Table 3.

Frequency of Barriers to HIV Testing and Prophylaxis Ranked as Most Important by SANE/FNE Program Coordinators

Response Category	Frequency n (%)	Exemplar
Barriers to HIV testing (n = 127)
Providing pre-test/post-test counseling and follow-up	41 (32)
Cost	24 (19)
Inability to do onsite rapid HIV testing	29 (23)
Obtaining appropriate consent	10 (8)
Qualitative themes
Risk Assessment	12 (9)	“We will offer the test if patient requests or falls into a moderate-to-high-risk group”
Confidentiality	3 (2)	“protecting patient privacy”
Other	8 (6)	“Medical Director choice to not test”
Barriers to nPEP (n = 105)
Cost of the medications	52 (49)
Availability of similar services at the local health department	25 (24)
Inability to bill patient’s insurance	5 (5)
Discomfort with when to offer HIV PEP	4 (4)
Concerns about legal implications of documenting patients’ HIV status	3 (3)
Concerns over whether the patient will face social stigma related to taking HIV medications	1 (1)
Reluctance to bill patient’s insurance due to concerns over losing coverage	0 (0)
Qualitative themes
Provider bias	6 (6)	“Patients routinely quit taking HIV PEP”
Risk assessment	4 (4)	“Risk benefit of exposure and HIV PEP”
Lack of follow-up resources	2 (2)	“Referrals for ongoing follow-up/ monitoring”
Other	3 (3)	“Do not have a license to dispense medication”

Note. nPEP = non-occupational post exposure prophylaxis; PEP = post exposure prophylaxis; SANE = Sexual Assault Nurse Examiner; FNE = Forensic Nurse Examiner