Abstract / Summary
Abstract To maximize the impact of doxycycline post-exposure prophylaxis (doxyPEP) in controlling the bacterial STI epidemic, understanding of the barriers to delivering doxyPEP to the most vulnerable populations is essential. Guided by the COM-B (capability, opportunity, motivation, and behavior) framework, we interviewed 26 racial and ethnically diverse participants eligible for doxyPEP to identify barriers and facilitators to doxyPEP use. Participants reported facilitators such as: knowledge; positive clinical encounters; community normalization; and beliefs regarding efficacy, peer attitudes and motivations around doxyPEP. Barriers included confusion with HIV PrEP and a need for more knowledge; access to healthcare or negative experiences with healthcare; limited community awareness and concerns around disclosure. However, participants also described potential solutions, including specific knowledge needed, low barrier and non-judgmental healthcare, home STI testing, and increased community awareness and normalization.