Developing and assessing acceptability of a shared decision-making tool for selecting among HIV pre-exposure prophylaxis options in the United States of America
Year: 2026
Type: article
Abstract: We developed a pre-exposure prophylaxis (PrEP) shared decision-making tool to support people who could benefit from PrEP in reaching their prevention goals and preferences when considering two effective PrEP modalities, oral or long-acting injectable (LAI) PrEP, in partnership with their healthcare providers (HCPs). This 2-phase study included formative research to develop a PrEP shared decision-making tool prototype followed by a pilot study to determine prototype acceptability. For the formative phase, we conducted semi-structured qualitative in-depth interviews with a diverse sample of people who could benefit from PrEP (n = 41) and HCPs (n = 20) in two community-based sites in Washington, DC, prior to and shortly after LAI PrEP became available in December 2021. Insights from in-depth interviews informed development of a PrEP shared decision-making tool prototype in both English and Spanish. This prototype was piloted in one-on-one mock clinical encounters with 37 people who could benefit from PrEP and 11 HCPs, in the two DC sites and at a university-affiliated clinic in Chapel Hill, North Carolina. After these encounters, people who could benefit from PrEP and HCPs were interviewed independently about acceptability of the prototype's language, visuals, content and flow as well as the usability, utility, and feasibility of the prototype to support informed shared decision-making. In the formative phase, people who could benefit from PrEP had low awareness of and high interest in LAI PrEP. They and HCPs agreed that side effects and efficacy should be a primary focus of a PrEP shared decision-making tool. Participants in the mock clinical encounters found that the prototype filled information gaps, supported shared decision-making regardless of an individual's experience with PrEP, and systematized, streamlined and normalized conversations around PrEP choice. Testing the effectiveness of the prototype in a larger-scale evaluation is highly warranted as the field seeks to address ongoing inequities in PrEP uptake.
Source: PLOS Global Public Health
Authors: Wendy W. Davis, Andrea Mantsios, Aimee A. Metzner, Ali Talan, Jennafer Kwait, Humberto Gonzalez Rodriguez, Tahilin Sanchez Karver, Daniel Wilhite, Suyanna Barker, Angela Suarez, Ricardo Fernandez, Carlos E. Rodriguez-Diaz, Tamara Taggart, Alan Oglesby, David Wohl, Clare Barrington, Deanna Kerrigan
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,496
Funders: Centre for Research on Pandemic Preparedness and Health Emergencies, David and Lucile Packard Foundation, National Aeronautics and Space Administration, Bill and Melinda Gates Foundation, Pfizer, Washington University in St. Louis, Rune och Ulla Amlövs Stiftelse för Neurologisk och Reumatologisk Forskning, European Respiratory Society, Finska Läkaresällskapet, Wellcome Trust, ViiV Healthcare, Newton Fund, International Development Research Centre, National Institute for Health and Care Research, Ovarian Cancer Action, European Commission, University of Edinburgh, University College Cork, Deutsche Forschungsgemeinschaft, Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung, Danmarks Grundforskningsfond, National Natural Science Foundation of China, Cabinet Office, Government of Japan, China Postdoctoral Science Foundation, National Research Foundation of Korea, Knut och Alice Wallenbergs Stiftelse, Tsinghua University, Princess Nourah Bint Abdulrahman University, Narodowe Centrum Nauki, Signe ja Ane Gyllenbergin Säätiö, Vetenskapsrådet, Mochida Memorial Foundation for Medical and Pharmaceutical Research, Forskningsrådet om Hälsa, Arbetsliv och Välfärd, Reumatikerförbundet, European League Against Rheumatism, Emil och Wera Cornells Stiftelse, Versus Arthritis, Directorate for Biological Sciences, Agricultural Research Service, Institute for Advanced Computer Studies, University of Maryland, Qatar National Library, Canadian Institutes of Health Research, Innovate UK, National Key Research and Development Program of China, Humanities and Social Science Fund of Ministry of Education of China, Spanish National Plan for Scientific and Technical Research and Innovation, National Heart, Lung, and Blood Institute, National Human Genome Research Institute, U.S. National Library of Medicine, National Center for Advancing Translational Sciences, HORIZON EUROPE European Research Council, Intramural Research Program
OpenAlex ID: W7161740871