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Advancing the community plan to end the HIV Epidemic in Philadelphia: a qualitative descriptive evaluation of low-threshold PrEP services in sexual health clinics
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Additional models:
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To achieve the goals of the Ending the HIV Epidemic in the United States initiative, systems-level adaptations are needed to lower barriers to PrEP access and expand access to Black, Latinx, and other historically marginalized communities. Local health departments play a vital role in this effort and can provide both funding and long-term planning that supports community efforts to strengthen access to HIV prevention tools. The strategies described in this study can be adapted by other Ending the HIV Epidemic jurisdictions and tailored to their local context to support the expansion of PrEP access.
In this study, staff at newly funded sexual health clinics in Philadelphia described their low-threshold PrEP care delivery models and implementation strategies. In total, 17 distinct strategies were identified, and four strategies were consistently identified at all three sites as cross-cutting strategies with the potential to improve PrEP access for marginalized populations. These key strategies were (1) co-locating services in a one-stop-shop model (e.g., HIV/STI testing and treatment, PrEP and PEP services, patient navigation, social services), (2) integrating universal PrEP counseling and expanding efforts to build trust with communities through, (3) conducting community outreach, and (4) diversifying the clinical workforce in alignment with the communities being served.

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