Table 2.

HIV specialists’ perceived barriers and facilitators to prescribing PrEP, Boston, 2012.

Perceived Barriers to Prescribing PrEP
Category	Sub-categories
Barriers to “real-world” effectiveness	Suboptimal adherence outside of clinical trial settings
	Logistical concerns (burdensome clinical and lab monitoring; time constraints; high cost of antiretroviral medications; uncertainty about insurance coverage)
	Challenges in identifying persons most likely to benefit from PrEP use (lack of provider skills in discussing HIV risk behaviors; inaccurate disclosures about risk behaviors by patients)
Potential unintended consequences of PrEP provision	Possible selection for and dissemination of drug-resistant viral strains
	Concerns about medication toxicities in otherwise healthy persons
	Belief that some individuals may increase risky behaviors while using PrEP
	Diversion of resources from HIV treatment programs
PrEP prescribing more feasible in primary care practices than HIV clinics
Perceived Facilitators to Prescribing PrEP
Category	Sub-categories
Belief that PrEP is efficacious
Patient motivation	Patient requests for PrEP prescription
	Anticipation that individual patients would be adherent to daily medication
Professional guidance	Prescribing guidelines from normative bodies (e.g., U.S. Centers for Disease Control and Prevention)
	Peer norms