEP and MOUD (like methadone or buprenorphine), what kinds of things might get in the way of getting it prescribed to them on the same day?” | Voting results |
|---|---|
Persons who inject drugs (n = 14) | 42 |
Social determinants of health barriers | 22 |
Lack of, or unstable insurance | 11 |
Lack of transportation to appointments and pharmacy | 6 |
Family support (e.g., access to childcare) | 2 |
Lack of communication tools (i.e., phone or Internet) | 2 |
Too costly/financially unstable | 1 |
Structural-level implementation factors | 8 |
Access to a provider | 4 |
Stigma of ‘drug use’ | 2 |
Mistrust in clinicians | 2 |
Client-level implementation factors | 8 |
The process is too time-consuming | 2 |
Need to attend different clinics | 2 |
Lack of interest/motivation to take the medications | 2 |
Cultural beliefs or religious obligations | 1 |
Actively using drugs or feeling ‘dope sick’ | 1 |
Knowledge barriers | 4 |
Fear of side effects and mixing of medications | 3 |
Lack of information about the two medications | 1 |
Clinical Stakeholders (n = 9) | 27 |
Time constraints on providers for clinical assessments | 7 |
Logistics (e.g., coordination between providers and labs) | 6 |
Availability of providers that can prescribe both medications | 5 |
Unreliable population (e.g., complications after getting prescription) | 4 |
Hesitancy of providers (e.g., due to getting lab results after the prescription process) | 3 |
Transportation challenges of the participants | 1 |
COVID-19 (e.g., following guidelines; future procedures; screening protocols) | 1 |