{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T01:06:15Z","timestamp":1789693575117,"version":"4.0.1"},"reference-count":55,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T00:00:00Z","timestamp":1748304000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T00:00:00Z","timestamp":1748304000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["3P30MH043520-33S3"],"award-info":[{"award-number":["3P30MH043520-33S3"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Assoc Provid AIDS Care"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Oral preexposure prophylaxis (PrEP) effectively prevents HIV but is underutilized in the United States, particularly among populations with higher incidence of HIV. Emergency departments (EDs), which often care for medically underserved individuals, could play a key role in expanding PrEP access. However, integrating PrEP into ED workflows presents challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This qualitative study involved interviews with 22 stakeholders from 15 EDs and 4 sexual health clinics across the United States. Participants included ED leaders, providers, and navigators. The data were analyzed using a PrEP care cascade model, focusing on provider buy-in, patient identification, education, PrEP initiation, and linkage to care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Key barriers included limited provider knowledge, ED priorities focused on acute care, and the reliance on grant funding without long-term plans for sustainability. Successful programs relied on ED champions to advocate for PrEP and improve staff engagement. Some EDs offered same-day PrEP prescriptions or starter packs, which improved uptake, but most relied on referrals and had low follow-up rates. Patient identification strategies, such as using navigators or risk scores, varied across sites. Education was often led by ancillary staff, as ED providers had limited time and training. Sustainability remained a major challenge, as most programs were dependent on short-term funding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>To expand PrEP access in EDs, it is essential to address systemic barriers, improve provider training and establish sustainable funding models. Streamlined workflows, dedicated staff, and targeted interventions can help EDs play a more active role in HIV prevention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23259582251342842","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T03:01:52Z","timestamp":1748314912000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["HIV Preexposure Prophylaxis Service Delivery Models for Emergency Departments: A Qualitative Study"],"prefix":"10.1177","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7276-0549","authenticated-orcid":false,"given":"Ethan","family":"Cowan","sequence":"first","affiliation":[{"name":"Rutgers, New Jersey Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susie","family":"Hoffman","sequence":"additional","affiliation":[{"name":"HIV Center for Clinical and Behavioral Studies"},{"name":"Mailman School of Public Health, Columbia University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurie J","family":"Bauman","sequence":"additional","affiliation":[{"name":"Einstein-Rockefeller-CUNY Center for AIDS Research, Departments of Pediatrics and Psychiatry and Behavioral Research"},{"name":"Albert Einstein College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvette","family":"Calderon","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatiana","family":"Gonzalez-Argoti","sequence":"additional","affiliation":[{"name":"Einstein-Rockefeller-CUNY Center for AIDS Research, Departments of Pediatrics and Psychiatry and Behavioral Research"},{"name":"Albert Einstein College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine T","family":"Rael","sequence":"additional","affiliation":[{"name":"University of Colorodo, School of Nursing"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Porter","sequence":"additional","affiliation":[{"name":"Mailman School of Public Health, Columbia University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne E","family":"Mantell","sequence":"additional","affiliation":[{"name":"HIV Center for Clinical and Behavioral Studies"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,5,27]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1108524"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1011205"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1110711"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-020-01295-0"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2018.05.006"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2016.303339"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/0956462416686722"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2017.02.003"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11524-015-0020-y"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001095"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-016-3364-7"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0252338"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1080\/26895269.2020.1780661"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.4324\/9781003073789-20"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2015.03.006"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10900-017-0325-8"},{"key":"e_1_3_2_18_2","unstructured":"Centers for Disease Control and Prevention. Diagnoses of HIV infection in the United States and dependent areas 2021. HIV Surveillance Report 2023; 34. Published online May 2023."},{"issue":"2","key":"e_1_3_2_19_2","first-page":"178","article-title":"What incentives are effective rewards for \u2018hidden populations\u2019 interviewed as a part of research projects?","volume":"110","author":"Cottler LB","year":"1995","unstructured":"Cottler LB, Compton WM, Keating S. What incentives are effective rewards for \u2018hidden populations\u2019 interviewed as a part of research projects? Public Health Rep. 1995;110(2):178. https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/7630995","journal-title":"Public Health Rep"},{"key":"e_1_3_2_20_2","doi-asserted-by":"crossref","unstructured":"O'connor G McGinty T Yeung SJ et al. Cross-sectional study of the characteristics healthcare usage morbidity and mortality of injecting drug users attending an inner city emergency department. Emerg Med J:emermed-2012-201934.","DOI":"10.1136\/emermed-2012-201934"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.1112"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2017.04.028"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2007.02072.x"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2012.02.006"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2007.0157"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1177\/2325957414553847"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000001351"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2018.0011"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2022.01.038"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1002\/emp2.12295"},{"issue":"2","key":"e_1_3_2_31_2","article-title":"Comfort discussing HIV pre-exposure prophylaxis with patients among physicians in an urban emergency department","volume":"80","author":"Tortelli BA","year":"2019","unstructured":"Tortelli BA, Char DM, Crane JS, et al. Comfort discussing HIV pre-exposure prophylaxis with patients among physicians in an urban emergency department. JAIDS J Acquir Immune Defic Syndr. 2019;80(2):e49\u2010e52.","journal-title":"JAIDS J Acquir Immune Defic Syndr."},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm042"},{"issue":"1","key":"e_1_3_2_33_2","article-title":"Implementing PrEP services in diverse health care settings","volume":"90","author":"Faro EZ","year":"2022","unstructured":"Faro EZ, Mantell JE, Gonzalez-Argoti T, et al. Implementing PrEP services in diverse health care settings. JAIDS J Acquir Immune Defic Syndr. 2022;90(S1):S114\u2010S128.","journal-title":"JAIDS J Acquir Immune Defic Syndr."},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1080\/14780887.2014.955224"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001385"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000002274"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.acap.2019.01.006"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2022.09.018"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2021.0012"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.83.3.372"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2017.1384534"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.1998.00184.x"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-020-03070-2"},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2018.1533238"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0157324"},{"key":"e_1_3_2_46_2","doi-asserted-by":"publisher","DOI":"10.1111\/acem.12987"},{"key":"e_1_3_2_47_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2009.00548.x"},{"key":"e_1_3_2_48_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000002945"},{"key":"e_1_3_2_49_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2011.03.034"},{"key":"e_1_3_2_50_2","doi-asserted-by":"publisher","DOI":"10.1177\/2050312118773261"},{"key":"e_1_3_2_51_2","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2021.0012"},{"key":"e_1_3_2_52_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2018.10.034"},{"key":"e_1_3_2_53_2","doi-asserted-by":"publisher","DOI":"10.1002\/emp2.13253"},{"key":"e_1_3_2_54_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2019.06.013"},{"key":"e_1_3_2_55_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2021.114523"},{"key":"e_1_3_2_56_2","doi-asserted-by":"publisher","DOI":"10.1177\/14733250211024516"}],"container-title":["Journal of the International Association of Providers of AIDS Care (JIAPAC)"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23259582251342842","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/23259582251342842","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23259582251342842","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T22:50:40Z","timestamp":1777503040000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/23259582251342842"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,27]]},"references-count":55,"alternative-id":["10.1177\/23259582251342842"],"URL":"https:\/\/doi.org\/10.1177\/23259582251342842","relation":{},"ISSN":["2325-9582","2325-9582"],"issn-type":[{"value":"2325-9582","type":"print"},{"value":"2325-9582","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,27]]},"article-number":"23259582251342842"}}