Nursing

Gerontology

Pre-exposure prophylaxis

Biology

Public health

Injection drug use

Health psychology

Anthropology

Environmental health

Physical geography

Qualitative research

Paleontology

Men who have sex with men

Appalachian Region

Psychology

Geography

Human immunodeficiency virus (HIV)

Family medicine

Sociology

Focus group

Syphilis

Medicine

Appalachia

Rural area

Pathology

Drug injection

Social science

AIDS and Behavior

The opioid crisis has increased risks for injection drug use-associated HIV outbreaks in rural communities throughout the United States. Existing research has examined pre-exposure prophylaxis (PrEP) utilization among people who inject drugs (PWID); however, no studies have been conducted to explore barriers and facilitators of PrEP use among rural PWID in Appalachia. We conducted qualitative interviews with PWID (n = 48) in two rural counties in West Virginia to explore barriers and facilitators of PrEP use. Among our participants, the majority (68.8%) had never heard of PrEP. Upon learning about PrEP, most participants expressed willingness to use it. Rural PWID described several factors that may impede PrEP utilization (e.g., housing instability, forgetting to take PrEP). Participants also identified practical strategies to support sustained PrEP utilization, such as integrating PrEP services into venues PWID access. This research provides important insights into the barriers and facilitators of PrEP utilization among rural PWID.

Barriers and Facilitators to PrEP Use Among People Who Inject Drugs in Rural Appalachia: A Qualitative Study