Table One.

Common Barriers and Facilitators to Prescription of PrEP in Different Health Care Settings

Where to provide PrEP?
Setting	Barriers	Facilitators
STD Clinics	○Don’t provide 1° care ○High patient volume ○Limited counseling time	○See high risk populations ○Sexual health focus ○Partner notification services
Community Health Centers	○Clinicians not trained in sexual health care ○Busy clinical practices ○Need to address 1° care issues Limited counseling staff	○Opportunity to integrate care ○Ongoing relationship ○Safety net insurance programs ○May be medical home for at risk, underserved patients
Community-Based Organizations	○Lack of clinical support ○Often limited resources ○Need to link to clinicians, who may or may not be responsive	○Work with at-risk populations ○Able to do community outreach ○May have peer navigators
Pharmacies	○Prescriber often not on site ○May not be able to address other health concerns ○Lack of private physical space for counseling	○Experience with medications and adherence counseling ○Collaborative drug therapy agreements ○Extended operating hours ○Potentially low service fees
Primary Care Providers	○Generalist ○Busy schedule ○Discomfort discussing sexual behaviors ○Discomfort using new medications	○Able to integrate other primary care issues ○Long-term patient relationship common ○“One-stop shopping”