Facilitators and Recommendations of Health Care Providers for the Implementation of Pre-Exposure Prophylaxis in HIV clinics in Colombia. “PrEP-Colombia Study”

Abstract

This article describes facilitators and recommendations of health care providers in HIV clinics for the implementation of pre-exposure prophylaxis (PrEP) in Colombia. A qualitative study was conducted using semi-structured interviews with twenty health care providers in nine clinics. In addition, the “Consolidated Framework for Implementation Research” was used to guide data collection and the analysis. Results are as follow: 1. Characteristics of the intervention: providers recognize PrEP as an innovative therapy with proven effectiveness; they recommend that it should be implemented by national regulations of the Ministry of Health and Social Protection with centralized purchase of medicines and adaptations to regional diversities. To assemble PrEP in clinics, they recommend linking it to preventive Sexual Health Programs, guided by trained interdisciplinary teams. 2. External environment: it was recommended to strengthen networking with the Secretaries of Health, Profamilia and LGTBI organizations; change contracting conditions with Health Promoting Entities to include PrEP aimed at partners of patients with HIV, and finance people who cannot pay for it with public resources. 3. Internal environment: climate and availability of implementation perceived as favorable for the adoption of PrEP. In order to reduce organizational tensions due to change, expanding training plans are recommended. 4. Implementation process: the design of national, local and institutional plans is recommended, as well as the attraction of key internal and external leaders. It is concluded that health providers in the HIV clinics in Colombia perceive a favorable environment for the adoption of PrEP in the country.