{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T22:11:22Z","timestamp":1790719882637,"version":"4.1.0"},"reference-count":57,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2020,2,17]],"date-time":"2020-02-17T00:00:00Z","timestamp":1581897600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R21- DA039019"],"award-info":[{"award-number":["R21- DA039019"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,3,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Pre-exposure prophylaxis (PrEP) is a highly effective biobehavioral strategy for preventing HIV acquisition. Although PrEP uptake has increased steadily, discontinuation rates are high among members of key populations like gay and bisexual men (GBM). Understanding the challenges that arise for PrEP users is key to better PrEP implementation and sustained use over time. We report on barriers that arose for PrEP-using GBM, as well as facilitating factors that aided PrEP persistence, with the goal of informing PrEP implementation efforts. In 2015\u20132016, 103 PrEP-using GBM in NYC completed qualitative interviews about their engagement with PrEP, including their experiences navigating PrEP-related medical care. Interviews were transcribed verbatim, coded, and analyzed thematically. Over half of participants (53%) received their PrEP-related care from their primary care provider (PCP), one-third (33%) from a community-based health clinic, and 13% from multiple medical providers. Emergent themes regarding the barriers and facilitators to PrEP persistence fell into two categories: insurance- and medical appointment-related barriers and facilitators to continued PrEP use. The experiences of PrEP-using GBM can provide useful insights for providers, program developers, and policymakers aiming to improve the implementation of PrEP. To support PrEP persistence, reliable insurance coverage, cost-assistance, and easy appointment scheduling are key to maintenance. Removing insurance- and appointment-related barriers to persistence may prove essential for sustaining use among GBM.<\/jats:p>","DOI":"10.1093\/tbm\/ibz191","type":"journal-article","created":{"date-parts":[[2020,2,17]],"date-time":"2020-02-17T15:09:41Z","timestamp":1581952181000},"page":"573-581","source":"Crossref","is-referenced-by-count":39,"title":["Insurance- and medical provider-related barriers and facilitators to staying on PrEP: results from a qualitative study"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5260-340X","authenticated-orcid":false,"given":"Alexa B","family":"D\u2019Angelo","sequence":"first","affiliation":[{"name":"Graduate School of Public Health and Health Policy, City University of New York, New York, NY"},{"name":"Institute for Implementation Science in Population Health, City University of New York, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Lopez-Rios","sequence":"additional","affiliation":[{"name":"Graduate School of Public Health and Health Policy, City University of New York, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony W P","family":"Flynn","sequence":"additional","affiliation":[{"name":"Department of Counseling Psychology, University of Wisconsin \u2013 Madison, Madison, WI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian W","family":"Holloway","sequence":"additional","affiliation":[{"name":"Department of Social Welfare, University of California, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W","family":"Pantalone","sequence":"additional","affiliation":[{"name":"The Fenway Institute, Fenway Health, Boston, MA"},{"name":"Department of Psychology, University of Massachusetts \u2013 Boston, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Grov","sequence":"additional","affiliation":[{"name":"Graduate School of Public Health and Health Policy, City University of New York, New York, NY"},{"name":"Institute for Implementation Science in Population Health, City University of New York, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,2,17]]},"reference":[{"issue":"151","key":"2021032404174463200_CIT0001","doi-asserted-by":"crossref","first-page":"151ra125","DOI":"10.1126\/scitranslmed.3004006","article-title":"Emtricitabine-tenofovir concentrations and pre-exposure prophylaxis efficacy in men who have sex with men","volume":"4","author":"Anderson","year":"2012","journal-title":"Sci Transl Med."},{"issue":"9","key":"2021032404174463200_CIT0002","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1016\/S1473-3099(14)70847-3","article-title":"Uptake of pre-exposure prophylaxis, sexual practices, and HIV incidence in men and transgender women who have sex with men: a cohort study","volume":"14","author":"Grant","year":"2014","journal-title":"Lancet Infect Dis."},{"issue":"12","key":"2021032404174463200_CIT0003","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1089\/apc.2017.0082","article-title":"Facilitators and barriers to pre-exposure prophylaxis willingness among young men who have sex with men who use geosocial networking applications in California","volume":"31","author":"Holloway","year":"2017","journal-title":"AIDS Patient Care STDS."},{"issue":"11","key":"2021032404174463200_CIT0004","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1080\/09540121.2017.1300633","article-title":"Stigma, medical mistrust, and perceived racism may affect PrEP awareness and uptake in black compared to white gay and bisexual men in Jackson, Mississippi and Boston, Massachusetts","volume":"29","author":"Cahill","year":"2017","journal-title":"AIDS Care."},{"issue":"5","key":"2021032404174463200_CIT0005","doi-asserted-by":"crossref","first-page":"1325","DOI":"10.1007\/s10461-016-1627-z","article-title":"Values and preferences on the use of oral pre-exposure prophylaxis (PrEP) for HIV prevention among multiple populations: a systematic review of the literature","volume":"21","author":"Koechlin","year":"2017","journal-title":"AIDS Behav."},{"issue":"8","key":"2021032404174463200_CIT0006","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1089\/apc.2014.0303","article-title":"Minimal Awareness and stalled uptake of pre-exposure prophylaxis (PrEP) among at risk, HIV-negative, black men who have sex with men","volume":"29","author":"Eaton","year":"2015","journal-title":"AIDS Patient Care STDS."},{"issue":"11","key":"2021032404174463200_CIT0007","doi-asserted-by":"crossref","first-page":"3566","DOI":"10.1007\/s10461-018-2045-1","article-title":"Why I Quit Pre-Exposure Prophylaxis (PrEP)? 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